After 50, a lot of us don’t sleep as well as we used to. In my work with people over 50, sleeping difficulties are one of the most common complaints I hear. As people get older, sleep changes (it’s not just your imagination). To understand this, you have to know a little bit about what happens when you go to sleep.

Sleeping is an active process. It isn’t that your brain just shuts down and then restarts itself in the morning. When you go to sleep, your brain activity changes. Sleep doctors talk about sleep stages. Stages are defined by what’s going on in your brain at any given moment, usually based on looking at brain waves recorded from the skin on your head. As your sleep changes, the brain waves change. You go through several sleep stages in cycles during the night, from a shallow kind of sleep to a much deeper kind of sleep.

As you get older, the light sleep stage gets even lighter. You may wake up more easily, and may have more trouble going back to sleep. You may not feel as well rested when you wake up, too.

Doctors talk about different types of insomnia. Initial insomnia is when you have trouble getting to sleep in the first place. People with initial insomnia may lay in bed worrying about things that happened during the day. Middle insomnia occurs when you get to sleep OK, but then wake up during the night. Final insomnia happens when you wake up early in the morning and can’t get back to sleep. There are a number of causes for any of these insomnias, but anxiety and depression are common causes of insomnia. There are a number of physical causes, too, so anyone with insomnia needs to have a regular check up.

Although most people think about using some kind of sleeping pill for insomnia, there are some major drawbacks to taking sleep medication. Some people may have daytime sleepiness, memory loss, and problems with balance. Having said that, there’s no doubt that medications can be really helpful.

Another treatment option is cognitive behavioral treatment for sleep problems. The core idea here is to use psychological techniques to treat the insomnia. Research studies have shown that this approach to treating insomnia works, and people may avoid some of the problems that come along with using medications for insomnia.

More next time about cognitive behavioral treatments for insomnia.

What is Generalized Anxiety Disorder, or “GAD?” Is it the same thing as worrying a lot?

If you worry a lot, other things may happen. You may be tense and you may not sleep too well. You may not be able to concentrate very well, and even may think that you have memory problems. You may have muscle tension and you may feel restless and be “jumpy.”

How does a doctor diagnose GAD? He or she would ask you about these symptoms. Many doctors use a list of symptoms from the DSM, or Diagnostic and Statistical Manual, of the American Psychiatric Association. (Click here if you’re interested in reading more about the DSM on Wikipedia.) If you have the right symptoms, and don’t have other reasons for having them (for example, an illness with your thyroid gland), then you may have GAD.

Do you want to take a short screening test about GAD? You can find one on the website of the Anxiety Disorders Association of America, ADAA. Click here to go to their GAD test.

Treatments for GAD include psychotherapy, medication, and lifestyle changes. More in our next post.