Health
Why Does My Sleep Become Worse as I Age?
Research has found that sleep quality does indeed get a little rusty as you grow older, but it’s not a fate you have to live with, experts say.
A lot of people complains that as they get older, they found it difficult to sleep and why is it so?
Dr. Abhinav Singh, medical director of the Indiana Sleep Center and a sleep professor at Marian University College of Osteopathic Medicine, likes to answer this question with an analogy. Think of your ability to sleep as though it were a car, he said. As it ages and clocks more miles, it begins to fall apart; it needs more repairs, and its ride becomes less smooth.
The same thing happens with your sleep, Dr. Singh said.
Researchers have found that sleep quality does indeed get a little rusty with age: Older adults are more likely to take longer to fall asleep, wake up more frequently throughout the night and spend more time napping during the day compared with younger adults. They also spend less time in deep, restorative sleep, which helps with bone and muscle growth and repair, strengthens the immune system and helps the brain reorganize and consolidate memories, Dr. Singh said. Your melatonin levels, which play an important role in sleep-wake cycles, also go awry with age, he said.
It is no surprise, then, that when researchers surveyed more than 9,000 people ages 65 and older in a landmark study published in 1995, they found that 57 percent of them reported at least one sleep complaint over three years. These included trouble falling or staying asleep, waking up too early, feeling unrested and napping during the day. In a different study, published in 2014, scientists found that a little more than half of the 6,050 older adults surveyed had either one or two insomnia symptoms over the past month.
Research suggests that women are more likely than men to report poorer sleep quality in general. And sleep begins to elude them earlier in life, usually starting around the menopausal transition (or the years leading up to menopause), which typically begins between 45 and 55, according to the National Institute on Aging.
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What exactly causes these changes?
The truth is that no one knows for sure. “We’re only just starting to understand why all of this happens,” said Luis de Lecea, a professor of psychiatry and behavioral sciences at Stanford University.
One explanation might have to do with an aging brain. In a study published in February, Dr. de Lecea and his team found that a particular cluster of neurons responsible for wakefulness became overly stimulated in aging mice, disrupting their sleep cycles. This shift “likely also happens to humans,” he said, because the part of the brain that regulates sleep in mice, called the hypothalamus, is similar to that of humans. (Many sleep studies are conducted in mice for practical and ethical reasons.) Researchers have also found that the suprachiasmatic nucleus, another brain region that regulates the body’s circadian rhythms, deteriorates in mice with age. This results in sleep disorders, including trouble falling asleep at regular times.
Certain lifestyle changes can lead to sleep disruption later in life, too, said Adam Spira, a professor and sleep researcher at the Johns Hopkins Bloomberg School of Public Health. As people retire, their days become less structured and routine. They may wake up later or nap during the day, which can make it harder to fall asleep at night, creating a vicious cycle.
Researchers have also found links between depression, loneliness, grief over the loss of a loved one and poor sleep in older adults. And in a 2014 study, Dr. Spira concluded that older adults who struggled with certain activities or household chores, like laundry, grocery shopping, meeting with friends or taking a walk, were more likely to report insomnia symptoms than older adults who were able to participate in those activities.
For women, hot flashes, night sweats and higher rates of depression, anxiety and stress — common symptoms of the menopausal transition — are also correlated with poor sleep. But researchers are still not exactly sure why those perimenopausal symptoms might be more severe and frequent in some women, and how best to address them.
Of course, certain medical conditions that are more prevalent in older adults can also wreak havoc on sleep, Dr. Singh said. Weight gain, for example, can increase the risk of developing a condition like sleep apnea, which can cause you to snore, gasp for air or feel like you’re choking while you’re sleeping. And medications, like diuretics for blood pressure, can also impair sleep because they can lead to more trips to the bathroom. They really can “act like darts into your sleep board,” Dr. Singh said.
Are sleepless nights a fate you have to live with?
The good news is that the same habits that improve sleep for people in general will work for older adults with changing sleep patterns, too, Dr. Spira said. Going to bed and waking up at the same time every day, avoiding naps and late-afternoon caffeine, following a healthy diet and exercising regularly are all things that will help your sleep, research suggests. In fact, one small study published in 2022 found that at least 40 minutes of either aerobic or resistance training four times a week helped older adults fall asleep faster and stay asleep for longer.
Keeping consistent mealtimes every day can also help maintain a routine, which, in turn, can help regulate sleep, Dr. Singh said — as can spending time outside in sunlight, which helps keep melatonin production and the body’s circadian rhythm in check. Older adults who are on medications should also check with their doctors about whether the drugs might be interfering with their sleep and if there might be alternative options or a different dosage, he added.
Tips for Better Sleep
Tired of tossing and turning? There are some strategies you could try to maximize your hours in bed.
Turn Your Bedroom Into a Sleep Sanctuary With Wirecutter’s Recommendations
- Good rest starts with a great mattress.
- Next, you’ll need a good pillow.
- White noise machines have the power to mask yapping dogs, clanky radiators and late-night parties. Consider buying one.

Health
Tips on Diagnosing Scabies skin diseases
Your GP should be able to diagnose scabies from the appearance of your skin, and by looking for the burrow marks of the Sarcoptes scabiei mite.
However, as scabies is spread very easily, it’s often possible to make a confident diagnosis if more than one family member has the same symptoms.
Your GP will also want to rule out other skin conditions that may be causing your symptoms, such as eczema or impetigo (a highly contagious bacterial skin infection). The burrows of scabies mites can be identified by using an ink test. Ink is rubbed around an area of itchy skin before being wiped off with an alcohol pad.
If scabies burrows are present, some of the ink will remain and will have tracked into the burrows, showing up as a dark line.
To confirm the diagnosis, a skin sample may be gently scraped from the affected area so it can be examined under a microscope for evidence of scabies mites, their eggs and faeces (poo).
Check up
Visit your GP if you think you have scabies. If you think you have genital scabies or your partner has been diagnosed with it, visit your nearest sexual health clinic, where you’ll be examined and, if necessary, treated.
If you decide to treat scabies yourself, you’ll need to have a full sexual health check to make sure you don’t have any sexually transmitted infections (STIs).
To prevent reinfection, it’s important that all members of your household are treated, as well as any sexual partners you’ve had over the last 6 weeks (in the case of genital scabies). If you’ve had genital scabies in the past, anyone you’ve had sex with in the previous 48 hours will need to be treated.
If you’re embarrassed about contacting previous sexual partners, your GP surgery or local sexual health clinic may be able to inform them that they’ve been exposed to scabies on your behalf without disclosing your identity.
Sexual health clinics
Some sexual health clinics operate on a walk-in basis. Others work by appointment only. It’s therefore a good idea to call first.
When you attend a clinic, you’ll be asked for your name, date of birth and contact details. These details will be treated confidentially and won’t be passed on to your GP without your agreement.
You’ll also be asked about your sexual history, including:
when you last had sex
whether you used condoms
whether you’ve had an STI in the past
whether you’re taking any medication
If you’re attending a clinic for scabies, you may also be offered tests for STIs.
Health
How To Find Affordable Health Care Without Insurance
How To Find Affordable Health Care Without Insurance: There are ways you can take control of your health without breaking the bank. Here’s what to know.
While having at least some medical insurance is recommended for everyone, it can be really expensive if your employer doesn’t pay for it. What’s more, navigating the health insurance marketplace may feel totally chaotic and soul-sucking. About 10% (PDF) of Americans didn’t have health insurance in 2020, and most that don’t are uninsured because they can’t afford it or don’t qualify for financial assistance in their state.
But everyone needs to go to the doctor sometimes. So what do you do?
First, you could qualify for Medicaid financial assistance depending on your circumstances and location, and you could also qualify for Medicare. Even if you’ve already checked in the past, it’s worth checking your state’s Medicaid eligibility since it was expanded in most states. You can also fill out this application to see which government assistance programs you’re eligible for. What’s more, there are plans that are alternatives to traditional health insurance.
If those plans aren’t a fit, you’re not out of options. Here are tricks to getting quality care when you’re paying out of pocket.
Take advantage of preventative care and free screenings
Some cities or pharmacies have pop-up events that run simple blood tests or health screenings. Keep your eye out for these events and take advantage, as they can help you keep tabs on your health and hopefully prevent more doctor’s visits or medical interventions down the line.
How To Find Affordable Health Care Without Insurance
In New York, for one example, the state health department says it offers free breast, colorectal and cervical cancer screening for uninsured people in the state. If you have a health issue that you’d like to check up on, searching “free screening/testing near me” wouldn’t be a bad way to start just in case there are any nearby opportunities.
Always tell your doctor and the front desk that you don’t have health insurance
Doctors’ jobs are to care for you, and that includes making sure you have access to the care that they recommend. Before we get into the details of where to go for health care and when, it’s a good idea to let whoever checks you in for your appointment know that you’re uninsured and will be paying out of pocket. That way, they can give you the available payment options, which may include a payment plan or a sliding payment scale if you qualify.
Use telemedicine for primary care/non-urgent doctor’s visits
Telemedicine isn’t going anywhere. And depending on which service you use, you could save money doing a doctor’s visit online, regardless of your insurance status.
If you don’t have health insurance, K Health is a good option for folks looking for general primary care. For $35, you can schedule an appointment with a doctor to discuss an issue or manage a preexisting condition. K Health also says you can start a monthly membership plan starting at $29 for unlimited primary care visits.
What sets K Health apart from other telemedicine services is its symptom-sourcing tool, which allows you to type in all of your symptoms and see some of the most common diagnoses of people with similar symptoms who got an official diagnosis.
Another good option if you don’t have health insurance is Sesame, which is a straightforward telehealth site for booking a cheap doctor’s appointment online (sometimes as low as $20). Their website is designed in a way that lets you shop around for a doctor, and you can also schedule an in-person appointment, though an in-person price might be higher.
Go to walk-in clinics, and shop around for ones with pay scales
If you have a health issue that requires hands-on healing from a provider that telemedicine just can’t provide, you should shop around for local walk-in clinics, community health centers or similar health care facilities. These facilities will probably be much cheaper than paying out-of-pocket at a hospital or private practice, but you should be prepared to pay a fee up front. One popular walk-in clinic for non-emergencies is the CVS MinuteClinic.
How To Find Affordable Health Care Without Insurance
Community health clinics often have a sliding payment scale available if you can’t afford the full cost, but you may have to bring proof of eligibility (like pay stubs). Fortunately, some community clinics have a “no patients turned away for lack of funds” policy, which is helpful if you can’t afford to pay any fee. You can search for a health center with sliding scales on this federal directory. Some public hospitals also offer sliding fees.
Some community centers are designed to serve certain specific populations like LGBTQ+ people, unhoused people or even musicians. It’s worth checking to see if any of these apply to you.
Look into direct primary care
Another health care model that’s gaining popularity is direct primary care, where you pay the health provider a monthly fee instead of the insurance company, which may allow you a deeper relationship with your doctor in addition to cheaper bills. This model should work well for many uninsured patients needing regular check-ups, but you might be on the hook for additional tests or referrals, if needed. Here’s a map to help you find a DPC facility near you.
Go to the emergency room if it’s a true emergency
If you’re injured or your life is in danger, call 911 or go directly to the ER. Regardless of your ability to pay or health insurance status, doctors are legally required to treat everyone who’s experiencing a medical emergency. Though medical bills can be daunting, your health is worth more than any dollar amount.
When you check in or out, you can tell the front desk you’re uninsured and they may help you work out a payment plan. You should also tell your doctor you’re uninsured in case it changes where they suggest a follow-up appointment or a follow-up care plan, should you need one.
If you’re experiencing a medical emergency and your life (or a body part) is at risk, go to the emergency room. Doctors will stabilize and treat you regardless of your ability to pay. If you’re experiencing a less urgent (but still pretty urgent) health issue, urgent care centers are usually significantly less expensive than ERs, and may treat things like sprains, non-life-threatening wounds and pains.
Negotiate when you get the medical bill
If you get the bill in the mail and are surprised to see what’s on it, call the hospital and ask for an itemized version, or go over every charge to make sure you were billed correctly. Then, if you still can’t pay it, see if they’ll lower it.
If they can’t lower it, ask to set up a payment plan. Tell them what you’re able and willing to pay, and someone in the billing department will most likely be able to work it out with you.
Do your research before the appointment so you don’t agree to unnecessary tests
Gone are the days of WebMD diagnoses. If you know how to look for it, there’s a lot of credible health information publicly available online. It’s important not to panic-diagnose yourself with cancer when you type in your headache symptoms. But we’ve come a long way in the year 2022, and some of the guidance and research that informs up-to-date diagnoses and treatments for common illnesses are just an internet search away, with outlines from reputable medical organizations.
How To Find Affordable Health Care Without Insurance
For example, if you need to go to the gynecologist, you can find information on different reproductive health topics from the American College of Obstetricians and Gynecologists, which is a large medical college that helps guide the standard of care for practicing OB-GYNs in the US. The American Academy of Pediatrics helps guide standards of care in the US for health care workers who treat children.
Large hospital systems, like the Cleveland Clinic and the Mayo Clinic, are also good online sources to reference before an appointment to see what the recommended treatment path might be for your health concern, so you’re not completely blindsided by a test (or you could see if another treatment option might be more affordable but equally effective). The US Preventive Services Task Force is another institution that you could reference for tests and preventative care. And the one we’ve all grown familiar with over the pandemic: the US Centers for Disease Control and Prevention is constantly updating its guidance on diseases and public health.
These are just a few sources that rely on current medical information. While you’re searching online, be sure to check the date on the page which shows when the article or page was last published. These colleges and institutes continually update guidance and health information to reflect new research on treating patients.
Health
Scabies: treating scabies skin disease
Treatment for scabies skin disease
Scabies treatment involves eliminating the infestation with medications. Several creams and lotions are available with a doctor’s prescription.
Your doctor will likely ask you to apply the medication to your whole body, from the neck down, and leave the medication on for at least eight to 10 hours. Some treatments require a second application, and treatments need to be repeated if new burrows and a rash appear.
Because scabies spreads so easily, your doctor will likely recommend treatment for all household members and other close contacts, even if they show no signs of scabies infestation.
Medications commonly prescribed for scabies include:
- Permethrin cream (Elimite). Permethrin is a topical cream that contains chemicals that kill scabies mites and their eggs. It is generally considered safe for adults, pregnant women, and children ages 2 months and older.
- Lindane lotion. This medication — also a chemical treatment — is recommended only for people who can’t tolerate other approved treatments or for whom other treatments didn’t work. This medication isn’t safe for children younger than age 10 years, women who are pregnant or nursing, or anyone who weighs less than 110 pounds (50 kilograms).
- Crotamiton (Eurax). This medication is available as a cream or a lotion. It’s applied once a day for two days. The safety of this medication hasn’t been established in children, adults 65 and older, or women who are pregnant or nursing. Frequent treatment failure has been reported with crotamiton.
- Ivermectin (Stromectol). Doctors may prescribe this oral medication for people with altered immune systems, for people who have crusted scabies, or for people who don’t respond to the prescription lotions and creams. Ivermectin isn’t recommended for women who are pregnant or nursing, or for children who weigh less than 33 pounds (15 kilograms).
Although these medications kill the mites promptly, you may find that the itching doesn’t stop entirely for several weeks.
Doctors may prescribe other topical medications, such as sulfur compounded in petrolatum, for people who don’t respond to or can’t use these medications.
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