As a 24/7 caregiver for her mother, my 52-year-old patient — I'll call her Becca — gets little rest. At night, lying on the couch next to her mother's hospital bed, she is jolted awake by her mom's frequent cries of pain and confused conversation with people who aren't there. During the day, she catnaps fitfully in the chair next to her mother's recliner as the TV blares. Becca jokes that the bags under her eyes have bags.
What's worse is that her health is being jeopardized by chronic sleep deprivation. She has gained weight, and her blood pressure and blood sugar levels are up. Fatigue makes her irritated with her mother and others. She operates in a constant brain fog, causing even minor household decisions to feel like monumental tasks.
Adequate sleep — generally seven to eight hours per night — has restorative powers. Too little sleep has been associated with increased appetite, higher rates of depression and anxiety, more frequent traffic accidents, memory problems and more. But a 2014 National Sleep Foundation survey found that 45 percent of Americans reported they had too little or poor sleep at least once in the previous week.
Many family caregivers, contending with their role's responsibilities and challenges, sleep even less than most — though it's so crucial to maintain your own health when you're caring for another. There are a few steps you can take to help yourself fall and stay asleep. Here are some ideas from our book AARP Meditations for Caregivers:
1. Create a nighttime environment for sleeping, not caregiving. Unless it is essential that you sleep in the same room as the person you're caring for, you should sleep in a separate room. Protect that room as a sanctuary. It should be cavelike — cool, dark and relatively quiet — to help elicit your natural sleep response. Keep it free from anxiety-provoking stimuli, such as insurance forms and medical reports. If you must listen for your loved one in another room, then use a baby monitor.
2. Worry intentionally during a specific "anxious hour." Many caregivers have difficulty falling or staying asleep because they have a head full of worries about their loved one's care. Rather than worrying at night when it's time for sleep, you can purposely worry at more convenient times during the day. Set an hour during the early evening to write down a to-do list as well as all the concerns that are troubling you. Then put the writing away in a drawer until the next morning. This simple action may have the effect of depositing your anxieties for the night, helping you relax and fall asleep.
3. Prompt sleep with good habits. Just as children need bedtime stories and lullabies, many adults need routines before sleep. Playing video games and watching TV can be too stimulating. Drinking alcohol may drop you into slumber but won't keep you asleep all night. Gentle stretching, reading or listening to relaxing music or guided imagery will help you attain a more restful frame of mind and promote more restorative sleep. Try to keep your sleep cycle regular by getting into bed at night and rising in the morning at the same times every day.
4. Use your breath. Yoga and meditation are based on the power of deep breathing. Sleep can be, as well. By taking deep, slow, regular breaths, you can slow your heart rate and begin to relax your muscles — all necessary physiological changes for falling asleep. It helps to keep your focus on your breathing by counting your breaths or feeling the air pass in and out of your nose and mouth. When your mind drifts back to your anxieties, just remember that staying awake and worrying doesn't make you a better caregiver or help you solve the next day's problems. It only makes you tired. Let sleep overtake you so you can face the coming challenges with your best energies.
Barry J. Jacobs, a clinical psychologist, family therapist and healthcare consultant, is the co-author of Love and Meaning After 50: The 10 Challenges to Great Relationships — and How to Overcome Them and AARP Meditations for Caregivers (Da Capo, 2016). Follow him on Twitter and Facebook.