Aging and Sleep - download
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-Like changes in hair color and vision and other signs of aging,
the "graying of sleep usually develops gradually. Aging makes
sleep more fragile, even in healthy older people.
- Early in life most people fall asleep quickly and sleep soundly.
As they grow older, they may find settling down to sleep more
difficult; they may awaken more often and then take longer to
go back to sleep. The honk of a car horn or the bark of a dog
may be enough to disturb light sleepers. As people mature, they
may find they doze off more easily while watching TV or reading
-Persistent trouble falling asleep at night is not normal at any
age, nor is falling asleep frequently during the day.
-Normal age-related changes can mask sleep disorders that become
more common as people grow older. Medical or psychiatric illnesses-especially
those involving pain or depression-go hand-in-hand with sleep
disorders. It is often difficult for healthcare providers to tell
which problem comes first.
-It's untrue that people need less sleep as they grow older, but
it is fact that most people sleep less atone stretch than they
did when they were younger. As we age, our bodies become less
adept at sustaining sleep.
-Recent research suggests that our bodies are designed for at
least one afternoon nap per day.
-Studies show that some people over 60 awaken briefly an astonishing
150 times a night. And it is shown that more than half of all
people age65 and over experience disturbed sleep. In addition
most people over 65 wake up at least once a night for a trip to
-The overuse of prescription drugs and over-the counter medications
by elderly people to aid sleep is a serious concern. Studies show
that some commonly used drugs may not work as well in older people,
and may even make sleep problems worse. The effects of medications
should be discussed with a healthcare provider, as even a slight
change in timing or amount of medication may bring about an improvement
-Waking too early may represent a "rebound" from the
use of alcohol at bedtime or from certain types of sleeping medications.
-Difficulty falling asleep, sleep disruption and waking up too
early in the morning can be caused by depression. Also surveys
show that three quarters of newly widowed people report trouble
sleeping a month after the death of a spouse. One year later,
half report that their sleep problems continue.
-While some older people may focus on trouble with sleep, others
may have trouble with mood or performance during the day.
-Trouble falling asleep sometimes stems from simple, easily correctable
causes, such as use of caffeine, eating heavy meals, or exercising
too late in the day.
-In the quiet of the bedroom, some people find that their worries
overwhelm them. It can be helpful to set aside a time during the
day for "worry time," to allow for the consideration
of problems and the formulation of solutions.
-When People lead quiet or restricted lives, they may doze more
during the day than they suspect. People with insomnia are often
less active during the day than those who are better sleepers.
Specific sleep disorders
Sleep apnea: A disturbance of breathing, sleep apnea may cause
problems while sleeping or awake. Sleep apnea disrupts sleep to
varying degrees in an estimated one in four people over age 60.
Obstructive sleep apnea: A particular type of snoring-that is
caused by obstructive sleep apnea (OSA)-demands a visit to a healthcare
provider. Such snoring consists of loud snorts and gasping, followed
by pauses in breathing due to a narrowing or closure of the throat.
The breathing disturbance causes brief awakenings which disrupt
sleep, but are not usually remembered in the morning.
Central sleep apnea: People with central sleep apnea (CSA) may
or may not snore. When the central nervous system breathing processes
fail to work properly, sleepers may sigh frequently or appear
to breathe shallowly. In the morning, they may remember the frequent
awakenings and complain of light fragmented sleep.
Advanced sleep phase syndrome: The tendency to be "early
to bed and early to rise" increases as we grow older. Many
people adapt successfully, but some people find that their bodies
are ready for bed earlier than they desire, often well before
9 p.m. This is known as advanced sleep phase syndrome (ASPS).
Periodic limb movement disorder: Perhaps half of all people age
65 and over experience twitching in the legs, and sometimes in
the arms, during the night. This disorder, known as periodic limb
movement disorder (PLMD), usually doesn't completely awaken the
sleeper, but it does interfere with sound sleep.
Restless legs syndrome: People who have PLMD during sleep may
also experience restless legs when awake. This syndrome causes
a peculiar crawling sensation in the calves or thighs, and occurs
when the person is sitting or lying down.
REM sleep behavior disorder: Ordinarily the body is virtually
paralyzed during dreaming sleep. This normal paralysis does not
occur in people with REM sleep behavior disorder. People with
this behavior literally act out their dreams. Such behavior challenges
the traditional view of sleep as a time of rest.
Sleepwalking and other disturbances: Seventy percent of caregivers
who decide to institutionalize an older person refer to sleep
disturbances. Two thirds of people living in long-term care facilities
suffer sleep disturbances. In a nursing home or hospital, nighttime
problems usually continue or increase, promoting widespread use
of tranquilizing drugs.
When to see a healthcare provider
Poor sleep for a month or longer and sleepiness during the day
that interferes with normal activities may warrant a visit to
a healthcare provider. The patient may then be referred to a sleep
specialist. After an appointment is made at a sleep center, a
sleep log of the patient's sleeping and waking patterns may be
needed before the patient is seen at the center. The patient may
also be asked to spend a night undergoing sleep monitoring.
Can sleeping pills help?
As we grow older, our bodies break down drugs less efficiently
than when we were younger. Because drugs stay in the body longer
as we age, their effects may last longer, too. Drowsiness-which
is desirable at bedtime-is not welcome when driving a car the
next day. Ideally, a sleeping pill should help a person fall asleep
faster and wake up less often, with no "hangover" the
Warning: A complaint of insomnia sometimes signals disturbed breathing
during sleep. It may be a mistake to use sleeping pills, since
they tend to make interruptions in breathing occur more often
and last longer.
The Sleep Book: Understanding and Preventing Sleep Problems in
People Over 50, by
Ernest Hartmann, M.D. (American Association of Retired Persons,
No More Sleepless Nights, by Peter Hauri, Ph.D., and Shirley
Linde, Ph.D. (John Wiley & Sons, Inc., New York, 1990)
Sleep and Aging: A Research-based Guide to Sleep in Later Life,
by Kevin Morgan (Johns Hopkins University Press, Baltimore, 1987)
Sleep: Problems and Solutions, by Quentin Regestein, M.D. and
David Richie (Consumers Union, Mount Vernon, NY, 1990)