Geriatric Sleep Disorders

Retiring for instance can be a quite traumatic event, one minute you are an important cog in society, and the next you are redundant.

This sort of thing can and does put stress on an older person.

Other problems that the older person might have to deal with are health issues, death of a spouse, as well as finances.

When we retire, it is assumed that we will need less money to stay alive. Nothing could be further from the truth.

As we grow older we need more help to do the everyday things that younger people take for granted and this costs money.

All of these stresses in addition to the normal aging process cause changes in our sleep patterns.

Unfortunately sleep disorders are responsible for an increased mortality rate in more ways than one.

As we get older we start to use more and more medications,(often this is because it is easier rather than because it is the best thing to do). Side effects such as falls, cognitive impairment and just the need to use the loo more often at night are a problem.

Treating insomnia in older people can improve the overall health of the patient, but extra care must be taken not to over-medicate when medications are used in this particular sector of the population.

Older patients with a sleep problem need a very careful and thorough evaluation. A comprehensive history of all drug use, reports from their partner where available.

The use of hypnotics should only be used with extreme caution and then only for transient sleep disturbances.

The most common primary sleep disorders in older people are sleep apnea, restless leg syndrome, or both.

Unfortunately the geriatric population is not on the whole receiving the primary health care that they deserve.

Currently they are the group that use the most hypnotic drugs.

33% of all hypnotic prescriptions are written for over 60's although they only comprise 14% of the population.

Patient education on sleep disorders is essential in helping the elderly to a healthier lifestyle.

A few things to try to maintain are:

1) Keep a regular wake-up time.

2) Keep a regular sleeping time.

3) Decrease or eliminate daytime naps.

4) Exercise every day but not immediately before bedtime.

5) Use the bed only for sleeping or sex.

6) Do not read or watch television in bed.

7) Avoid heavy meals at bedtime.

8) Limit or eliminate alcohol, caffeine, and nicotine before bedtime.

9) Maintain a routine period of preparation for bed.

10) Control the night time environment with comfortable temperature, quietness, and darkness.

11) Wear comfortable, loose-fitting clothes to bed.

12) If unable to sleep within 30 minutes, get out of bed and perform a soothing activity, such as listening to soft music or reading, but avoid exposure to bright light during these times.

13) Get adequate exposure to bright light during the day.

A sleep study (Polysomnograph) should be done when primary sleep disorders such as Sleep Apnea or periodic limb movement syndrome are suspected.

Yoga, meditation, acupuncture, and acupressure are a few good non-medicinal ways to manage sleep patterns.

If we can keep the above in mind the treatment of geriatric sleep disorders is not as difficult as it is sometimes assumed.

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