Schlafprobleme im Alter

Insomnia in the Elderly

There are two categories of insomnia in the elderly. First off, there is sleep onset insomnia and secondly, sleep maintenance insomnia.

Sleep onset insomnia is when you have difficulties falling asleep. Sleep maintenance insomnia on the other hand is when you can’t stay asleep for a longer period of time.

In addition, the duration of insomnia in the elderly can also be split into 3 categories: transient insomnia, acute insomnia and chronic insomnia.

Transient insomnia can last anywhere from a few days to a week. Acute insomnia on the other hand may last a few weeks, and chronic insomnia can even last years if left untreated.

Suffering from this sleep disorder can have a significant impact on your health, safety and quality of life.

Symptoms of Insomnia in the Elderly

During the day, symptoms include excessive sleepiness, depression, accidents due to sleep deprivation, irritability, impaired memory, and difficulty concentrating.

During the night, symptoms include trouble staying asleep, taking over 30 minutes to fall asleep, waking up too early, and the inability to fall sleep again.

Insomnia Test

If any of the above seems familiar to you, we highly recommend you look into it.

Generally speaking, the elderly should find themselves having problems with staying awake and not the other way around.

There is also the option to do an insomnia test online. However, it is by no means a substitute for your general practitioner.

You can take the test here if you are interested!

Here is the link to the insomnia test!

Sleep cycle changes in elderly

A normal sleep cycle has some stages during each sleep period. You can divide your sleep into non-REM (non-rapid-eye-movement) sleep and REM (rapid-eye-movement) sleep. When you fall asleep, your body enters into non-REM sleep.

Non-REM sleep is split into four stages. It begins with light sleep, progressing to deeper sleep. The deepest non-REM sleep usually occurs early at night. At this stage, usually people do not have trouble staying asleep. The issue, though, comes a bit later.

After the four stages of non-REM sleep, you will enter the fifth phase of sleep. This stage is called REM-sleep. It occurs in about 90 minutes cycles. Your breathing becomes irregular, and your eyes move rapidly in this stage. Also, you won’t be able to use your limb muscles. It’s common that dreams occur in this phase as well. The duration of REM sleep tends to increase each time throughout the night. One sleep cycle lasts about 90-110 minutes and is repeated 4 to 5 times during the night of healthy sleep.

Research has shown that in the elderly, people spend more time sleeping in the lighter stages. The deepest stages 3 and 4 are very short as you age. Also, the time spent in the REM sleep ireduces, but the frequency stays the same. This is why the elderly often have trouble staying asleep.

The reason you sleep lighter is because your body produces lower levels of growth hormone. When you produce fewer growth hormones, you also produce less melatonin. You will often experience more fragmented sleep and trouble staying asleep. The changes can influence your health, and the disruption may lead insomnia in the elderly. This is where you have trouble staying asleep.

Circadian rhythm changes the elderly

The tendency to sleep and wake up earlier than usual is one of the sleep problems in the elderly. The cause is your circadian rhythm. Also known as you internal clock. Your circadian rhythm controls your energy levels and tells you when to sleep and wake up. In the elderly, your sleep rhythm shifts forward. This makes you want to go to bed earlier. You still get your 7-9 hours of sleep, because you also wake up earlier. Known as advanced sleep phase syndrome.

Older people may find this annoying to wake up at 5 AM instead of 7 AM. However, there may be consequences if they don’t listen to their body and sleep earlier. Sleep problems such as sleep deprivation and excessive sleepiness in the elderly may occur. You can also consider taking naps during the day to compromise the sleep lost. Don’t take the naps close to bedtime, this can cause more trouble staying asleep. Resulting in delayed sleep and less duration of night-time sleep.

Types of medication may effect sleep of elderly

Many elderly people are on medications that can affect and disrupt sleep. Many have real trouble staying asleep or falling asleep due to medications. Medications such as antidepressants often have sleep-related side effects. Also, diuretics is often taken for high blood pressure or glaucoma. Using diuretics at night time can cause you to wake up more often to go to the bathroom. Other medication that can disrupt the sleep in the elderly are:

• Bronchodilators:

Prescribed for those with chronic obstructive pulmonary disease (COPD)

• Antihypertensive drugs:

Used to treat high blood pressure

• Corticosteroids (prednisone):

Used to treat conditions like rheumatoid arthritis

• H2 blockers (Zantac, Tagamet):

Used to treat gastroesophageal reflux disease (GERD) or peptic ulcers

• Levodopa:

Medication used to treat Parkinson’s disease

• Sympathomimetics:

Drugs used in extreme situations, such as an asthma attack or extremely low blood pressure

Medical conditions in the elderly

Elderly people may also have an underlying medical condition that causes sleep problems. One could be that they have trouble staying asleep. Neurological conditions such as Parkinson’s disease and Alzheimer’s are examples. Acute and chronic medical conditions can also occur. Examples are arthritis, cardiovascular disease, or prostatic hypertrophy. Other examples are gastrointestinal and pulmonary conditions which may cause trouble staying asleep. The discomfort and pain may make it harder to fall asleep and sleep less long. Conditions that affect the bladder can wake you up more often to go to the bathroom. Depression, anxiety and dementia can also cause sleep problems.

Sleep disorders in the elderly

Several primary sleep disorders are connected to aging. Primary sleep disorders can cause difficulties in falling asleep and awakenings at night. The lack of sleep can also cause excessive daytime sleepiness. Sleep disorders are often diagnosed through history, physical tests and polysomnogram. Primary sleep disorders that are connected with people in the elderly are:

Sleep apnea

Sleep apnea causes brief breaks in breathing while sleeping. This results in sleep disruptions and also awakenings throughout the night. This can lead to insomnia and excessive daytime sleepiness. Snoring is a common sign of this disorder.

Weight loose mouthpieces and breathing devices such as CPAP are used to treat sleep apnea. Surgery to widen breathing passage is also possible.

Restless leg syndrome

Restless legs syndrome causes discomfort in the legs and the urge to walk to get rid of the feeling. It is often described the unpleasant, tingling and creepy feeling. The feeling gets worse during the evening and makes it hard to sleep throughout the night. Excessive daytime sleepiness may result from this sleep disruption.

Regular exercise can help greatly. Soaking the legs and feet in a warm bath can be a relief too. At least for some restless legs syndrome patients. Other options include Dopaminergic agents, or benzodiazepines. Opiates are also used to treat restless legs syndrome.

Periodic limb movement disorder

Periodic limb movement disorder can occur alone or accompanied with restless leg syndrome. Periodic limb movement disorder causes muscle contractions. This can make your arms and legs move (kicking legs).

Dopaminergic agents are often used to treat periodic limb movement disorder. This can reduce the number of problems during sleep and increases the time of deep sleep.

REM-behaviour disorder

The REM-behaviour disorder is a rare condition and occurs most commonly in elderly people. Usually, you can’t make many movements while you dream. However, this disease doesn’t prevent the muscle activity. It can cause you to crash into bed, fall or leap from the bed, which can create injuries.

To control this disorder, treat with bedtime doses of the benzodiazepine. One example is clonazepam.

Sleeping all the time?

Do you have the feeling that you or an elderly person you know can sleep all day?

As mentioned above, the main issue with sleep in the elderly is that they have trouble staying asleep. In turn, this generally means that they have a lighter sleep than younger people.

Actually, they don’t sleep all day. In most cases, it just seems that way. Low quality sleep in the elderly may cause them to dose off frequently. They need to compensate for their lost sleep. There are basically many short naps in between rather than one long period of high quality sleep.

Another reason which leads to the elderly sleeping all the time is medicine. The side effects of the medicine they take to be exact. Some may make them very sleepy and tired.

Treatment for sleep problems in the elderly

Avoid

• Caffeine, other stimulants and alcohol no later than 3 hours before bedtime

• Heavy meals, spicy food, and excessive amounts of liquid before bedtime (a light snack or warm milk is all right)

• Taking naps close to bedtime

• Activities in bed such as work, reading or watching television

Start

• A regular sleep/wake schedule

• Exercise early in the day or no later than 4 hours before bed

• A sleep environment that is dark, quiet, safe and comfortable

• Activities that encourage relaxation before bed, such as a warm bath or shower, or calming music.

Sleeping pills

If you have trouble staying asleep, you can also opt for sleeping pills. But please do so with care, especially if you are of age.

Elderly people tend to absorb medicines quickly, and the medications may last longer in the body. This can potentially lead to interaction with other medications. We advise to consult a doctor first before using any sleeping pills. Sleeping pills, which are available in pharmacies, are usually for temporary sleep issues. Dependence on sleeping pills can be the physical necessity, but it can also become an addiction.

They may remove the trouble staying asleep, but may also come at a cost.

Sleeping pills side effects

We think it is important to note that sleeping pills side effects can occur. This is fully dependent on which sleeping pills you take, how regular, as well as the dosage. We strongly advise to visit your general practitioner before taking any further action with sleeping pills. They will also be able to tell you all about sleeping pills side effects!

Sleep Disorders in The Elderly

Did you know that many primary sleep disorders are linked to aging?

They can cause difficulties in both falling and staying asleep during the night.

Primary sleep disorders are often diagnosed through your medical history, a physical test or a polysomnogram.

Let’s take a look at some of the most common sleep disorders in the elderly!

Sleep Apnea

The most prominent sleep disorder that comes with age is sleep apnea. It is a condition which causes brief breaks in your breathing as you sleep.

These breaks may cause you to wake up frequently during the night. In turn, they may also become the cause of insomnia or excessive daytime sleepiness.

In addition, snoring is also one of the most common signs of this disorder.

To treat sleep apnea, many use weightless mouthpieces or breathing devices, such as a CPAP. In very severe cases, surgery is required to fully fix this issue.

Restless Leg Syndrome

This condition causes discomfort in the legs and the urge to walk.

It almost feels like a reflex. You know, the test that many doctors do where they hit you gently with a hammer in the knee?

It is often described as an unpleasant, tingling and creepy feeling.

This feeling gets worse during the night, making it hard to fall and stay asleep. It has also been linked to excessive daytime sleepiness!

One of the best things to do against restless leg syndrome is regular exercise! Alternatively, you can also soak your legs and feet in a warm bath.

In severe cases, you may have to take some medicine, such as dopaminergic agents or benzodiazepines. Even opiates are used to treat restless leg syndrome.

As always, we highly recommend you to see a doctor before taking any form of medication. In addition, it is always best to try the natural remedies first like exercise or a warm foot bath.

After all, exercise is good for so many things – including increasing your sleep quality!

Periodic Limb Movement Disorder

This sleep disorder is also a fairly common one. It can come on its own, but it is often combined with restless leg syndrome.

Periodic limb movement disorder causes muscle contractions, making your arms and legs twitch or even kick and punch.

More often than not, dopaminergic agents are used to treat this sleep disorder.

They reduce the number of occurrences during the night, and therefore increase the quality of your sleep.

REM-Behavior Disorder

While this sleep disorder is very rare, it most commonly affects elderly people.

As you sleep, your body usually doesn’t allow you to move as you are in your dreams. However, this disease prevents that from happening.

Instead, you may find yourself kicking, walking, running or falling – depending on what you are dreaming!

This can cause many injuries, and is especially dangerous for elderly people with pre-existing conditions.

This condition is usually treated with bedtime doses of benzodiazepine, such as clonazepam.

If you suspect that you might be suffering from REM-behavior disorder, please contact a medical professional in your area.

Also do not self-medicate in any way as your other medications, age and pre-existing conditions may otherwise lead to possible health hazards.

Sleeping All The Time

Many people think that elderly people sleep all the time. However, we have now learnt that that isn’t always true.

The main issue between elderly people and sleep is usually that they find it difficult staying asleep. That is because they experience lighter sleep than younger people do.

While it may seem that some sleep all day, that isn’t actually true.

Low quality sleep in the elderly make them dose off frequently or make them feel the need for more frequent naps.

They essentially need to make up for their lost sleep caused by their aging.

Think of elderly sleep in this way: instead of having one huge chunk of sleep at once, they need a fragmented sleep schedule with a few naps in between.

Also keep in mind that many types of medicine the elderly take are often linked to sleepiness.

Treating Sleep Problems in The Elderly – Some Tips & Tricks

Do’s

• A regular sleep/wake schedule

• Exercise early in the day or no later than 4 hours before bed

• A sleep environment that is dark, quiet, safe and comfortable

• Activities that encourage relaxation before bed, such as a warm bath, a shower, or calming music.

Don’ts

• Caffeine, other stimulants and alcohol no later than 3 hours before bedtime

• Heavy meals, spicy food, and excessive amounts of liquid before bedtime (a light snack or warm milk is alright)

• Taking naps close to bedtime

• Activities in bed such as work, reading or watching television

What About Sleeping Pills for the Elderly?

Many also choose to take sleeping pills against their sleep disorders. While this may not have been problematic in the past, it does come with issues as you get older.

First of all, only take prescribed sleep aids after visiting a medical professional. There are too many dangers otherwise involved if you go rogue on this one.

Also, sleeping pills which are available in pharmacies are usually only for temporary sleep issues.

Finally, keep in mind that while sleeping pills may be a physical necessity for the time being, they can also quickly become an addiction.

Elderly people tend to absorb medicine much quicker than younger people. In addition, they may also last longer in their bodies.

In turn, this may cause an interaction with other medications that are being taken.

The Right Sleep Environment

As we get older, we tend to spend more and more time in bed. Even during our younger days we would spend a third of our day in bed.

If you add that up, that is also a third of your life!

Having the right sleep environment and products around you is important throughout your entire life.

That is why we do what we do at Vita Talalay. We want to make the healthiest sleep experience possible with our latex mattresses, latex mattress toppers and latex pillows.

If you haven’t tried one yet, we highly recommend you to do so in one of our many retailers around the world.

To do so, simply click here!