WEBVTT
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Language: en

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- My name is Brienne Miner,
and I'm assistant professor

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at Yale University in the
section of geriatrics.

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I've also done training in sleep medicine.

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And today, I'm gonna talk
about sleep and aging

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and I'm gonna cover the different ways

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that sleep might change as we age,

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all of the different factors

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that might be causing sleep
problems as we get older,

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and when you should speak with your doctor

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about a sleep problem.

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Most people think that as you
get older you need less sleep.

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But if we look at how
much sleep is recommended,

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it really doesn't change
from middle to older age.

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So middle-aged adults,

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according to the National
Sleep Foundation,

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should be getting, the
real sort of sweet spot

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is seven to nine hours.

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And in adults 65 and older
it's seven to eight hours.

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So you know, we do
recognize that a little bit

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on either side, so five
hours or up to nine hours

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may be appropriate.

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But I think the interesting thing is that

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if you compare middle-aged
and older age adults,

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the recommendation for how much
sleep you should be getting

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is the same.

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As we get older, there are
probably multiple things going on

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at the same time that
might impact our sleep.

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So I like to think about
what medical conditions

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or medications a patient
of mine might be taking

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and how that might affect their sleep.

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Medical conditions could
certainly cause pain

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or other sleep disruptive symptoms.

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People can be on medications

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that could make them very
sleepy during the day.

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Those medications could
make it hard for them

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to sleep at night.

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Or interestingly, those
medications might cause

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or worsen an underlying sleep disorder.

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In terms of behavioral factors,

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we like to think about
having good sleep hygiene,

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having good behaviors around sleeping.

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And so those are basic
things like going to bed

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at the same time every night,

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getting up at the same time every morning,

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avoiding napping during the day,

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especially if you have
trouble sleeping at night,

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and a big one that I like to touch on

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is what substances might
contribute to sleep.

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So alcohol, especially as you get older,

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can cause more problems with sleep

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because your body is not as
good at metabolizing alcohol

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as you get older, and you
can't drink the same amount

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in your older age that you
could in your middle age.

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Caffeine, same story as
alcohol, and nicotine as well

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can make it hard to fall asleep,

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can make it hard to stay asleep.

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Other things like being socially isolated,

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I think we've all been
thinking a lot about that

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especially in the setting of COVID.

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So why does social isolation
cause problems with sleep?

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Well, you're less physically
active during the day

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and that can make it harder

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to have a normal sleep/wake schedule.

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And those social interactions
are actually also

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very important for giving cues to our body

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to help help us maintain a
normal sleep/wake rhythm.

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And then I would be remiss if
I didn't mention what we think

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about a lot in sleep medicine,
which is that almost all

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of the sleep disorders that are out there

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become more common as we age.

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So people in their older age could have

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multiple things going on at the same time.

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One of the major changes that's normal

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and is not necessarily a sign of disease

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is that many older people
prefer to go to bed earlier

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and wake up earlier.

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So as opposed to going to bed
at maybe say 10 or 11 o'clock,

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some people may have a
preference to go to bed at seven

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or 8:00 PM, and that's
because there's a a change

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in the timing of melatonin
release from our brain.

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So melatonin is sort of
setting that time for us.

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And in many older people,
our brain releases melatonin

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in an earlier time.

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So again, it's not necessarily a problem

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except that many people don't
like to go to bed at 7:00 PM

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or wake up at three or four
o'clock in the morning.

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So I would say, if your
preference is to go to bed

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at 8:00 PM, there's no problem with that.

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But you wouldn't want to,
or it would be normal then

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to wake up at three or four
o'clock in the morning.

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That's still a normal amount of sleep.

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So there's actually no problem with that

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unless it's a problem for your schedule.

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So some important takeaways
about sleep as we age,

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are first that the timing
of sleep may change.

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So older adults may find
that they have a preference

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to go to bed earlier and
therefore wake up earlier.

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The amount of interruptions
or arousals from sleep

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become more frequent as we get older.

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But as long as they're
brief and you're able

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to get back to sleep,
that's not a problem.

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And then finally, I
would say there could be

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a lot of things contributing
to sleep problems in older age,

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but I look at that as a glass
half full kind of person.

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When somebody comes to
me with a sleep problem,

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I think there are a lot of
things we could do to help sleep,

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whether it has to do with
medical conditions, medications,

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behaviors or treating an
underlying sleep disorder.

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So I think that's an important takeaway.

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If you do have a sleep problem,

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you should talk to your doctor,

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you should get an evaluation,
and there might be

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a lot of options for you
that don't necessarily mean

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having to take another medication.