AS you age, you may realize the time you could drift off to sleep and remain in a state of fitful slumber well past breakfast the next day is over - and now your sleep is likely to be lighter and more fitful, leaving you not always feeling refreshed when you wake up the next morning, says the February 2014 issue of the Harvard Medical School Harvard Women’s Health Watch.

A lack of good quality sleep does more than make you drowsy - chronic insomnia has been linked to a variety of health problems, including obesity, high blood pressure, heart disease, diabetes and depression.

Many conditions can disrupt your rest, and they can be treated - it could be a natural consequence of changing sleep-wake patterns after menopause.

Also, check your medicine cabinet - some medicines, including corticosteroids, beta blockers, cold and flu remedies, and certain antidepressants can interfere with sleep.

A list of possible sleep-stealers with a recommended solution for each one is offered to help you address these issues:

• Sleep apnea - While the conventional image of sleep apnea is of the overweight man who snores, women of any size can also develop these repeated pauses in breathing while they sleep - “A woman who has a narrow jaw or a change in muscle tone can get apnea,” says Dr. Julia Schlam Edelman, clinical instructor in obstetric and reproductive biology at Harvard Medical School and author of Successful Sleep Strategies in Women and Menopause Matters: Your Guide to a Long and Healthy Life. While snoring might not be your main symptom if you do have sleep apnea, you will notice that you’re especially sleepy during the day, says Dr. Edelman.

• Solution: See a specialist for a sleep study - a) You may be able to relieve apnea with a few lifestyle adjustments, such as sleeping on your side or losing weight; and b) Your doctor might suggest an old appliance or a CPAP machine that blows air into your airways to keep them open at night.

• Diet - What you eat can affect your sleep: 1) Spicy foods can contribute to painful heartburn; 2) Big meals leave you uncomfortably full, and over time can lead to obesity - a well-known risk factor for sleep apnea; 3) Too much caffeine could keep you wide awake, even if you finish your coffee in the morning (“It takes six hours to clear half of the caffeine from your body,” says Dr. Edelman); and 4) Although a glass of wine or two will make you feel relaxed or even sleepy, it won’t help you sleep. “You can fall asleep, but once you’re asleep you can’t sleep deeply,” adds Dr. Edelman.

• Solution: a) Eat dinner at least a couple of hours before bedtime; b) Keep the meal light; c) Avoid spicy, fatty foods, as well as alcohol and caffeine; and d) Limit your fluid intake before bedtime - to avoid constantly getting up to go to the bathroom, which can also disrupt your sleep.

• Lack of exercise - Sleep and exercise complement each other - working out regularly can help you sleep better and, conversely, you’re more likely to exercise if you get a good night’s rest.

• Solution: Exercise every day if you can, ideally in the morning - a high-energy aerobic routine too close to bedtime can have the opposite of the intended effect, making you too energized to sleep. A gentle yoga stretch before bed probably won’t hurt, though - it might even help you relax, says the health letter.

• Pain - 1) Arthritis aches or any other kinds of pain do not make for restful slumber; 2) Conversely, a lack of sleep can increase your pain - researchers believe that a lack of sleep may activate inflammatory pathways that exacerbate arthritis pain; and 3) Poor sleep can also make you more sensitive to the feeling of pain.

• Solution: a) Take the pain remedies as recommended by your doctor; b) Try using a heating pad or taking a warm bath before bed to soothe achy joints or muscles; and c) Lying against a pillow can put you in a more comfortable position while you sleep.

• Restless legs syndrome - Women are twice as likely as men to have restless legs syndrome (RLS) - a condition that causes a creepy, crawly feeling and uncontrollable movements in the legs at night. While it’s often linked to hormonal changes early in life and during pregnancy, RLS can continue as you get older. Aside from being just miserably uncomfortable, this condition has been linked to an increased risk for heart disease and depression in women, according to researchers at Harvard.

• Solution: Try simple interventions first, such as - a) Exercise every day; b) Take a hot bath before bed; c) Massage your legs; and d) Cut back on things that could make you jittery, like caffeine and tobacco. If these measures don’t work, e) Your doctor may recommend one of several medicines that reduce RLS symptoms - including ropinirole (Requip), pramipexole (Mirapex), rotigotine (Neupro), or gabapentin enacarbil (Horizant).

• Depression - 1) “Depression is a common compromiser of sleep, and it is much more common in women than in men,” says Dr. Edelman. While women who are depressed may sleep more than usual, their sleep isn’t restful. 2) Some of the antidepressants meant to counteract depression, particularly SSRIs, can also interfere with sleep.

• Solution: 1) See your primary care doctor, psychologist, psychiatrist or therapist for help - which may include medications, talk therapy or both; 2) If your antidepressant seems to be keeping you awake, ask your doctor to switch you to another drug.

• Stress - It’s impossible to sleep when the problems of the day are pressing on you - it’s not easy to find a sense of calm before bed, especially when you can’t unplug from the demands of your day, says the health letter.

• Solution: a) Establish wind-down time - do a quiet, relaxing activity before bed that doesn’t involve a screen (TV), including talking to a friend or family member, sewing or reading a real book (not a back-lit tablet device); and b) Don’t sleep with your smartphone on your bedside table.

• Poor sleep habits - Sometimes insomnia stems from long-ingrained behaviors, like staying up too late or engaging in stimulating activities before bed.

• Solution: Follow a few basic hygiene strategies: a) Go to bed and wake up at the same time each day; b) Keep your bedroom cool, dark and comfortable; c) Use your bedroom for sleep and sex only; d) If you can’t fall asleep within 15 minutes, get up and leave the bedroom - read or do another quiet activity for 15 to 20 minutes until you get sleepy; e) “If those strategies don’t work, I would recommend they talk to a sleep expert,” Dr. Edelman concludes.

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