Many of the people we talked to believed that they slept poorly because of their age, and therefore there was nothing that could be done about it. They also often had significant health problems, such as arthritis, diabetes or heart disease, for which they had to visit their GP on a regular basis and were prescribed a range of medications. Problems sleeping were therefore seen as less important, and because of this, they didn’t feel they should bother the doctor with disturbed sleep. Indeed, most people said that their sleep would need to be considerably worse for them to go to their doctor for help.
In most cases, people felt the trigger for them to go to the doctor about their sleep would be if they weren’t able to do all the things they needed to do during the day. Many people were very keen to keep busy and active during the day, not only doing household chores and gardening, but also maintaining an active social life. Their main concern was that if they slept very badly at night, or started needing to take naps during the day, that this would interfere with all their plans for the day, and on that basis they might go and see their doctor specifically for help with sleep. Several people who were retired, also commented that they might have considered going to the doctor about their sleep had they still been working, but now they were retired there was less pressure to get up at a certain time.
How bad will it have to be for you to go to the doctor and say I need help now?
Peter' I don’t know.
Is it more about the length of time or the disturbance?
Peter' I think it would be a case that I wasn’t coping in the day.
Peter' Coping with what I wanted to do in the day. Wasn’t able to drive or walk somewhere I needed to go. Wasn’t able to study. I started to read and I fell asleep too often.
Then that would be your trigger say for going to the doctor.
Peter' Yes. I think so. You know, if I am not doing what I want to do. I am not able to generally cope I think that would be the trigger. Not the sleep itself. I don’t see why a lot of elderly people complain about not sleeping at night. If they are getting enough sleep and able to cope I don’t see the problem. Your Dad used to complain didn’t he and I thought what is he doing, what's the bother? He can doze in the day, just doze in the day, why bother about sleeping at night?
Heather' It wasn’t stopping him doing anything he wants.
Age at interview:
Married, 2 children, retired Aircraft Engineer
And do you think it is something you might do in the future. Would you go to the doctor? How bad would your sleep have to be?
I think it would have to be really bad because as I have said before, I mean I do occasionally get the good night’s sleep as well and I can quite easily put up with the inconvenience if you like of the bad night, purely and simply because of the situation we are in now, where it doesn’t really matter, from the point of view of having to be anywhere or going to work. It probably does matter from your point of view, saying I should be getting proper sleep, but from my personal point of view it isn’t a great problem. It is a nuisance. Obviously. But obviously it would be a completely different situation if I was still having to go to work I would probably pursue it more then. If I were in a working situation.
There was also a perception that because poor sleep was largely related to getting older, that it was not necessarily an illness, and therefore many older people thought it was not something they should see their doctor about. In these circumstances, they tended to either ignore their disturbed sleep, or go to the chemist instead and find alternative remedies. Others would prefer not to go to the doctor for any reason, if they could help it.
Married, 2 children, Renal Social Worker (part-time)
Do you ever see a point when you sleep deteriorates that you might have to do something about it. I mean how bad would it have to be for you to go to the doctors and say I am really not sleeping well?
It would have to be quite bad. I don’t think I would go to the doctor about it. I don’t regard it as an illness or a problem. It is annoying not to sleep. Because one feels one ought to be sleeping because it is a waste of time really just lying there not sleeping, but no – well I would have to be quite bad. Well I mean, I think I do envisage a time, if I was bereaved, if I lost my husband. I would want sleeping tablets. I think I wouldn’t sleep. I know I wouldn’t sleep then.
Age at interview:
Married, two children, retired Managing Director, Care Facilities for Older People
Have you been to the doctor about it?
Why is that. Do you mind me asking?
For me to go to a doctor I have to be dying. I don’t believe in taking medication, tablets. I am very stubborn. I come from a long line of very healthy and lucky people. My parents, my granddad, my uncles, great uncles all lived [a long time]. My two great uncles never had a doctor.
Some people did speak to their doctor about their poor sleep, but usually when they were already attending for some other reason relating to their health, and would mention their problems sleeping to the doctor in passing. Very few visited the doctor purely to ask for help with their sleep either because they believed the doctor would prescribe them sleeping tablets, which they didn’t want to take, or that their doctor would refuse to prescribe them tablets, and it would therefore be a waste of time going.
Married, 5 children, part-time Test Centre Administrator
So you’ve never been to the doctor about your sleep?
Has it ever come up in the context of any other health issues?
I don’t think so. I certainly don’t remember. I mean I went into the surgery a couple of years ago and had this MOT business and I probably mentioned in passing that I didn’t sleep particularly well. But I don’t think anybody. Because it didn’t seem important to me I don’t think anybody’s ever flagged it up as important. So I’m sure I have certainly never been to a doctor and said ‘look I’m sleeping terribly badly’. Whether, I mean I haven’t been to a doctor desperately often anyway, but if I had and there’s probably been a couple of occasions and I can’t think from where perhaps I have had something else and I might have said well I’m not sleeping very well. But it’s never been an issue.
There were, however, a few people who did seek help from their doctor, either because of a particularly severe sleeping problem, such as sleep apnoea, or to help with difficult situations such as stress and bereavement. For these special circumstances their doctor usually prescribed sleeping tablets to be taken for a short period of time. Some people did take the sleeping tablets, but most chose not to because it made them too sleepy during the day (see 'Sleep medication, other medication and over the counter remedies'). Anne’s doctor suggested she changed the times she took some of her current medication and that seemed to help her sleep better.
Can you take me back to, you mentioned about this diagnosis of sleep apnoea, could you take me back to that and tell me how that came about, what sort of led up to you seeking help for it and how that happened?
A good question. Very difficult now in 2008 to remember. All I can think of was the snoring that I must have gone to my GP and the GP referred me to the unit in the local hospital, because they did this research into sleep apnoea, and therefore I was taken on board there and I spent two separate nights, they did one sleep study and then because of the results of that whatever they were, they said we want you to come back and do another one, which I did and that was difficult because I had a camera like this focused on me like that and I found it was hard to get to sleep. I was too aware of it, but whatever, they said I had sleep apnoea and gave me this sleep apnoea machine and as I say it was too much to cope with.
How long did you have it for?
Well I only coped with it for a few weeks really.
Did you have anybody sort of advise you mid-term what they do now, is they go back to you and say how are you getting on, they try and help you get through?
The thing that spoilt it if you like, was when that was diagnosed, because I was on their books as it were, by this time you see we had moved south, so that it split, it cut me off from them, because you know, once they’d made this diagnosis and I’d had this machine and I couldn’t cope with it, I suppose really it was my fault, I could have gone back and said look I’m not coping and can you help me. But I didn’t do that. So there is no responsibility on the hospital.
You know, for the fact that it just didn’t work for me.
People felt differently about going to the chemist for help with their sleep. Peter said he wouldn’t consider going to the chemist, because if he needed help with his sleep he believed the proper place to go would be his GP. Others thought the opposite, that they would rather go to the chemist and find an alternative to prescribed medication than bother their doctor with their problems sleeping. For people already taking a lot of prescribed medicines there was a concern that taking an over the counter medicine from a chemist may cause problems and react badly with their existing medication.
Have you thought about getting anything over the counter or seeing a pharmacist to say I’m having real difficulty sleeping can you recommend something, or bought anything at a chemist?
I wouldn’t because I’m on a certain level of medication, but I’ve been told once or twice by the GP that for instance there are certain painkillers I mustn’t take because I’m on Warfarin and also I’m on other tablets as well for my heart and that. And therefore I’ve been told I have to be very careful with that. So no, I’d have to go to my GP.
Age at interview:
Widowed, 2 children, retired Engineering Development Manager
I would always go to the doctor yes. And after that I would, for example I ran of Citaloprams and I could fax it through to the dispensary and then send a note to the pharmacy well I knew I would be without for a couple of days because it takes a couple of day, so I see him and he will give me the stuff on the promise that is coming through. And in the case of Citalopram it probably didn’t matter, but in the case of some other it might. But I am on a good basis with them, but I have to be very careful, it’s not on the basis of being a hypochondriac. Be cautiously aware when you are 77 years old, it’s all plus. I mean it is like the noises of an old car isn’t it. You have hardly any noises in a new car, but when you hear a new rattle coming in you wonder what the hell it is. And you can more often than not, perhaps, stop it then and there.