Why you have trouble falling asleep

Poor sleep can be a function of inferior quality (having your sleep stages out of sync for any number of reasons), or inadequate quantity (getting too little sleep, which cuts off sleep stages), or it can be a function of both, which is absolutely the worst-case scenario. No matter what the cause, however, you can get your sleep problems under control and it is vitally important that you do so. I find that the best way to encourage my patients to practice better sleep habits is to let them know exactly what conditions and choices have a negative impact on sleep.

Aging
It turns out that the definition of normal sleep goes out the window as we age. Much of the trouble has to do with shifting hormones at midlife – for men, too! – that affect the amount and type of rest you get. Chronic conditions that often come with age such as arthritis, sinus congestion, and acid reflux can also disrupt sleep. With age, there is a decrease in growth hormone and evening elevations of the stress hormone cortisol as well as an increase of the immune system messengers called inflammatory cytokines (especially interleukin­6) – all of which negatively affect sleep and reduce the amount of time spent in the more restorative stages 3 and 4 of non-rapid eye movement. This means that older people are predisposed to have problems not only with sleep quantity but sleep quality – with inevitable consequences for both their health and energy.

Some of the trouble with aging can be addressed with better stress management. By age forty, levels of the stress hormone, cortisol, tend to be elevated for most people, which scientists now believe may be a result of that hormone not reaching its low point at night. Managing stress during the day so that you are able to get to sleep earlier and sleep longer may promote beneficial declines in cortisol at night. In some cases sleeping more can be seen as an anti­aging potion – circulating testosterone levels in healthy men are known to decline with advancing age, but when men sleep longer they are able to make more testosterone. Which just goes to show sleeping is not for sissies!

One of my favorite observations from sleep medicine labs is that people of a certain age (65 and up) tend to believe that their sleep is worse than it actually is. Much of the trouble has to do with attitude. With meticulous psychological surveys, scientists have determined that whether a person views getting less sleep as insomnia or merely accepts it as a normal part of aging depends largely on his individual attitude about growing old. One of my longtime patients who cruised into her seventies with abundant energy once told me that she had learned to accept getting less sleep as "No big deal." I'm not suggesting you ignore a sleep problem, but I am encouraging you not to become one of those folks of an advanced age who sit around complaining about sleep – that's a sure energy-draining activity.

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Excerpted from The Source, copyright 2008 by Woodson Merrell. Used by permission of Random House Canada. All Rights Reserved. No part of this excerpt may be reproduced except with permission in writing from the publisher.