Few generations have treated their sleep with as much disregard as baby boomers, many of whom partied into the wee hours, rose before dawn to go running, and pushed themselves through marathon work days as they climbed the corporate ladder.
Now, as they move through their 50s and 60s into retirement and look forward to relaxing, boomers are finding a good night’s sleep is often hard to come by. Like previous generations, many are grappling with insomnia, snoring, and other disorders associated with aging, excess weight, and uncooperative sleep cycles.
“The body clock changes,” said Dr. Atul Malhotra, associate professor at Harvard Medical School and medical director for the sleep disorders program at Harvard-affiliated Brigham and Women’s Hospital in Boston. “It’s not just that people sleep poorly because they’re older. As we get older, we’re more at risk for conditions such as insomina or sleep apnea.”
Sleep problems of one sort or another bedevil about 70 million Americans, according to the National Center on Sleep Disorders Research at the National Institutes of Health. The consequences can vary from feeling drowsy at work to dozing off while driving, something that causes an estimated 1,500 deaths and tens of thousands of injuries per year.
Indeed, the Centers for Disease Control and Prevention has classified insufficient sleep as a public health epidemic, citing surveys that found 48 percent of adults snore and nearly 38 percent unintentionally fell asleep during the day at least once in a month.
Researchers have identified a link, what they call a “bidirectional relationship,” between sleep disorders and other medical conditions afflicting older people. “Individuals with sleep disorders are more likely to develop hypertension, depression, cardiovascular, and cerebrovascular disease,” said an article in the Journal of the American Geriatric Society. “Conversely, individuals with any of these diseases are at higher than normal risk of developing sleep problems.”
The article discusses, among other things, changes in sleep rhythms as people age, the impact of medications on sleep, and efforts to address less prevalent sleep disorders ranging from restless leg syndrome to sleepwalking. One positive sign cited by the sleep researchers is a growing awareness of sleep problems and a willingness to acknowledge their impact on health.
“We continue to see that people are more and more engaged in learning about their sleep,” said Dr. Doug Kirsch, clinical instructor at Harvard Medical School and regional medical director at Sleep Health Centers, a Brighton-based chain of private sleep labs and clinics across Massachusetts, Rhode Island, and Connecticut. “It used to be that people would come in and say, ‘I’m snoring and it’s become a problem for my wife.’ Now people understand that if they’re not breathing at night, it has an effect on their work performance and their health.”
Pauses in breathing are a symptom of obstructive sleep apnea, a common disorder that affects 2 to 4 percent of the adult population, according to the American Academy of Sleep Medicine, a professional association for those that treat sleep disorders. People suffering from sleep apnea, which is usually caused by a blocked air flow, may stop breathing more than 25 times an hour, resulting in day-time fatigue and impaired alertness.
This can be particularly dangerous for people who drive or operate heavy machinery for a living. “If you have sleep apnea, you might not want to be driving an 18-wheeler,” Kirsch said.
Sleep apnea, often accompanied by snoring, is typically diagnosed through sleep studies undertaken during overnight visits to sleep clinics, though some clincians have begun performing the studies in patients’ homes. Treatments include surgery to improve the nasal airway or remove excess tissue in the throat in the most severe cases, and continuous positive airway pressure, a mask tethered to a machine that helps keep airways open during sleep.
“If people can tolerate [the mask], it can be transformative,” Malhotra said, but he noted that only 60 to 70 percent of patients will use the appliance consistently.
The other most common sleep problem is insomnia, difficulty in falling asleep or staying asleep. A behavioral risk survey taken by the CDC in 2009 showed that 35.3 percent of adults reported getting less than seven hours of sleep during a typical 24-hour period. The causes vary widely and are sometimes hard to pinpoint, but doctors often prescribe medications, advise patients to stop drinking coffee in the afternoons and evenings, suggest reading rather than tossing around in bed, and counsel patients to stop worrying — or, at least, change the way they worry.
“You may want to make your worry list at 6 p.m., after dinner, so you’re not waking up at 3 in the morning thinking about how you’re going to pay your bills,” said Malhotra.
While aging boomers may face any number of sleep problems, some of which may overlap, doctors generally recommend keeping regular bedtime and rising hours, while avoiding alcohol, tobacco, and caffeine. Some also recommend relaxation techniques such as yoga or meditation. Those who can improve their sleep often find improved performances in the office — but also on the golf course and in other recreational pursuits, according to physicians.
“There is a growing awareness that sleep is an important aspect of everybody’s health,” said Kirsch. “When people can’t sleep, the level of frustration can be very high.”