January/February 2003
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Reviewed by Lynne Lamberg |
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Poor sleep is not inevitable as people grow older. Nor is it an isolated symptom. People who sleep poorly often complain of pain, and they worry a lot about their health. Many call their doctors or family members frequently to discuss their concerns, particularly in late life. Poor sleep also may herald a mood disorder, say Mark Miller and Charles Reynolds, both geriatric psychiatrists at the University of Pittsburgh School of Medicine. Difficulty sleeping, the authors say, should prompt doctors and family members to look for other possible symptoms of depression. Besides pain, these include weight loss, apathy, social withdrawal, and agitation. Once identified, depression often can be treated successfully, improving the quality of a person's days and nights. To thwart or help combat depression, Miller and Reynolds urge older people to keep a regular daily routine. Improving sleep habits may benefit both sleep and mood. The body's sleep-wake cycle, hormone secretion, mood, appetite, and other daily rhythms interact much like instruments in an orchestra. Going to bed and getting up at the same time each day helps keep other body clocks in sync. Regular exercise and mealtimes, along with regular commitments to volunteer and social activities, also help strengthen daily rhythms. Some people use caffeine to self-medicate the sluggishness of depression, often drinking many cups of coffee or tea every day. But caffeine may make the heart beat rapidly and worsen anxiety; it also may make people queasy, jittery, and sleepless. Most people get caffeine from multiple sources: coffee, tea, colas and other caffeinated drinks, chocolate, and some medications, such as non-prescription cold remedies. Those who wish to keep enjoying their favorite beverages can switch gradually from regular to decaf. Also avoid using alcohol and sedative drugs to relax and to aid falling asleep. Both drugs are downers and can make depression worse. If you consume alcohol at bedtime, it may disrupt your sleep when its effects wear off a few hours later. Miller and Reynolds explore different types of depression, emphasizing causes common in late life, including thyroid hormone abnormality, Vitamin B12 deficiency, chronic pain, stroke, Alzheimer Disease, and other medical problems. They explain how physicians evaluate depression, discuss treatment options including psychotherapy, medication, and electroconvulsive therapy, and tell where to find help and what to expect. They also survey alternative treatments, such as melatonin, valerian, and kava kava for insomnia, cautioning about lack of standards for efficacy and safety. The book wraps up with a discussion of new and promising research in late-life depression. It also provides resources for further information, including phone numbers and websites of medical organizations. Miller and Reynolds address concerns of physicians, patients, and families in a conversational manner, enabling each group to understand the others' thinking. They suggest ways to brooch sensitive topics, such as end-of-life issues, and give older readers strategies for taking charge of decision-making. Seniors and their adult children both will profit from reading and discussing this well-rounded compendium. |
© 2003
WebSciences and Lynne Lamberg |
LIVING
LONGER DEPRESSION FREE: