Sleep disorders represent one of the most annoying and potentially
debilitating symptoms
of Andropause. Long-term persistent lack of adequate sleep can disrupt
daytime activity, affect job performance and general lifestyle, and trigger multiple
health related physical and emotional problems in turn. Fortunately, most
common cases of sleep disorders are preventable and treatable through lifestyle
and diet changes, medications, and hormone replacement therapy as last resort.
Male and Female
Differences in terms of Sleep
Differences in sleep patterns between men and women are
found throughout the ages, and it is confirmed that men are more likely to
suffer from sleep disturbances such as snoring and sleep apnea amongst others,
than women are.
The traditional picture of the male sleeping anywhere or
falling asleep on the sofa may not be just a joke. Recent research has shown
that men may in fact sleep better alone. When men and women were tested for
cognitive ability and levels of stress after sleeping together, the men fared
worse than the women. The men appeared to be more disturbed when sharing a bed
than the women, while the women enjoyed a better night's sleep.
Another major difference between men and women is related to
the fact that men frequently fall asleep immediately after the intercourse,
while women may stay awake for long. That created many jokes and multiple
family conflicts, while women were accusing men in lack of feelings. However,
it was scientifically proven that there are many reasons for men to fall asleep
straight after sex, and that is nothing to do with attitude to the partners.
One supposition is that men have sex at night and the
combination of daytime exhaustion and muscular tension followed by deep
relaxation induces sleep. Another is that prior, and during ejaculation, men
hold their breath for a short period and readjustment causes changes in
breathing that create deep relaxation, encouraging sleep.
Whatever the reason, it appears that sex is a good prelude
to falling asleep for men and not the best time for conversation. Women may
feel more stimulated after sex and find it harder falling asleep. An awareness
of the affects of sex on both partners will help maintain harmony in the
bedroom.
According to researchers from the Penn State University lack
of sleep can be fatal for men. Surprisingly, women were not significantly
affected by lack of sleep. Researchers studied for more than a decade 2,000 men
and women, examining their sleep patterns in a sleep laboratory. They found out
that men who slept for only 5-6 hours a night had five times higher risk
of dying from medical complications. In comparison to those who slept
6 hours or more.
Sleep Stages and
Aging
Normal sleep has different stages that cycle throughout the
night. Sleep specialists classify these as rapid eye movement (REM) sleep and
non-REM sleep.
- REM sleep is the stage in which muscles relax most completely. Dreaming occurs during REM sleep.
- Non-REM sleep is subdivided into 4 stages. Stages 1 and 2 constitute light sleep; stages 3 and 4 are called deep sleep. Deeper sleep generally is more refreshing.
Sleep changes with age. Older people are less efficient sleepers
and have different patterns of sleep than younger people.
·
The duration of REM sleep decreases somewhat
with aging.
·
The duration of stage 1 sleep increases, as does
the number of shifts into stage 1 sleep. Stages 3 and 4 decrease markedly with
age in most people, especially men. In people aged 90 years or more, stages 3
and 4 may disappear completely.
Common Sleep
Disorders
Men at Andropause are experiencing significant sleep
disturbance patterns, making it hard to impossible to sleep properly through
the night. The most common sleep disorders include:
- Insomnia: Inability to fall asleep and/or waking up frequently on a regular basis.
- Sleep apnea: Cessation of breathing during sleep (often accompanied by snoring).
- Night sweats: Nocturnal hot flashes (sudden sensation of intense heat, perspiration, flushing) that disrupt sleep.
- Restless Leg Syndrome (RLS): Irresistible urge to move the legs during rest, often experienced as an itching or spasmodic sensation. This is a neurological condition that is rarer than the other symptoms.
- Narcolepsy: Daytime "sleep attacks".
- Other: Other sleep related problems include nightmares, night terrors, sleepwalking, sleep talking, head banging, wetting the bed and grinding your teeth. Such sleep problems are called parasomnias.
Sleep Apnea
The menopausal causes of sleep apnea and insomnia in men often vary significantly from the causes of
insomnia in women. The low testosterone associated with andropause largely
contributes to sleep apnea in men, leading to insomnia or sleeplessness. Sleep
apnea is the interruption of or difficulty breathing during sleep. It is
a sleep disturbance where a short period of oxygen deprivation to the brain
means numerous awakenings during the night. This means that sufferers may be
getting less REM sleep. REM (Rapid Eye Movement) sleep is the light sleep where
dreaming occurs. Sleep apnea affects approximately 9% of adult males and is more common in
obese males. The inhibited breathing and loud snoring common of sleep apnea
tends to disrupt sleep many times throughout the night.
Insomnia in men resulting from low
testosterone and sleep apnea can lead to several other problems
including fatigue, reduced insulin sensitivity, low human growth hormone levels
and high cortisol levels. Cortisol,
the stress hormone, will increase with prolonged insomnia because of the
stress on the body. Constant high levels of cortisol can create a hormone
pattern that further reduces testosterone production. It can also lead to
adrenal fatigue which often worsens the fatigue and insomnia.
Human growth hormone is naturally made during the first 90 minutes of
sleep. Therefore, if your sleep is disrupted, your growth hormone production is
reduced. This can lead to lower levels of testosterone
and reduced lean muscle mass. Sleep is also very important for proper insulin
sensitivity and glucose control. If sleep is disrupted, the body stops
utilizing insulin as effectively and the body begins to need more and more
insulin to control blood sugar. This leads to weight gain and a pre-diabetic
state that, if not well managed, can lead to diabetes. Research has also
discovered a connection between sleep apnea and erectile dysfunction.
Alcohol and smoking affect sleep and should be limited.
Caffeine, large meals and heavy exercise are best avoided before bedtime.
Anxiety and stress are part of life but by learning how to relax some of the
physical and emotional damage can be avoided. Lack of sleep may be inevitable
at certain times but by being sensitive to the body's need for sleep and
catching up on any sleep with daytime naps and extra sleep at weekends, sleep
can become a cooperative partner through life's challenges.
Obstructive
Sleep Apnea vs. Central Sleep Apnea
Obstructive
Sleep Apnea (OSA)
is caused by obstructed breathing, either due to too much tissue as seen in
obesity or decreased muscle tone which may be seen with low testosterone. This
inhibits the air flow in the mouth and nose which causes snoring and decreased
ability for adequate oxygenation during sleep. As a result, men often wake up
numerous times during the night and rarely achieve deep sleep.
Central Sleep Apnea (CSA) is a central nervous system
disorder in which the brain signal for breathing is delayed. CSA if often
caused by injury or disease affecting the brain stem. Most cases of sleep
apnea caused by low testosterone is obstructive sleep apnea.
Other Causes of Sleep
Disorders
While hormonal deficiency is a common source of sleep disturbance
during male menopause, there are other multiple causes, which may contribute,
trigger, or escalate the sleep related problems. Let’s review them briefly.
Medical disorders
·
Physical pain is one of the most common reasons
for poor sleep in aging people.
·
Heart failure often causes breathing problems
that can disturb sleep.
·
Rapid heartbeat and palpitations can interrupt
sleep.
·
Other breathing problems that can disturb sleep
include heart disease, certain neurological problems, and emphysema.
·
A frequent need to urinate and other urinary problems
may cause frequent awakenings.
·
Persons with Parkinson disease may
experience frequent urination, difficulty turning in bed, and difficulty
getting out of bed. These problems may impair sleep.
·
Gastroesophageal reflux disease (GERD) causes
discomfort that can interfere with sleep.
·
Constipation can cause discomfort that can
disturb sleep.
·
Allergies, sinus problems, nasal congestion, and
similar problems can disrupt sleep.
·
Itchy skin conditions often cause sleep
problems.
Mental disorders
·
Depression
disrupts sleep in all ages, and this condition is especially common in older
people. Many people with depression have trouble falling asleep at night or
wake in the night and are unable to go back to sleep.
·
Dementia, especially Alzheimer disease, increases
the length of stage 1 sleep and decreases stage 3, stage 4, and REM sleep.
Dementia is linked to more episodes of sleep disruption and awakening,
nocturnal wandering, and daytime napping.
·
Bipolar disorders, psychosis, and anxiety can
result in difficulty falling asleep and/or staying asleep.
Medications
·
Sedative antidepressants and sedative
antipsychotics can cause daytime drowsiness. Sleeping during the day
interferes with nighttime sleep.
·
Beta-blocker medications can cause
difficulty falling asleep, an increased number of awakenings, and vivid dreams.
·
Prolonged sleeping medication use may
cause daytime drug withdrawal effects or daytime drowsiness.
·
Theophylline and caffeine are stimulant drugs.
These drugs increase wakefulness and decrease total sleep
time. Caffeine's effect can last as long as 8-14 hours and may be
more pronounced in older patients. Over-the-counter pain relievers, cold
or allergy remedies, appetite suppressants, and tonics may contain
caffeine.
·
The stimulant nicotine affects sleep like
caffeine. Smokers have more sleep disturbances than nonsmokers. Smokers
also have difficulty falling asleep and decreased sleep duration. Even a nicotine
patch can disrupt sleep.
Lifestyle and social
factors
·
Many older people are less active, and their
bodies are not as ready for sleep at the end of the day.
·
Alcohol can disrupt sleep.
·
Daytime sleeping or lying on the bed to read or
watch television can interfere with nighttime sleep.
·
Sadness and bereavement can interfere with
sleep.
·
Everyday stress can make sleep more difficult.
Sources and Additional
Information:
