Causes of Sleep Disorders in Elderly

Causes of Sleep Disorders in Elderly

Sleep disorders and improper sleep hygiene in the elderly maybe related to several factors such as age, stressful events and age related diseases.

a. Age and Sleep

b. Sleep and Diseases

c. Primary Sleep Disorders

d. Psychological Factors

e. Improper Sleep Hygiene

a. Age and Sleep:

• With age, sleep tends to get shorter in duration. On an average there is less sleep, even in healthy non-complaining older adults, compared to the younger individuals.
• There is increased fragmentation of sleep in older people. They wake up more often and for longer periods of time during the night.
• Sleep becomes shallow with increasing age. As a person grows older, there is less delta (or slow wave) sleep, which usually occurs when sufficient growth hormone is produced. This is considered as the 'classic sleep hallmark' of ageing.
• Although men lose more slow wave then women, it is the latter who report more sleep disturbances.

In older people there are less delta waves or slow waves - this is the classic hallmark of growing old.

b. Sleep and Diseases:

Most age-related diseases have a 'vicious relationship' with sleep. One of the two states of sleep, NREM or REM sleep takes the brunt, or in some cases, one state may worsen the other.

For example, painful conditions, like arthritis or back pain, may keep the patient awake or can cause frequent arousals during the night and lead to problems with sleep. At other times an emotionally stressful event may keep the person awake and this in turn may play up the symptom of arthritis. Some diseases get aggravated by sleep, such as heart failure, when symptoms of breathlessness become worse. This is due to the improvement in return of blood to the heart when a patient is lying down which in turn leads to congestion in the lungs, that manifests as shortness of breath. Raising the head end may, in this situation, be helpful in overcoming the problem

A patient with heart disease may also have to wake up frequently in the night to pass urine due to the improved blood supply to the kidneys. This in turn may disturb one's sleep.

An enlarged prostate gland in the elderly can also lead to frequent night visits to the toilet to pass urine (called nocturia) and lead to disturbed sleep.

c. Primary Sleep Disorders:

Sleep disorders can make it hard to fall asleep or stay asleep during the night and this can result in excessive daytime sleepiness. The following are the most common sleep disorders among older adults:

• Insomnia
• Sleep-disordered breathing, such as snoring and Obstructive Sleep Apnea (OSA)
• Movement disorders, such as Restless Legs Syndrome(RLS)

"Laugh and the world laughs with you; snore and you sleep alone" -
......Anthony Burgess, English novelist

d. Improper Sleep Hygiene

Some old people also have habits that make it more difficult to get a good night's sleep.

• They may nap more frequently during the day
• They may not exercise as much as required. Spending less time outdoors can reduce their exposure to sunlight and upset their sleep cycle.
• Drinking more alcohol or caffeine, especially before bedtime can keep them from falling or staying asleep.

References:

1. General Advocacy Tips for Changing School Start Times - (http://www.sleepfoundation.org/hottopics/index.php?secid=12&id=225)