World Sleep Day takes place on 15 March, which means that it is time to wake up to the importance of getting enough sleep. Whoever we are, sleep is as essential to life and water and food. While we can withstand the odd restless night, getting too little sleep, or long-term poor quality sleep can make us feel tired, grumpy and out of sorts. Taken to extremes, lack of sleep can seriously impact our mental and physical health and can affect every single part of our life.
Most of us can function on around eight hours per night, but this can vary from person to person. Regularly getting less than six hours sleep per night can cause problems, including associations with obesity, heart disease and other medical conditions.
As we age, the circadian rhythms of our bodies (the patterns that time when and for how long we perform certain functions, such as sleep) can change. Care home managers must keep a close eye on the amount and quality of sleep that their residents are getting – and do everything that they can to support healthy sleep.
Why do our sleep patterns change as we get older?
Older people can feel more tired in the early evening and wake up earlier in the morning than they used to. Many people can also feel the need for increased afternoon naps. Night-time sleep can also be disturbed in older age, for example by a more frequent need to urinate in the middle of the night. Snoring, low moods and dementia can also have adverse effects.
Eating a heavy meal too late in the evening can also prevent us from dropping off, as can drinking too much alcohol, nicotine or caffeine. People new to a care home may also take some time getting used to sleeping in new and unfamiliar surroundings, so may need a little extra reassurance and support when they are first settling in.
How can diet help?
It is no coincidence that when you drink a soothing hot drink, such as warm milk, you often start to feel sleepier. The heat in the drink raises body temperature, which is thought to help prepare the body for falling asleep. Milk also contains melatonin, the hormone that helps control circadian rhythms and sleep.
The body’s production of melatonin tends to lessen as we age, which goes some way to explaining why older people can experience more problems regulating their sleep. Herbal teas known for their own soothing effects, such as chamomile, can also help. Sticking to regular, meal times with nutritious, well-balanced food can help too, as it tells the body when to expect food, and so help regulate its sleeping and eating cycles.
Providing the right conditions
Routine is a key part of achieving good quality sleep. Create and maintain calming bedtime routines for your residents so that they can relax and get ready for sleep at night. Keep noise levels low in the evenings and dim the lights where it is safe to do so. Have fixed times for going to bed and waking up. Maintain a comfortable temperature in bedrooms – neither too warm nor too cold. Use a thermometer to monitor this.
If residents are hungry at night, provide a small snack or calming drink, rather than a heavy meal or drink containing stimulants. If residents are worried about anything that is preventing them from falling asleep easily, put them in touch with a counsellor, or have a trusted staff member offer a listening ear to try and ease worries and calm them down for sleep.
Make sure people know how to rouse a member of staff at night if they feel ill or fall out of bed. Check the position of any mirrors or reflective surfaces in the bedroom. These could cause someone to worry that someone is in their room if they wake up feeling disorientated or alarmed.
Staff training
Make sure that your staff are properly trained for providing care at night. From understanding how to work with people with dementia or other demanding conditions to demonstrating how to carry out routine checks while people are asleep.
This can include such basic things as trying to be as quiet as possible so as not to disturb anyone who is asleep. Not ‘over-checking’, which disturbs people needlessly and could lead to alarm.
Reading up on what causes sleep problems and how to ‘wind down’ the care home from early evening onwards to create the best possible conditions for sleep.