Dan Onion, MD, MPH

Mt. Vernon/Vienna Health Officer

293-2076  -- November, 2019

Many people experience “problems” sleeping at some point in their lives, more often the older they get and when travelling across several time zones. My wife and I have experienced both recently. I’ll review the issues and some do’s or don’t solutions.

First, aging gradually speeds the internal body clock. When experimenters house teens or adults in a room with a constant level of light 24/7, they tend to develop their own endogenous rhythm, waking and falling asleep at the same times every day after a week or so. Those between 25 and 45 years old tend to exactly match the 24-hour cycles of our earth’s spin around its axis. Teens and younger adults tend to settle into moderately longer, about 25-26 hours., wake/sleep cycles. Older people shorten their days to that of their endogenous (built-in) body clock cycles of less than 24 hours; and the older they are, the shorter those cycles are, down to 21-22 hours a day. So, by the time people reach retirement age, their natural cycle will tend to have them waking up earlier and earlier every day and going to bed earlier and earlier too. Teens are the opposite, going to bed later and waking up in the morning later and later. That’s why the recent big push makes sense, to allow teens to arrive at school later than their middle-aged and older teachers and superintendents tend to schedule classes. Each group’s tendencies are curbed by the sun and scheduled activities.

Travel across time zones can be heartening in one direction, and more stressful going in the opposite direction. So, an old guy, like me, is thrilled to find, when travelling east five time zones to England, he can stay up until after midnight easily, and sleep until 9 am local time instead of awakening at 5 or 6 am for a few days. Teens and young adults traveling west, find that their usual late to bed, late to rise, fits the normal pattern of their elders for the first few days after they arrive. For all, correction for time zone travel is more rapid if one gets some sun or any daytime outdoor exposure around noon local time for a few days.

So usually, the young have trouble falling asleep in the evening, and the older have trouble sleeping late in the morning. The safest and best solutions are to go with the flow. Avoid sedation with medications or alcohol. Antihistamines (like Benadryl, Sominex, Tylenol pm, and many others), can sedate (make you sleepy) somewhat, but are likely to cause confusion the older a person is, because of their effect on the brain. Typical benzodiazepine sleep medicines (Valium, Librium, Ativan and many others), likewise can cause confusion . in spades and are more likely, the older a person is, because their metabolism of such drugs is slower. Alcohol can make people sleepy, but it has an awakening effect several hours later. And the flickering light of a bedtime TV can mess up wake/sleep cycles. Daytime exercise, at least 4 hours before going to bed, can facilitate falling asleep more soundly. 

So, understand your body clock cycles’ tendencies and don’t fight them too hard. Regular bed and awakening times help; avoid shift work, if you possibly can.

Sleep well!  Happy Holidays! And get a flu shot soon; tis the season (see Mt V newsletter, Nov. 2018, p5 about why)!