Mind Matters -- December 2002
Written by Ron Sterling, M.D. and Published in Northwest Prime Time Magazine

Seriously Sleepless in Seattle

    Dear Dr. Ron:

      I never thought I would have a sleep problem. I expected that sleeping would become easier as I got older. I just turned 60. In the last six months, I have gone from sleeping a solid seven hours a night to sometimes less than five. It takes me longer to get too sleep and I often wake up three or more times. I worry more. I am more short-tempered. My wife has had some health problems. I had minor surgery for a hernia. That affected me, even though it wasn't a big deal. Any suggestions? Signed -- Seriously Sleepless in Seattle!

    Dear Seriously Sleepless:

      It may seem strange, but as we grow older sleeping becomes more of a challenge with frequent awakening and a biological cycle that pressures us to go to sleep earlier and wake up earlier. If you are trying to be a "night owl" and are pushing yourself to stay awake longer, it can produce significant problems with getting to sleep and staying asleep. The Internet has many great sites for getting information on healthy sleeping. Check www.SleepFoundation.org.

      The most important thing to keep in mind is that if your sleep problem is mostly one of waking up very early and not being able to return to sleep and you are either overeating or you have lost your appetite and are experiencing sadness or depression, you should consult a professional about depression. Depression is very treatable. The sleep problems associated with moderate to severe depression usually won't go away without treating the depression.

      Here are a few things to keep in mind about sleep hygiene and sleeping: (1) avoid naps as much as possible; (2) avoid alcohol, tobacco and caffeine in the evening -- alcohol may help you relax, but it wears off quickly and fragments sleep; (3) exercise; (4) wind down -- develop a relaxing routine such as reading in a chair, not in bed, before getting into bed.

      If you wish to try an over-the-counter sleeping medication such as Unisom or melatonin, use it for only a week or two at a time. Melatonin may be more useful than antihistamine-type sleep inducers because as we get older we may experience more "hangover" effects from antihistamines.

      Your Place of Relaxation

      Even when we are doing everything right, we can still experience trouble sleeping. Thoughts and worries can intrude. It seems that you have been worrying more than usual. Here is my most useful exercise for inducing sleep. And, no, it does not involve counting sheep.

      List a few relaxing or pleasant places that you have actually been to that you can visualize now. If you have photographs of the places, even better. Real places work better than fantasy places. It could be a place in a park or a spot near a waterfall. It could be a meadow you camped in. The more solitary and serene the situation was, the better it will be for blocking distracting thoughts.

      Pick the most relaxing scene. When you are in bed, use that scene. The goal is to keep your focus on the scene as if it were on a screen right in front of your eyes. If a distracting thought starts to creep into the picture, refocus on the scene. It helps even more to focus on details in the scene, such as light or wind in leaves or the movement of waves or river water.

      As researchers at Oxford University reported in the New Scientist this year, "Picturing an engaging scene takes up more brain space than picturing some dirty old sheep."

      You just gotta agree with that! -- Dr. Ron

        Author Bio:

        Ron Sterling, M.D. is a 64 year-old General and Geriatric Psychiatrist with a private practice in Seattle. He invites you to e-mail him at with any questions about mental wellness or emotional, relationship, or aging concerns. He is the only person who reads e-mail sent to Dr. Ron. Please be assured that your questions and identities are completely confidential and protected. For more information about Dr. Ron and for resources related to senior mental health, please go to SeniorMentalHealth.org. Read our Disclaimer.

        Thank You for Stopping By!

      Have a great day!

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