By Dr. Stacey E. Rosen and Dr. Jennifer H. Mieres

Sleep. Something that should come naturally to us all. Why do we need to sleep? During sleep, our bodies have the chance to repair and regenerate. Even the brain cleanses itself during sleep. Not getting enough sleep is truly risky behavior as the immune system doesn’t work as efficiently as it should when the body is sleep-deprived. But at least 75% of us are not getting enough sleep.

Many find that as they get older, sleep becomes elusive. Not only do they find it harder to fall asleep, they also find that sound, restful sleep becomes problematic along with a host of other sleep-related concerns. Among the sleep-related problems seen in older people are difficulty falling asleep, early morning awakening, less total sleep time, forgetfulness, and insomnia related to daytime napping. Many folks nap in the daytime because they aren’t sleeping enough at night, but if you sleep too much in the daytime, you will invariably find it hard to sleep at night.

Sleep deficits are linked to a variety of problems, including relationship problems, depression, and accidents of all kinds. For example, being drowsy at the wheel can reduce reaction times as much as driving drunk!

Added to all this, an increasing number of health risks are associated with poor sleep. Among them are: heart disease, diabetes, and obesity. Poor sleep leads to increased levels of inflammation, which may increase the risk of stroke and cardiovascular disease. Obesity is far more common in those who do not sleep enough, possibly because of increases in hunger and appetite. Finally, caffeine, alcohol, and certain medications can also interfere with restful sleep in different ways. Caffeine is a stimulant. While alcohol is initially sedating, it later prevents deep sleep and increases arousal. Some medications, such as bronchodilators, diuretics and corticosteroids, may also hinder sleep. 

What are some practical solution?

First of all, try to establish proper sleep habits. It is helpful to go to bed at the same time each night. And when should you go to sleep? Ideally, about an hour after you first start to feel tired in the evening (and that will probably be much earlier than you are used to – most of us go to sleep far too late!)

Try to establish a relaxing bedtime routine. This will get your body into the habit of recognizing when it’s time for bed. Try to avoid caffeine and alcohol in the evening. And keep your clock away from the bed.

Make sure you take time during the day to exercise and move.

Try to keep quiet. Limit loud music or loud conversation when winding down. 

We tend to sleep better when the room temperature is cool -- 65° F is recommended (don’t believe us? Think about how well you sleep in an air-conditioned room!) If you’re concerned about being too cool, don appropriate pajamas and use a warm comforter. 

Try to avoid using the bedroom for activities such as watching TV or exercising or even balancing your checkbook. And don't bring your computer with you to bed. The light will keep you up.

Finally, avoid lying in bed when sleep just won’t come – you only end up getting more and more frustrated, which will certainly not help you to drop off. Instead, get up and go into another room. Read a book until you begin to feel sleepy and then return to the bedroom.

Of course, if you think your medicines are affecting your sleep, discuss them with your healthcare provider and see whether changes can be made in your regimen. DO NOT STOP TAKING YOUR MEDICATIONS ON YOUR OWN!

If none of these tips help, discuss your sleep problems with your physician.

Wishing you pleasant dreams and a very good night!

Drs. Stacey E. Rosen and Jennifer H. Mieres are cardiologists with decades of experience caring for women with heart disease. They are now at Northwell Health's Katz Institute for Women's Health. Each of them is passionate about recognizing the distinct health needs of women, and empowering women with information and resources to optimize their health and well-being.