While older adults need about seven to eight hours of sleep each night, many often get less sleep, which may make them more susceptible to health problems. Underlying health issues are often the cause of these disturbances. Arthritis and pain can cause frequent awakenings and interfere with falling asleep. Cardiovascular, neurological, urological and psychological disturbances can likewise play havoc with our sleep. In fact, most all medical problems can disturb our sleep, and the older adults' sleep is most vulnerable.
Disruptive sleep-related disorders that can occur during arousals from rapid eye movement (REM) sleep or partial arousals from non–rapid eye movement (NREM) sleep. REM sleep usually involves a state of sleep paralysis (atonia), but people with this condition move the body or limbs while dreaming. Usually, RBD occurs in men aged 60 and older, but the disorder also can occur in women and in younger people. Not getting enough sleep increases the risk of having high blood pressure, heart disease, and other medical conditions. Insomnia—trouble sleeping at night—is more common in females, people with depression, and people older than 60.
Older Americans are convinced that a good night's sleep is necessary to maintaining their health. Last year (20 Mar 2007) a survey by the Gallup Poll found that seventy-two percent of seniors have discussed poor sleep with their doctors. National Institutes of Health (NIH) estimates that about 10% complain of chronic insomnia, meaning their troubles last for more than one month and occur at least three nights a week. It disturbances of sleep affect more than half of people aged 65 and older. The direct health costs include the medical costs attributable to sleep disorders in the development of other conditions such as cardiovascular disease and depression. There are several causes and effects:
Sleep disorder for drug and substance abuse:
People who stop breathing during sleep because of faulty brain control have central sleep apnea as opposed to obstructive apnea, which is triggered by obesity and other health problems and accompanied by loud snoring. Researcher from Lifetree Clinical Research and Pain Clinic in Salt Lake City, Utah ((Sep. 11, 2007)) found a direct dose-response relationship between central sleep apnea and methadone and benzodiazepines, an association which had not been previously reported." They found that sleep-disordered breathing was common when chronic pain patients took prescribed opioids, effective medications for chronic pain treatment.
Sleep problems can be a sign of alcohol misuse or abuse. Alcohol may help someone fall asleep, but it actually decreases the amount of restful sleep throughout the night. This in turn increases anxiety and irritability. People who abuse alcohol are also lighter sleepers who wake up early in the morning, which can result in feeling tired and sluggish during the day. People with insomnia should never use alcohol as a way to fall asleep.
Sometimes sleep-wake reversals are a side effect of drugs. Sleep-wake reversals are common among people who are hospitalized because they are often awakened during the night. The drugs most likely to be abused by older adults include anti-anxiety drugs, oral narcotics (e.g., codeine), and sleeping pills. However, abuse of illegal drugs (including marijuana, cocaine, hallucinogens, and intravenous narcotics) has also been reported among older adults.
Sleeping pattern:
A large-scale study suggested that those women with more disrupted sleep as characterized by shorter sleep duration and longer wake time during the night, and those with greater daytime sleepiness as characterized by napping behavior, were at greater risk for poorer neuromuscular performance and poorer daytime function. Women with objective measures of poor sleep had more trouble performing independent activities of daily living; they found.
Lifestyle:
Many of the health changes associated with aging, including the decline in sleep and cognitive abilities, can be attributed to sedentary lifestyles and social disengagement among older individuals.
In addition, recent studies associate lack of sleep with serious health problems such as an increased risk of obesity, cardiovascular disease and diabetes. Sleep deprivation also makes the effects of alcohol worse. A tired person who drinks will become much more impaired than someone who is well rested. Sleep apnea deprives people of oxygen, which can lead to morning headaches, loss of interest in sex, decline in mental functioning, high blood pressure, irregular heartbeats, and increased risk of heart attacks or stroke.
Disease conditions:
Periodic leg movement disorder (PLMD) is a condition that causes people to jerk and kick their legs every 20 to 40 seconds during sleep. As with restless legs syndrome, PLMD often disrupts sleep -- not only for the patient, but the bed partner as well. One study found that roughly 40 percent of older adults have at least a mild form of PLMD.
Restless legs syndrome, or RLS, is a hereditary disorder that causes unpleasant crawling, prickling, or tingling sensations in the legs and feet. The patient has an urge to move them for relief. RLS is becoming one of the most common sleep disorders among older people, adversely affects the lives of tens of millions of people worldwide.
A team of researchers, led by Emory University clinician scientists, has found (Jun. 13, 2007) evidence that periodic leg movements of sleep (PLMs) seen in most RLS patients are associated with increased release of adrenaline that are at significantly increased risk for developing hypertension.
Suppression of slow-wave sleep in healthy young adults significantly decreases their ability to regulate blood-sugar levels and increases the risk of type 2 diabetes, report researchers at the University of Chicago Medical Center. This study found that after only three nights of selective slow-wave sleep suppression, young healthy subjects became less sensitive to insulin.
Insomnia is the most common sleep problem in adults age 60 and older. People with insomnia have trouble falling and staying asleep. Insomnia can last for days, months or even years. If you’re having trouble sleeping, you may:
* take a long time to fall asleep,
* wake up many times in the night,
* wake up early and be unable to get back to sleep,
* wake up tired.
Nocturnal leg cramps are sudden, involuntary contractions of the calf muscles during the night or periods of rest. The cramping sensation may last from a few seconds to 10 minutes, but the pain from the cramps may linger for a longer period. Nocturnal leg camps tend to be found in middle-aged or older populations, but people of any age can have nocturnal leg cramps.
Sleep disturbances associated with Alzheimer’s disease include increased frequency and duration of awakenings, decrease in both dreaming and nondreaming stages of sleep, and daytime napping. Similar changes occur in the sleep of older people who do not have dementia, but these changes occur more frequently and tend to be more severe in people with Alzheimer’s disease. There is also evidence that sleep disturbances may be worse in more severely affected patients. However, a few studies have reported that sleep disruption may also occur in people with less severe impairment. Coexisting conditions may intensify sleep problems for older adults with Alzheimer’s. Two conditions in which involuntary movements interfere with sleep are periodic limb movement and restless leg syndrome.
In terms of insomnia, it is complicated by the fact that you can have a secondary or primary condition. There are lots of medical and psychiatric conditions that secondarily cause insomnia, depression being the most notable. Any kind of medical condition that involves pain or inflammation can have secondary effects on sleep. US National Sleep Foundation (NSF) poll found sleep problems were associated with specific medical conditions and were more likely to occur proportionate to the number of medical conditions reported (see box below). Sleep problems were also associated with frequent pain (77%); obesity (77%) and overweight (64%); and among those with ambulatory limitations (84%).
As you age, you're more likely to develop health problems that could cause your sleep patterns to change. Mayo clinic researchers listed some diseases that that may contribute to insomnia and sleep disorder. Examples include: arthritis, osteoporosis, heartburn, cancer, diabetes, high blood pressure, parkinson’s disease, alzheimer's disease, incontinence, gastro esophageal reflux disease (GERD), stroke, chronic obstructive pulmonary disease (COPD), asthma, heart disease, leg edema, enlarged prostate or incontinence.
A team of Canadian researchers has determined that there are significant relationships between laryngopharyngeal reflux (LPR), OSA, and upper airway sensory impairment. Laryngopharyngeal reflux, or LPR, is the backflow of stomach contents up the esophagus and into the upper airway, whereas GERD includes backflow only into the esophagus.
Hormone Levels:
The testosterone levels of healthy men decline as they get older. A study, conducted by University of Chicago, found (Apr. 3, 2007) that older men who obtain less actual sleep during the night have lower blood testosterone levels in the morning. As sleep quality and quantity typically decrease with age, objectively measured differences in the amount of sleep a healthy older man gets can affect his level of testosterone in the morning
A study (Dec. 3, 2007) finds that altered levels of both sex hormones and gonadotropins may contribute to sleep disturbance in older postmenopausal women and confirm the results of previous studies indicating that higher body temperature is associated with poorer sleep quality. According to the results, lower estradiol (E2) and higher luteinizing hormone (LH) levels were significantly correlated with indices of poor sleep quality, with relationships between LH and quality of sleep being stronger than those for E2.
Patients may also assume sleep problems are inevitable as they grow older and not mention them to their doctors. Some changes in sleep -- such as reduction in slow wave or deep sleep starting at about age 40 -- are natural as we age. But insomnia is not. One recent study showed that among older people with exceptionally good health, only about 1 percent had sleep difficulties. But treating the sleep disorders results in improved health and quality of life; according to Feinberg School of Medicine at Northwestern University (found at 2007).
Sleep requirements and patterns change throughout life, but sleep problems in the elderly are not a normal part of aging. Study at Saint Louis University found that "Sleep disturbance in the elderly is associated with decreased memory, impaired concentration and impaired ability to function. It contributes to an increased risk of accidents, falls and chronic fatigue."
In obstructive sleep apnea (OSA) or Sleep-disordered breathing (SDB), the sleeping person repeatedly stops breathing as a result of partial or complete blockage of the upper airways. This stoppage occurs long enough to decrease the amount of oxygen in the blood and brain, and to build up carbon dioxide. After a breathing pause of 10 seconds or longer, the person usually awakens enough to resume breathing. These episodes can occur numerous times during the night. According to American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine noted that detected early atherosclerosis by uncovering vascular abnormalities in 42- to 44-year-old predominately male patients who had severe obstructive sleep apnea but no overt cardiovascular disease.
People awakened during deep sleep do not adjust immediately and often feel groggy and disoriented for several minutes after they wake up. There are more than 70 different sleep disorders. Most of them can be managed successfully once they are diagnosed. The most common sleep disorders are insomnia, sleep apnea, restless legs syndrome, or RLS and narcolepsy.
A study ((Jun. 15, 2007), conducted by Rebecca Bernert of Florida State University, focused on data that were collected among 14,456 community elders over a 10-year period and suggested that, as a warning sign, poor sleep quality constitutes a significant and modifiable risk factor for completed suicide.
UCLA study suggested that unlike obstructive sleep apnea – in which a person stops breathing when their airway collapses -- central sleep apnea is triggered by something going awry in the brain's breathing center. Over time, the breathing lapses increased in severity, spreading into non-REM sleep.
Elderly people with severe sleep apnea have more than two times the risk of ischemic stroke than elderly people with no or mild apnea, according to research reported in Stroke: Journal of the American Heart Association. Prof. Ron Grunstein, Head of the Woolcock's Sleep Research Group, Sydney, Australia, said (23 Feb 2007),"There is a large body of evidence suggesting that a vicious cycle exists between sleep apnea (to have 'breathing pauses' while asleep and shallow breathing) and Metabolic Syndrome (a predictor of future diabetes and heart disease in people with obesity). It appears that sleep apnea worsens aspects of metabolic syndrome and metabolic syndrome may worsen sleep apnea.
Taking multiple medications, as many older people do, can also lead to fatigue and "hypersomnia," or being tired all the time, Bloom, a senior associate at the International Longevity Center-USA and associate clinical professor of geriatrics and medicine at the Mount Sinai School of Medicine in New York City added (November 23, 2007). Another big problem, he noted, is depression and anxiety. "Those are very commonly associated with sleep problems." Despite the prevalence of sleep difficulties in older adults, many patients aren't getting the help they need.
It is recommended that older adults get seven to eight hours of sleep each night for good health and optimum performance. Actigraphy is indicated to assist in the evaluation of patients with advanced sleep phase syndrome, delayed sleep phase syndrome, and shift work disorder. Appropriate temperature control, adequate ventilation, and dark sleep environment may also lead to dramatic improvement in sleep quality.
You may also be interested in . . .
- Tips for better sleep
- Morality lowered for sleep deprivation
- Obesity for sleep disorder
- Ramelteon sleeping pill
- Sleep disorder for viagra
- Daytime nap
- Daily recommended sleep for children
- Sleep for heart disease
- Sleep to sharp memory
- Older women hip fracture
- HYPOTHESIS OF AUTOIMMUNE DISEASE
- Influenza vaccine for older
- Diet and exercise for aged obese
- Exercise for older
- Diabetes at older age
- Nutrition for aged older
|
| 147 : vote(s) so far
| Cast your vote: