21September 2018

Let’s learn about sleep disorders in the elderly

Sleep disturbance in the elderly is a fairly common condition. There are many causes of this disorder. Understanding the cause will help your doctor come up with the right treatment.

Sleep disorders are quite common in the elderly. As you get older, your sleeping habits will change. As a result you can:

  • Difficulty sleeping
  • Sleep less
  • Waking up frequently during the night or early in the morning
  • Do not sleep very well

These can lead to problems like falls and fatigue during the day.

Many older people have difficulty staying asleep and have difficulty falling asleep. Behavioral therapy is preferable to medication, according to the majority of studies, because it does not cause side effects such as vomiting.

See your doctor if you or a loved one has trouble sleeping. Depending on the cause, you may need to make lifestyle changes or take medication.

1. What causes sleep disturbances in the elderly?

Rối loạn giấc ngủ nguyên phát

Primary sleep disturbance is not usually caused by a medical or mental illness. Primary sleep disorders include:

  • Insomnia, difficulty falling asleep or not being able to sleep
  • Sleep apnea
  • Restless leg syndrome. Legs move during sleep
  • Disorders of cyclical limb movement. The state of limbs is not moving unintentionally during sleep
  • Sleep disorder, also known as circadian rhythm disturbance – sleep
  • REM sleep behavior disorder

Note that insomnia is both a symptom and a disease. Diseases like depression, anxiety and dementia can increase the risk of sleep disorders, especially insomnia.

Related diseases

According to a study on sleep disturbance among the elderly in Singapore, people with sleep disorders often have pre-existing medical conditions and sedentary. These include:

  • Parkinson
  • Alzheimer
  • Chronic pain such as arthritis
  • Heart-related diseaes
  • Neuropathy
  • Gastrointestinal disease
  • Lung or respiratory disease
  • Urinary incontinence

Related drugs

Most older adults often take medications that can interfere with sleep, such as:

  • Diuretics treat hypertension and glaucoma
  • Anticholinergic for the treatment of chronic obstructive pulmonary disease
  • Medications to treat high blood pressure
  • Corticosteroids (prednisone) for the treatment of rheumatoid arthritis
  • Antidepressants
  • H2 blockers (Zantac, Tagamet) to treat gastroesophageal reflux or peptic ulcers
  • Leovodopa treats Parkinson’s disease
  • The drug acts on the Adrenergic system to treat asthma attacks or cardiac arrest.

Common substances

Caffeine, alcohol and tobacco can cause sleep problems.

2. Adjuvant therapies for the treatment of sleep disorders in the elderly

As for the elderly, you should use non-pharmacological treatments such as previous behavioral therapy. This is because older people often have taken a variety of medications before.

Behavioral therapy usually lasts about 6 weeks or longer, including disseminating sleep knowledge, controlling stimulation, and limited time in bed.

According to a randomized controlled clinical study, cognitive behavioral therapy significantly improves sleep quality in people with insomnia. According to this study, cognitive behavioral therapy is more effective than other therapies because it focuses on sleep quality rather than helping you fall asleep faster.

You can also build healthy sleep habits like:

  • Go to bed and wake up at around the same time each day
  • Only use the bed for sleeping, not for work
  • Do quiet activities, like reading before bed
  • Avoid leaving lights on before going to bed
  • Create a comfortable bedroom environment
  • Avoid napping

If you can’t sleep for 20 minutes, get up and do something before bed. Trying to force yourself to sleep will make it even harder for you to fall asleep.

According to one study, to manage sleep disorders in older adults, you can:

  • Limit drinking water or fluids before bed
  • Avoid caffeine and alcohol
  • Eat 3–4 hours before going to bed
  • Exercise regularly, but avoid it before bedtime
  • Take a warm bath to relax

If these methods don’t work, your doctor may prescribe you to take them.

Talk to your doctor before taking any medications. They can interact with medications you are taking.

In the elderly, persistent sleep disturbances can lead to greater concerns such as depression and the risk of falls. If sleep quality is the main issue, behavioral therapy may be more effective. This means building healthy sleep habits through sleep education, stimulation control, and limited time in bed. The changes can take more than 6 weeks to take effect.

If behavioral therapy isn’t working, your doctor may prescribe medications or other treatments. However, sleeping pills are not a long-term solution. You will find that the best way to get good sleep is to control your sleep habits.

(Source: extracted from “hellobacsi”)

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