How to Get a Better Night's Sleep in Midlife

Are Early Nights Really the Answer?

I believe that sleep is ‘top of the tree’ of health. 

If we feel rested we are more likely to have the energy to exercise and make healthier food choices. Research has shown that fatigued (along with stress) is more likely to makes us reach for high-fat and high-sugar snacks to ‘keep us going’.

My key top tip to improving sleep is routine. Establish a routine that works for you. Start by deciding what time you need to wake up every morning. Then decide how many hours sleep you need. Work backwards and you have your bedtime.

Now establish the mechanisms necessary for you to unwind and get into bed at the right time for you.

Below is another insightful article by Peta Bee, with new research on aspects that might benefit you.

Most of us are only too aware that a good night’s sleep is harder to achieve as we get older. What has been less clear, until now, are the reasons for this. According to the latest research, it is not just aches and pains or worry that are keeping us awake at night. There are physical changes in our brains from midlife onwards that mean that the brain cells that promote wakefulness may become overactive as we age.

As part of his research into why sleep becomes so elusive for those in their forties and above, Luis de Lecea, a professor of psychiatry and behavioural sciences at Stanford University in California, investigated a small cluster of neurons in the hypothalamus, the region of the brain located between the eyes and ears. These neurons produce hypocretins, key brain chemicals that transmit signals and play a vital role in maintaining alertness. But in older people, de Lecea discovered, levels of these hypocretins decline and degrade by as much as one fifth, while the remaining hypocretins become overactive, possibly resulting in fragmented sleep patterns. So far, he doesn’t know precisely why this happens, but it could be down to deterioration of “potassium channels” in the cells, the on-off switches that control the cells’ functions. “We just don’t know why the potassium channels are less forceful in aged neurons,” he says.

The downturn can be considerable. For his study published in Science journal, de Lecea found that ageing mice had lost approximately 38 per cent of hypocretins compared with younger mice. And the hypocretin neurons left in the brains of the older mice fired up more easily — or became “hyperexcitable” — making the animals more prone to waking throughout the night. But when these older mice were treated with a drug to counter the neuron overactivity he found their sleep quality improved and their sleep duration was less fragmented. And the same is likely to be true for humans.

It’s possible, according to de Lecea, that sleep medication will be developed to calm hypocretin neurons in this way so that some age-related sleep issues can be resolved. “An existing drug called retigabine which targets a similar pathway was approved in Europe as an anti-epileptic medication but withdrawn a couple of years ago because of side effects unrelated to their activity in the brain,” he says. “There are multiple pharmaceutical companies developing similar drugs without side effects.” But while such drugs hold promise, they are unlikely to be a cure-all. “The mechanism we describe in our research is just one of many possible causes of disrupted sleep in older people,” de Lecea says. He says that often the reason the elderly are prone to sleep disturbances is not down to ageing itself, but to age-related illnesses or the medications used to treat them.

“Back and joint pain, urinary problems, anxiety, snoring and breathing problems are all more common as we get older,” says the sleep scientist Dr Neil Stanley, the author of How to Sleep Well. “And they are also common causes of wakefulness and disrupted sleep.”

Despite feeling sleepier, older people often have more difficulty getting to sleep, with 80-year-olds typically taking an average of ten minutes more than 20-year-olds to drop off. But it’s a myth that we have less need for sleep, physiologically, as we age. “Researchers have shown that our need for sleep is pretty much set in stone from our twenties and that does not change,” Stanley says. “You need about the same amount of sleep at 80 that you needed at 25.” What does change over time are our sleep patterns and the ability to achieve the amount of sleep we need. “From about the age of 30-40 for men and 50 for women we start to lose the deep, restorative, slow-wave sleep, so we wake up feeling less refreshed,” Stanley says.

One of the worst habits that Stanley sees in older people is staying up later than they need to because they think it will help them “sleep through”. Along with our sleep patterns there are subtle changes to our circadian rhythms beyond middle age meaning we gradually begin to get tired earlier than we used to. “A rule when you are older is to go to sleep when you feel sleepy at night,” Stanley says. “If that means hitting the sack at 9pm, do it.”

De Lecea agrees that, while medications are promising and relevant to some, many of the sleep issues associated with age can be solved without resorting to drugs. “There are many possible causes of insomnia that occur with age and many of them are treatable,” he says. “Being aware of the problem and being proactive in seeking help are important steps in solving it.”

Here are the new rules of better sleep in midlife:

Don’t assume an early night is the answer

Researchers have shown that irregular sleep patterns play havoc with the body’s circadian rhythms and its production of melatonin, the sleep-inducing chemical, ultimately affecting sleep quality. In one study, people who changed their routine at weekends when they went to bed and got up later than during the week reported poor overall sleep.

“Routine is more important than anything else and our bodies crave it for good sleep,” Stanley says. “Whenever possible, try to go to bed and wake up at more or less the same time.” It follows that getting an early night because you have a big day ahead will probably backfire. “You will almost certainly lie there not sleeping because your body isn’t prepared for it,” Stanley says. “And the frustration adds to your inability to drop off. Your regular routine would serve you better.”

Lift Weights three times a week

We already know that resistance training builds your muscles and bones, but new research suggests it’s better than cardio exercise when it comes to improving sleep. Researchers at Iowa State University found that previously sedentary and overweight people who struggled to sleep responded well to regular resistance-training workouts. Lifting weights or performing bodyweight exercises — sit-ups, push-ups etc — resulted in them falling asleep faster, sleeping longer, and feeling more rested the next day compared with another group asked to do aerobic workouts or those who did not exercise at all.

The strength group used gym resistance machines to work all the key muscle groups in each session with a mix of leg press, chest press, leg curl, leg extension, biceps curl and shoulder-press exercises for 60 minutes three times a week. By the end of the year-long study, 42 per cent of poor sleepers (who were getting less than seven hours a night) increased their sleep by an average of 40 minutes.

Part of the reason strength training boosts sleep could be that it triggers muscles to release human growth hormones and testosterone, both of which are known to enhance sleep. “Resistance exercise significantly improved sleep duration and sleep efficiency, which are critical indicators of sleep quality,” says Angelique Brellenthin, an assistant professor of kinesiology and lead author of the study presented at the American Heart Association’s Epidemiology, Prevention, Lifestyle and Cardiometabolic Health Conference this month.

Try Spinning at least two hours before bedtime

The timing of workouts appears to be critical in determining whether you get a good night’s sleep, at least according to the results of a recent study published in the journal Sleep Medicine.

Emmanuel Frimpong, a research fellow at the Sleep, Cognition and Neuroimaging Lab at Concordia University, Montreal, and lead author, reviewed data from 15 published studies to see how a single workout in the hours before bedtime affects middle-aged healthy adults.

Overall Frimpong and colleagues found the best time to exercise if you want a good night’s sleep is early evening when even 30 to 60-minute high-intensity interval training (HIIT) sessions promoted sleep onset and improved sleep duration. HIIT-style indoor cycling was found to benefit participants most in terms of onset and deep sleep. Just don’t leave it too late.

“Overall, our analysis showed that when exercise ended two hours before bedtime, there were sleep benefits, including the promotion of sleep onset and increased sleep duration,” Frimpong says. “On the other hand, when exercise ended less than two hours before bedtime, it took longer for participants to fall asleep and sleep duration decreased.”

Meditate for a minimum of 5 minutes each day

Calming the mind through daily mindfulness meditation proved beneficial for a group of middle-aged adults with moderate sleep disturbance issues, in a study by researchers at the University of Southern California.

Participants in the six-week trial were split into two groups, one group attending a weekly two-hour sleep education class that taught them ways to improve their sleep habits and the other completing a weekly two-hour course in mindfulness that taught them meditation.

Results showed that the mindfulness meditation group had less insomnia, fatigue and depression at the end of the study compared with those who had the sleep-education sessions. Stanley says meditation in the hour or two before sleep can help your mind to unwind.

Use odour cues to help your drop off

Odour cues are scents and smells that resonate, sometimes at a subconscious level, to influence our behaviour. Emerging studies have shown that they can even affect how well we sleep.

Lavender is a known sleep aid. One study asked students with self-reported sleep problems to wear an inhalation patch on their chest at night containing either lavender essential oil or a patch with no scent. After two weeks, those inhaling the lavender each night found their sleep quality had improved and they woke feeling more refreshed.

Researchers at the University of British Columbia found that just being exposed to an absent partner’s scent on a T-shirt, pillowcase or scarf led to subjects experiencing better sleep quality, even when the partner was not physically present.

“Merely sleeping with a partner’s scent improves sleep efficiency, or how quickly we drop off and how soundly we sleep,” says Marlise Hofer, the study’s lead author. Her participants had an average sleep efficiency improvement of more than 2 per cent, which Hofer says is “an effect similar in size to what has been reported from taking oral melatonin supplements — often used as a sleep aid”.