For older adults (those over 65) the quest for a good night’s sleep can be particularly challenging. Sleep deficiencies may be linked to inadequate zeitgebers, the environmental cues which impact on the timing of sleep and waking. Sleep disturbance may also be due to life stressors, muscular pain, and the use of medications, or the sleep environment being too hot or cold, noisy or light. Community-dwelling healthy individuals have better sleep than healthy individuals living in nursing homes.
Although sedative-hypnotics may be effective in promoting sleep onset and sleep duration, these medications can impair balance and therefore increase the risk of falls, fall-related injuries and hip fractures in older adults. Natural light exposure has the benefit of synchronising the sleep-wake rhythm, since light suppresses the production of melatonin, a hormone that induces sleep.
Exercise and diet may positively influence and modify sleep, and are vital for sleep health and healthy ageing. Subjective reports of sleep suggest that moderate aerobic exercise is effective in promoting sleep in older adults. The effects of aerobic exercise training have also been investigated through objective sleep measures in older adults, using polysomnography (the gold standard measure of sleep quality and quantity). Supervised anabolic exercises (resistance or weight training), involving three sessions per week for 10 weeks, showed self-rated sleep improvements using the PSQI.
Along with exercise, eating the correct foods before bedtime is an easily adapted pre-sleep behaviour that can enhance sleep.

Some consideration of the foods selected for the evening meal may have a significant impact on the quality of sleep.
Ageing does not necessarily have to be associated with a decline into an unhealthy lifestyle with poor sleep.
Dr Chow is a lifestyle scientist for sleep, with a research focus on natural approaches (diet, exercise and thermal comfort-related factors) to sleep health. Poor sleep can cause daytime sleepiness, fatigue, and mood deterioration and has implications for poor health outcomes. Research has discovered that even those older adults who are healthy may display significantly disturbed sleep with longer sleep onset time, and frequent awakenings during the sleep period, with complaints of symptoms of insomnia. Visual and light stimulation, associated with television viewing or computer use prior to bedtime, may delay sleep onset and disrupt sleep. Exercise and diet are two approaches that can be harnessed and incorporated into daily living to improve sleep, without the side effects of hypnotic drugs. A well-validated questionnaire, the Pittsburgh Sleep Quality Index (PSQI), has been employed in many of the aerobic training studies.
This study demonstrated a significant reduction in light sleep (non-rapid eye movement (NREM) sleep stage 1), an increase in NREM sleep stage 2, and a decrease in the number of awakenings.
For example, older adults are at greater risk of falls, may suffer from arthritis, and may have pre-existing cardiovascular (hypertension) or metabolic conditions (diabetes).
It is well-known that caffeinated beverages can delay sleep onset and adversely affect the depth of sleep in susceptible individuals.

Research has shown that foods that increase the availability of tryptophan, or those that contain high levels of tryptophan, may be effective in promoting sleep. As seen, healthier sleep can be promoted in the over 65s through adequate natural light exposure during the day, regular moderate exercise and appropriate food choices, especially before going to bed. Individuals who are house bound or institutionalised, with diminished time cues for meals, activities or social cues may experience poor sleep. An increased stage 2 sleep may have some physiological significance, since its associated sleep spindle appearance may protect individuals from being woken, consistent with reduced wake time during the sleep period. Apart from sleep improvements, aerobic exercise training has the added advantage of increasing cardiovascular fitness, and anabolic exercise training increasing muscle mass and bone density and thereby buffering the risk of falls and fall-related injuries. Diminished light exposure and limited programmed physical activities may result in individuals sleeping at all times of the day and night, overall resulting in poor sleep.
Notably, sedentary adults need to undergo a conditioning period of gradually building up to a physical fitness level to prepare for moderate intensity exercise training.

Severe long term insomnia
First trimester fatigue

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