As we grow older, we face a lot of difficulties and changes in our routine pattern. These changes include physical, cognitive and psychological changes. Similarly, our sleep pattern also changes with the passage of time as we grow older. Sleep disturbances are also caused in most of the population over the course of time. However, it becomes a commonly occurring phenomenon in most of the older adults. People in their teens or early adulthood are also likely to suffer from sleep disturbances, but older adults are more at risk. According to an estimate, almost one half of the elderly population has not less than one sleep disorder.
Different Types of Elderly sleep disorders
It is not necessary that sleep disorder of sleep disturbance in adults occur because they are not able to sleep. At times, people are not able to maintain the sleep cycle and keep waking up during night. There are a few types of sleep disorders which are among the most occurring elderly sleep disorders.
1. Insomnia
It is the most occurring sleep disorder among others. Complaints of insomnia occur in older women more than older men who are 65 years or older. Its symptoms include difficulty falling or staying asleep. People who are suffering from insomnia also have early awakenings or arousals in the middle of the night. It is considered a primary sleep disorder. However, it is also found to be occurring co-morbidly with other psychological conditions like depression, chronic pain or dementia.
It has been found out through researches that psychotherapy and more specifically cognitive behavior therapy (CBT) is the most effective one for treatment of insomnia. Physician and therapist prefer psychological treatment and psychotherapy for insomnia more than medications and physical treatment.
2. Obstructive Sleep Apnea
Sleep apnea is a sleep disorder characterized by difficulty breathing or complete blockage of respiration. Most of the people suffering from sleep apnea face shortness or complete cessation of breath. It is found mostly in older men than in older women, and older age is known to be the most important risk factor of sleep apnea.
Obesity, genetics, medications and alcohol consumption are some of the other risk factors of obstructive sleep apnea. Snoring and sleepiness during day are considered to be the most common symptoms of obstructive sleep apnea. It has also seen that dementia increases the incidence of sleep apnea as well as other cognitive problems are related to obstructive sleep apnea in older adults.
3. Rapid Eye Moment (REM) Sleep-Behavior Disorder
It is one of the most dangerous disorders because older adults may act out their dreams if they are suffering from this disorder. Rapid eye movement sleep behavior disorder is most commonly occurs in men and it is a manifestation of their aggressive of violent behavior. With the passage of time our normal skeletal muscles named atonia are degenerated and that’s why it is difficult for patient to control their movements during sleep and they might jump, yell or kick something during their sleep. REM sleep behavior disorder is important to diagnose and to cure because it might be one of the early signs of more complex neurodegenerative disorders.
4. Periodic Limb Movements in Sleep (PLMS) and Restless Leg Syndrome (RLS)
This is also a commonly occurring sleep disorders in older adults. In periodic limb movements in sleep, there are repetitive leg movements, jerking or kicking by the patient during his sleep. The duration between two continuous movements during PLMS is 20-40 seconds. This can go on for the whole night and each jerk will wake the patient up causing a restless sleep and sleep fragmentation. It can be found comorbidly occurring with dementia and obstructive sleep apnea. RLS is associated with an aching sensation in legs which can only be relieved by walking and these two disorders also cause awakening and disturbed sleep in older adults.
5. Circadian rhythm sleep disorders
Our body system is control by internal clock which works with the daylight and darkness of night. Our body produces melatonin at night which is important for our body to sleep at night and wake up during day. However, with the passage of time the internal clock of our body weakens and production of melatonin is also decreased which is why circadian rhythm is disturbed causing sleep problems in older adults. One of these sleep disorders include Advanced Sleep Phase Syndrome which is the most occurring one and the patient has involuntary sleep and awake times.
6. Dementia and Sleep Disturbance
The process of dementia, which is a neurodegenerative process, is responsible for disturbed sleep patterns in people suffering from dementia. However, there are other comorbidities which can be the cause of sleep disturbance in patients of dementia. These comorbidities include REM sleep-behavior disorder, RLS, PLMS or even depression.
Patients with dementia also have primary sleep disorders like obstructive sleep apnea, and they should be treated accordingly. Patients can be treated with drugs as well as psychological treatments including therapies and session for disturbed sleep patterns. If the problem persists, the need for institutionalization increases for the patients.
Read more: Sepsis Symptoms In Elderly People
7. Sleep Disturbances due to Medications or Substance Abuse
It is harder to identify the main cause of sleep disturbances because of a number of contributing factors. However, it is of high importance to identify the real cause and treat the problem to remove the problem from its roots. It is necessary to look at the medications a patient is taking and look out for the side effects because sleep disturbance can be one of the side effects of these medications. Moreover, substance abuse is also reported to be one of the sleep disorders like caffeine can be a stimulating factor for 8 to 14 hours straight for an older adult.
Causes
There are a number of causes for a disturbance in sleep pattern, a few of them are given below.
- Age
As we grow older, our brain structure also changes to some extent which can cause a problem in our sleep patterns. For example, neurodegenerative disorders can cause sleep disturbance in the elderly.
- REM sleep
It is important for a person to achieve rapid eye movement sleep in order to get a fulfilling and refreshing sleep. However, in most of the older adults, it is not possible for them to REM sleep which is the deepest phase sleep, and they remain in light sleep which cause awakening and sleep fragmentation.
- Melatonin
Production of melatonin is crucial in our sleep patterns, but melatonin production decreases with the passage of time. This is the main reason of circadian rhythm being disturbed and causing disturbed sleep pattern.
Treatment
Problems with sleep pattern and sleep disturbances cannot only be cured by pharmacological treatment as some of these are problem psychological. Hence, a combination of psychopharmacology is the best possible treatment for elderly sleep disorders. An older adult with sleep problem is in need of a psychiatrist as well as a psychologist.
Conclusion
It is of supreme importance to find out the underlying problem of a disturbed sleep pattern and then treat the problem instead of giving away sedatives. An older adult’s complete care is only possible if his sleep pattern is taken care of.
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