Sleep disorders in the elderly
Key points
- Sleep disorders in the elderly involve any disruptive pattern of sleep such as problems with falling or staying asleep, excessive sleep, or abnormal behaviors associated with sleep.
- In general, older people require less sleep, and their sleep is less deep than that experienced by the young.
- The relief of Chronic pain and control of underlying medical conditions such as frequent urination may improve sleep in some people.
- Most people see improvement in sleep with treatment or interventions.
Definition
Sleep disorders in the elderly involve any disruptive pattern of sleep such as problems with falling or staying asleep, excessive sleep, or abnormal behaviors associated with sleep.
Causes, incidence, and risk factors
Sleeping problems are common in the elderly. In general, older people require less sleep, and their sleep is less deep than that experienced by the young. Some causes of and contributors to sleep disturbances include the following:
- Sedentary lifestyle
- Depression among the elderly (Depression is a common cause of sleep problems among people of all ages.)
- Chronic pain caused by diseases such as arthritis
- Chronic diseases such as Congestive heart failure
- A need to urinate frequently at night
- Stimulants such as caffeine
- Prescription drugs, recreational drugs, or alcohol
- Neurological conditions o Alzheimer's disease o Organic brain syndrome
Symptoms
- Frequent night awakenings
- Difficulty falling asleep
- Early morning awakening
- Confusion differentiating between day and night
Signs and tests
- History of sleep disturbances and history of contributing factors
- Physical examination to rule out medical causes
Treatment
The relief of Chronic pain and control of underlying medical conditions such as frequent urination may improve sleep in some people. Effective treatment of Depression can also improve sleep.
Sleep-promoting interventions such as a quiet sleep environment and a glass of warm milk before bed may improve the symptoms. Other ways to promote sleep include the following:
- Have a specific bedtime and awakening time each day.
- Do not take naps during the day.
- Use the bed only for sleep or sexual activity.
- Exercise early in the day.
- Avoid large meals shortly before bedtime.
- Avoid stimulants such as caffeine.
If you can't fall asleep after 20 minutes, get out of bed and do a quiet activity such as reading or listening to music.
Written and revised by
Gerald Hurowitz, M.D.
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