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Aging and Sleep - download this document in Microsoft Word format

-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 the newspaper.
-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 bathroom.

-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 in sleep.
-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 next day.
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.

Further Reading
The Sleep Book: Understanding and Preventing Sleep Problems in People Over 50, by
Ernest Hartmann, M.D. (American Association of Retired Persons, Washington, DC,
1987)

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)

 

 

 

 

 

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