Safe Effective Sleep Aids For Seniors
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Safe Efective Sleep Aids For Seniors
Choosing a safe, effective sleep aid can be difficult, especially as we get older. Take for example this research review, which practically says, when it comes to drugs, “Nope nope nope nope nope, definitely not, we don’t know, wow no, useful in one (1) circumstance only, definitely not, fine if you must”:
Review of Safety and Efficacy of Sleep Medicines in Older Adults
Let’s break it down…
What’s not so great
Tranquilizers aren’t very healthy ways to get to sleep, and are generally only well-used as a last resort. The most common of these are benzodiazepines, which is the general family of drugs with names usually ending in –azepam and –azolam.
Their downsides are many, but perhaps their biggest is their tendency to induce tolerance, dependence, and addiction.
Non-benzo hypnotics aren’t fabulous either. Z-drugs such as zolpidem tartrate (popularly known by the brand name Ambien, amongst others), comes with warnings that it shouldn’t be prescribed if you have sleep apnea (i.e., one of the most common causes of insomnia), and should be used only with caution in patients who have depression or are elderly, as it may cause protracted daytime sedation and/or ataxia.
See also: Benzodiazepine and z-drug withdrawal
(and here’s a user-friendly US-based resource for benzodiazepine addiction specifically)
Antihistamines are commonly sold as over-the-counter sleep aids, because they can cause drowsiness, but a) they often don’t b) they may reduce your immune response that you may actually need for something. They’re still a lot safer than tranquilizers, though.
What about cannabis products?
We wrote about some of the myths and realities of cannabis use yesterday, but it does have some medical uses beyond pain relief, and use as a sleep aid is one of them—but there’s another caveat.
How it works: CBD, and especially THC, reduces REM sleep, causing you to spend longer in deep sleep. Deep sleep is more restorative and restful. And, if part of your sleep problem was nightmares, they can only occur during REM sleep, so you’ll be skipping those, too. However, REM sleep is also necessary for good brain health, and missing too much of it will result in cognitive impairment.
Opting for a CBD product that doesn’t contain THC may improve sleep with less (in fact, no known) risk of long-term impairment.
See: Cannabis, Cannabinoids, and Sleep: a Review of the Literature
Melatonin: a powerful helper with a good safety profile
We did a main feature on this recently, so we won’t take up too much space here, but suffice it to say: melatonin is our body’s own natural sleep hormone, and our body is good at scrubbing it when we see white/blue light (so, look at such if you feel groggy upon awakening, and it should clear up quickly), so that and its very short elimination half-life again make it quite safe.
Unlike tranquilizers, we don’t develop a tolerance to it, let alone dependence or addiction, and unlike cannabis, it doesn’t produce long-term adverse effects (after all, our brains are supposed to have melatonin in them every night). You can read our previous main feature (including a link to get melatonin, if you want) here:
Melatonin: A Safe Natural Sleep Supplement
Herbal options: which really work?
Valerian? Probably not, but it seems safe to try. Data on this is very inconsistent, and many studies supporting it had poor methodology. Shinjyo et al. also hypothesized that the inconsistency may be due to the highly variable quality of the supplements, and lack of regulation, as they are provided “based on traditional use only”.
Chamomile? Given the fame of chamomile tea as a soothing, relaxing bedtime drink, there’s surprisingly little research out there for this specifically (as opposed to other medicinal features of chamomile, of which there are plenty).
But here’s one study that found it helped significantly:
The effects of chamomile extract on sleep quality among elderly people: A clinical trial
Unlike valerian, which is often sold as tablets, chamomile is most often sold as a herbal preparation for making chamomile tea, so the quality is probably quite consistent. You can also easily grow your own in most places!
Technological interventions
We may not have sci-fi style regeneration alcoves just yet, but white noise machines, or better yet, pink noise machines, help:
White Noise Is Good; Pink Noise Is Better
Note: the noise machine can be a literal physical device purchased to do that (most often sold as for babies, but babies aren’t the only ones who need to sleep!), but it can also just be your phone playing an appropriate audio file (there are apps available) or YouTube video.
We reviewed some sleep apps; you might like those too:
The Head-To-Head Of Google and Apple’s Top Apps For Getting Your Head Down
Enjoy, and rest well!
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Over-50s Physio: What My 5 Oldest Patients (Average Age 92) Do Right
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Oftentimes, people of particularly advanced years will be asked their secret to longevity, and sometimes the answers aren’t that helpful because they don’t actually know, and ascribe it to some random thing. Will Harlow, the over-50s specialist physio, talks about the top 5 science-based things that his 5 oldest patients do, that enhances the healthy longevity that they are enjoying:
The Top 5’s Top 5
Here’s what they’re doing right:
Daily physical activity: all five patients maintain a consistent habit of daily exercise, which includes activities like exercise classes, home workouts, playing golf, or taking daily walks. They prioritize movement even when it’s difficult, rarely skipping a day unless something serious happened. A major motivator was the fear of losing mobility, as they had seen spouses, friends, or family members stop exercising and never start again.
Stay curious: a shared trait among the patients was their curiosity and eagerness to learn. They enjoy meeting new people, exploring new experiences, and taking on new challenges. Two of them attended the University of the Third Age to learn new skills, while another started playing bridge as a new hobby. The remaining two have recently made new friends. They all maintain a playful attitude, a good sense of humor, and aren’t afraid to fail or laugh at themselves.
Prioritize sleep (but not too much): the patients each average seven hours of sleep per night, aligning with research suggesting that 7–9 hours of sleep is ideal for health. They maintain consistent sleep and wake-up times, which contributes to their well-being. While they allow themselves short naps when needed, they avoid long afternoon naps to avoid disrupting their sleep patterns.
Spend time in nature: spending time outdoors is a priority for all five individuals. Whether through walking, gardening, or simply sitting on a park bench, they make it a habit to connect with nature. This aligns with studies showing that time spent in natural environments, especially near water, significantly reduces stress. When water isn’t accessible, green spaces still provide a beneficial boost to mental health.
Stick to a routine: the patients all value simple daily routines, such as enjoying an evening cup of tea, taking a daily walk, or committing to small gardening tasks. These routines offer mental and physical grounding, providing stability even when life becomes difficult sometimes. They emphasized the importance of keeping routines simple and manageable to ensure they could stick to them regardless of life’s challenges.
For more on each of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Top 8 Habits Of The Top 1% Healthiest Over-50s ← another approach to the same question, this time with a larger sample size, and/but many younger (than 90s) respondents.
Take care!
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Best Salt for Neti Pots?
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❓ Q&A With 10almonds Subscribers!
Q: What kind of salt is best for neti pots?
A: Non-iodised salt is usually recommended, but really, any human-safe salt is fine. By this we mean for example:
- Sodium chloride (like most kitchen salts),
- Potassium chloride (as found in “reduced sodium” kitchen salts), or
- Magnesium sulfate (also known as epsom salts).
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Saunas: Health Benefits (& Caveats)
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The Heat Is On
In Tuesday’s newsletter, we asked you your (health-related) opinion on saunas, and got the above-depicted, below-described, set of responses:
- About 53% said it is “a healthful activity with many benefits”
- About 25% said it is “best avoided; I feel like I’m dying in there”
- About 12% said “it feels good and therefore can’t be all bad”
So what does the science say?
The heat of saunas carries a health risk: True or False?
False, generally speaking, for any practical purposes. Of course, anything in life comes with a health risk, but statistically speaking, your shower at home is a lot more dangerous than a sauna (risk of slipping with no help at hand).
It took a bit of effort to find a paper on the health risks of saunas, because all the papers on PubMed etc coming up for those keywords were initially papers with “reduces the risk of…”, i.e. ways in which the sauna is healthy.
However, we did find one:
❝Contraindications to sauna bathing include unstable angina pectoris, recent myocardial infarction, and severe aortic stenosis.
Sauna bathing is safe, however, for most people with coronary heart disease with stable angina pectoris or old myocardial infarction.
Very few acute myocardial infarctions and sudden deaths occur in saunas, but alcohol consumption during sauna bathing increases the risk of hypotension, arrhythmia, and sudden death, and should be avoided. ❞
~ Dr. Matti Hannuksela & Dr. Samer Ellahham
Source: Benefits and risks of sauna bathing
So, very safe for most people, safe even for most people with heart disease, but there are exceptions so check with your own doctor of course.
And drinking alcohol anywhere is bad for the health, but in a sauna it’s a truly terrible idea. As an aside, please don’t drink alcohol in the shower, either (risk of slipping with no help at hand, and this time, broken glass too).
On the topic of it being safe for most people’s hearts, see also:
Beneficial effects of sauna bathing for heart failure patients
As an additional note, those who have a particular sensitivity to the heat, may (again please check with your own doctor, as your case may vary) actually benefit from moderate sauna use, to reduce the cardiovascular strain that your body experiences during heatwaves (remember, you can get out of a sauna more easily than you can get out of a heatwave, so for many people it’s a lot easier to do moderation and improve thermoregulatory responses):
Sauna usage can bring many health benefits: True or False?
True! Again, at least for most people. As well as the above-discussed items, here’s one for mortality rates in healthy Finnish men:
Not only that, also…
❝The Finnish saunas have the most consistent and robust evidence regarding health benefits and they have been shown to decrease the risk of health outcomes such as hypertension, cardiovascular disease, thromboembolism, dementia, and respiratory conditions; may improve the severity of musculoskeletal disorders, COVID-19, headache and flu, while also improving mental well-being, sleep, and longevity.
Finnish saunas may also augment the beneficial effects of other protective lifestyle factors such as physical activity.
The beneficial effects of passive heat therapies may be linked to their anti-inflammatory, cytoprotective and anti-oxidant properties and synergistic effects on neuroendocrine, circulatory, cardiovascular and immune function.
Passive heat therapies, notably Finnish saunas, are emerging as potentially powerful and holistic strategies to promoting health and extending the healthspan in all populations. ❞
~ Dr. Jari Laukkanen & Dr. Setor Kunutsor
(the repeated clarification of “Finnish sauna” is not a matter of fervent nationalism, by the way, but rather a matter of disambiguating it from Swedish sauna, which has some differences, most notably a lack of steam)
That reminds us: in Scandinavia, it is usual to use a sauna naked, and in Finland in particular, it is a common social activity amongst friends, coworkers, etc. In the US, many people are not so comfortable with nudity, and indeed, many places that provide saunas, may require the wearing of swimwear. But…
Just one problem: if you’re wearing swimwear because you’ve just been swimming in a pool, you now have chlorinated water soaked into your swimwear, which in the sauna, will become steam + chlorine gas. That’s not so good for your health (and is one reason, beyond tradition and simple normalization, for why swimwear is usually not permitted in Finnish saunas).
Want to read more?
You might like our previous main feature,
Turning Up The Heat Against Diabetes & Alzheimer’s ← you guessed it, sauna may be beneficial against these too
Take care!
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The Plant Power Doctor
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A Prescription For GLOVES
This is Dr. Gemma Newman. She’s a GP (General Practitioner, British equivalent to what is called a family doctor in America), and she realized that she was treating a lot of patients while nobody was actually getting better.
So, she set out to help people actually get better… But how?
The biggest thing
The single biggest thing she recommends is a whole foods plant-based diet, as that’s a starting point for a lot of other things.
Click here for an assortment of short videos by her and other health professionals on this topic!
Specifically, she advocates to “love foods that love you back”, and make critical choices when deciding between ingredients.
Click here to see her recipes and tips (this writer is going to try out some of these!)
What’s this about GLOVES?
We recently reviewed her book “Get Well, Stay Well: The Six Healing Health Habits You Need To Know”, and now we’re going to talk about those six things in more words than we had room for previously.
They are six things that she says we should all try to get every day. It’s a lot simpler than a lot of checklists, and very worthwhile:
Gratitude
May seem like a wishy-washy one to start with, but there’s a lot of evidence for this making a big difference to health, largely on account of how it lowers stress and anxiety. See also:
How To Get Your Brain On A More Positive Track (Without Toxic Positivity)
Love
This is about social connections, mostly. We are evolved to be a social species, and while some of us want/need more or less social interaction than others, generally speaking we thrive best in a community, with all the social support that comes with that. See also:
How To Beat Loneliness & Isolation
Outside
This is about fresh air and it’s about moving and it’s about seeing some green plants (and if available, blue sky), marvelling at the wonder of nature and benefiting in many ways. See also:
Vegetables
We spoke earlier about the whole foods plant-based diet for which she advocates, so this is that. While reducing/skipping meat etc is absolutely a thing, the focus here is on diversity of vegetables; it is best to make a game of seeing how many different ones you can include in a week (not just the same three!). See also:
Three Critical Kitchen Prescriptions
Exercise
At least 150 minutes moderate exercise per week, and some kind of resistance work. It can be calisthenics or something; it doesn’t have to be lifting weights if that’s not your thing! See also:
Resistance Is Useful! (Especially As We Get Older)
Sleep
Quality and quantity. Yes, 7–9 hours, yes, regardless of age. Unless you’re a child or a bodybuilder, in which case make it nearer 12. But for most of us, 7–9. See also:
Why You Probably Need More Sleep
Want to know more?
As well as the book we mentioned earlier, you might also like:
The Plant Power Doctor – by Dr. Gemma Newman
While the other book we mentioned is available for pre-order for Americans (it’s already released for the rest of the world), this one is available to all right now, so that’s a bonus too.
If books aren’t your thing (or even if they are), you might like her award-winning podcast:
Take care!
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In the Realm of Hungry Ghosts – by Dr. Gabor Maté
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We’ve reviewed books by Dr. Maté before, and this one’s about addiction. We’ve reviewed books about addiction before too, so what makes this one different?
Wow, is this one so different. Most books about addiction are about “beating” it. Stop drinking, quit sugar, etc. And, that’s all well and good. It is definitely good to do those things. But this one’s about understanding it, deeply. Because, as Dr. Maté makes very clear, “there, but for the grace of epigenetics and environmental factors, go we”.
Indeed, most of us will have addictions; they’re (happily) just not too problematic for most of us, being either substances that are not too harmful (e.g. coffee), or behavioral addictions that aren’t terribly impacting our lives (e.g. Dr. Maté’s compulsion to keep buying more classical music, which he then tries to hide from his wife).
The book does also cover a lot of much more serious addictions, the kind that have ruined lives, and the kind that definitely didn’t need to, if people had been given the right kind of help—instead of, all too often, they got the opposite.
Perhaps the greatest value of this book is that; understanding what creates addiction in the first place, what maintains it, and what help people actually need.
Bottom line: if you’d like more insight into the human aspect of addiction without getting remotely wishy-washy, this book is probably the best one out there.
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Galveston Diet Cookbook for Beginners – by Martha McGrew
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We recently reviewed “The Galveston Diet”, and here’s a cookbook (by a nutritionist) to support that.
For the most part, it’s essentially keto-leaning, with an emphasis on protein and fats, but without quite the carb-cut that keto tends to have. It’s also quite plant-centric, but it’s not by default vegan or even vegetarian; you will find meat and fish in here. As you might expect from an anti-inflammatory cookbook, it’s light on the dairy too, though fermented dairy products such as yogurt do feature as well.
The recipes are quite simple and easy to follow, with suggestions of alternative ingredients along the way, making for extra variety as well as convenience.
If you are going to buy this book, you might want to take a look at the buying options, to ensure you get a full-color version, as recent reprints have photos in black and white, whereas older runs have color throughout.
Bottom line: if you’d like to cook the Galveston Diet way, this is as good a way to start as any.
Click here to check out the Galveston Diet Cookbook for Beginners, and get cooking!
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