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Aging News & Information
Senior Citizens Toss and Turn with Many Sleep
Problems that Come with Aging
Many older people may not be getting enough sleep
for healthy aging
 Aug. 14, 2007 As people age they seem to
encounter a new challenge almost weekly, but one of the most common, and
troublesome, is an unfavorable change in sleep patterns. Experts say
senior citizens need seven to eight hours of sleep each night for health
aging, but it is difficult for many who face a number of sleep problems
not the least of which is the ability to fall asleep.
Many older adults often have more trouble falling
asleep than persons in other age groups. A study of adults over the age
of 65 found that 13 percent of men and 36 percent of women take more
than 30 minutes to fall asleep.
As we get older, our sleep is more easily
disturbed, says James P. Krainson, MD, of the South Florida Sleep
Diagnostic Center in Miami and a spokesperson for the American Academy
of Sleep Medicine (AASM).
Underlying health issues are often the cause of
these disturbances. Arthritis and pain can cause frequent awakenings and
interfere with falling asleep. Cardiovascular, neurologic, urologic and
psychologic 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.
Possible explanations for changes in older adults
sleep patterns:
> Older adults may produce and secrete less
melatonin, the hormone that promotes sleep.
> They may also be more sensitive to changes in
their environment, such as noise, and this may cause them to awaken.
> Further, older adults may also have other
medical and psychiatric problems that can affect their sleep, says Dr.
Krainson, adding that researchers have noted that people without major
medical or psychiatric illnesses report better sleep.
Several studies that outline the negative
consequences of bad sleep among older adults were presented at SLEEP
2007, the 21st Annual Meeting of the Associated Professional Sleep
Societies, this past June:
● Cognitive behavioral therapy successfully
improves both immediate and long-term self-reported sleep and pain in
older osteoarthritis patients. This demonstrates that improving sleep
can be analgesic in older osteoarthritis patients, and that techniques
to improve sleep should be considered for addition to treatment programs
for pain management in osteoarthritis and possibly other pain-states.
● Regular aerobic exercise, combined with sleep
hygiene education, improves sleep and quality of life in older adults
with chronic insomnia.
● Untreated sleep complaints may pose a risk for
falls.
● Older adults who reported engaging in shorter
and less frequent naps during the day also reported spending more time
asleep at night. Such older individuals also experienced more sleep time
and slept more efficiently at night.
● A sleep-related breathing disorder may be
associated with impairments in cognitive function in older men.
● Objectively determined estimates of short sleep
were strongly related to obesity in older men and women.
Dr. Krainson notes that several studies published
in recent issues of the journal SLEEP have some interesting findings
about older persons and sleep:
● The effects of insomnia are different in older
and younger people. While associations between insomnia and separated,
divorced or widowed marital status were strongest in younger age groups,
longer bouts with insomnia were more common in the older population, who
are also more likely to be taking types of sedatives that have
particular problems with addiction and side effects.
● 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 brief behavioral treatment for insomnia
appears to be a promising intervention for older adults who suffer from
insomnia.
According to Dr. Krainson, some of the more common
sleep disorders in older adults include:
● Insomnia affects almost half of adults 60 and
older.
● Obstructive sleep apnea (OSA) can elevate the
risk for high blood pressure, stroke, heart disease, and cognitive
problems. Snoring, a symptom of OSA, is a very common condition
affecting nearly 40 percent of adults, and is more common among older
people.
● Restless legs syndrome, where one experiences
uncomfortable feelings in the legs, affects more than 20 percent of
people 80 years and older.
● Periodic limb movement disorder, a condition
that causes people to jerk and kick their legs every 20-40 seconds
during sleep, is evident in almost 40 percent of older adults.
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Sleep Apnea in Elderly Associated with Stroke
Aug. 14, 2007 - A new study published in the journal Stroke by
a team of Spanish researchers finds that elderly people with severe
sleep apnea have more than twice the risk of having a stroke compared to
elderly people with mild or no sleep apnea.
The researchers point out that a number of studies show an increased
risk of stroke among people with sleep apnea but that elderly persons
have been generally excluded from these studies. Questioning whether
sleep apnea represents an independent risk factor in this population,
the research team examined 394 subjects with a median age of 77 years
and found that the risk for stroke did increase more than two-fold, even
after adjusting for confounding factors such as smoking, alcohol
consumption, blood pressure and hypertension.
Sleep apnea is more common in elderly people compared to middle-aged
or young people.
Symptoms include excessive daytime sleepiness and snoring, although
these symptoms are sometimes less prevalent in elderly people with sleep
apnea.
When asked about daytime sleepiness in the 2003 Sleep in America
poll, 15% of 55-84 year olds reported having daytime sleepiness so
severe that is interferes with their daily activities at least a few
times a week. Sleep apnea is a serious but treatable condition.
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Not sleeping well can lead to a number of problems.
Older adults who have poor nighttime sleep are more likely to have a
depressed mood, attention and memory problems, excessive daytime
sleepiness, more nighttime falls and use more over-the-counter or
prescription sleep aids.
In addition, recent studies associate lack of
sleep with serious health problems such as an increased risk of obesity,
cardiovascular disease and diabetes.
Despite obstacles many older adults have to
overcome in order to get a good nights sleep, Dr. Krainson says that it
does not mean they are doomed to chronic sleep deprivation.
While most
people require seven to eight hours of sleep a night to perform
optimally the next day, older adults might find this harder to obtain,
says Dr. Krainson, adding that they must be more aware of their sleep
and maintain good sleep hygiene by following these tips:
● Establishing a routine sleep schedule
● Avoiding utilizing bed for activities other
than sleep or intimacy.
● Avoiding substances that disturb your sleep,
like alcohol or caffeine.
● Not napping during the day. If you must snooze,
limit the time to less than one hour and no later than 3 p.m.
● Stick to rituals that help you relax each night
before bed. This can include such things as a warm bath, a light snack
or a few minutes of reading.
● Dont take your worries to bed. Bedtime is a
time to relax, not to hash out the stresses of the day.
● If you cant fall asleep, leave your bedroom
and engage in a quiet activity. Return to bed only when you are tired.
● Keep your bedroom dark, quiet and a little
cool.
Dr. Krainson says that, although sleep patterns
change as people age, disturbed sleep and waking up tired every day are
not part of normal aging. Those who have trouble sleeping are advised to
see a sleep specialist at a facility accredited by the AASM.
Be prepared to tell the doctor how you spend your
day and night, including your medicines, fluid intake and activities so
that they will have all the information needed to decide how best to
help you, says Krainson.
Editors Notes:
The American Academy of Sleep Medicine says it is
the leader in setting standards and promoting excellence in sleep
medicine health care, education and research. The American Academy of
Sleep Medicine says it serves its members and advances the field of
sleep health care by:
Setting the clinical standards for the field of sleep medicine
● Advocating for recognition, diagnosis and
treatment of sleep disorders
● Educating professionals dedicated to providing optimal sleep health
care
● Fostering the development and application of scientific knowledge
Membership is open to physicians, researchers,
technologists, nurses, students and other allied health professionals,
as well as, sleep disorders centers and laboratories that have earned
accreditation from the AASM.
AASM is a professional membership organization
dedicated to the advancement of sleep medicine and sleep-related
research.
American Academy of Sleep Medicine.
For a listing of AASM-accredited facilities in your
area, visit
www.SleepCenters.org.
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