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Aging News for Senior Citizens
Sleep Problems are Not a Normal Part of Aging and
May Not Require Medicine
Doctors should try changing patient's routines
before medications
July 24, 2006 - Help may be available for the more
than 50 percent of older adults who have difficulty sleeping and have
come to accept their problem as part of growing older, according to
Saint Louis University geriatricians.
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"Sleep requirements and patterns change throughout
life, but sleep problems in the elderly are not a normal part of aging,"
says Julie Gammack, M.D., assistant professor of geriatrics at Saint
Louis University, and an author of a review published in the American
Journal of Medicine.
"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."
It's important to address sleep problems, which can
make life miserable and frequently can be solved, Dr. Gammack says.
She suggests patients with sleep problems keep a
diary for a week or two that includes tracking usual wake-up and
bedtimes, timing and size of meals, amount of exercise, medications and
descriptions of how much and how restful sleep was each day.
"The first step in evaluating sleep problems in the
elderly is to establish that the person truly has insomnia," Dr. Gammack
says.
She suggests doctors try treating sleep problems by
changing the routines of patients before prescribing medications.
Lifestyle changes also can be beneficial even if sleep medicines are
given.
"A daytime walk with correctly timed daylight
exposure is useful for insomnia," she says. "Appropriate temperature
control, adequate ventilation, and dark sleep environment may also lead
to dramatic improvement in sleep quality."
Among the other lifestyle medications she suggests:
● Increase exposure to bright light and natural
light during the day and early evening.
● Avoid napping after 2 p.m. and allow yourself
at most one half-hour nap a day.
● Check the effect of the medications you are
taking on sleep.
● Wait until you're sleepy to go to bed.
● Avoid heavy meals before bedtime. If you're
hungry, eat a light snack.
● Limit liquids in the evening.
● Keep a regular schedule.
● Rest and retire at the same time each day.
● Eat and exercise regularly.
● Manage stress by discussing worries long
before bedtime and tapping into relaxation techniques.
While many senior adults experience unpleasant side
effects when they take traditional medications for insomnia, a new group
of medicines that work on a different mechanism are promising, she adds.
"There are several newer sleep medications on the
market that potentially could better assist with sleep and have fewer
side effects," Dr. Gammack says.
"Given the prevalence of insomnia in the elderly
population and the availability of effective treatment, it is important
to screen older individuals for the presence of sleep disorders.
Patients must be educated on normal sleep-related changes but also made
aware that sleep problems are not a part of normal aging. Sleep
impairment may have a negative impact on health and health-related
quality of life."
Notes:
Established in 1836, Saint Louis University School
of Medicine has the distinction of awarding the first M.D. degree west
of the Mississippi River. Saint Louis University School of Medicine is a
pioneer in geriatric medicine, organ transplantation, chronic disease
prevention, cardiovascular disease, neurosciences and vaccine research,
among others. The School of Medicine trains physicians and biomedical
scientists, conducts medical research, and provides health services on a
local, national and international level.
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