sleep problems, which plague up to 40% of the elderly, include light sleep, frequent waking, and daytime fatigue. Among older people, there is also a decrease in the deep-sleep stage and an increase in periods of wakefulness during the night.

1. SLEEP PROBLEMS IN ELDERLY
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2. INTRODUCTION
Sleep plays a crucial role in the health
of all human beings, especially the
elderly. Complete and comfortable
sleep leads to excitement and
cheerfulness yielding high energy, a
very good mood, and the ability to
perform everyday tasks during the day.
Any disorder in the elderly causes
physical and mental disorders.
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3. Why is sleep so important for
older adults?
Approximately 50% of older adults
complain of difficulty sleeping. Poor
sleep results in increased risk of
significant morbidity and mortality.
A good night’s sleep is especially
important to older adults because it
helps improve concentration and
memory formation, allows your body to
repair any cell damage that occurred
during the day, and refreshes your
immune system, which in turn helps to
prevent disease.
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4. Sleep Disorders In Older Adults
If you have a sleep disorder it can be hard to
get a good night's sleep. Sleep disorders can
make it hard to fall asleep or stay asleep
during the night and can make you drowsy
during the day. The following are the most
common sleep disorders among older
adults:
1. Insomnia
2. Sleep-disordered breathing, such as
snoring and sleep apnea
3. Movement disorders, such as restless
legs syndrome
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5. Insomnia is the most common sleep complaint at
any age. It affects almost half of adults 60 and
older.
If you have insomnia, you may experience any one
or any combination of the following symptoms:
1. Taking a long time -- more than 30 to 45
minutes -- to fall asleep
2. Waking up many times each night
3. Waking up early and being unable to get
back to sleep
4. Waking up feeling tired
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6. Types Of Insomnia
There are two types of insomnia: primary insomnia and secondary
insomnia.
● Primary insomnia: Primary insomnia means that a person is having
sleep problems that are not directly associated with any other health
condition or problem.
● Secondary insomnia: Secondary insomnia means that a person is
having sleep problems because of something else, such as a health
condition (like asthma, depression, arthritis, cancer, or heartburn);
pain; medication they are taking; or a substance they are using (like
alcohol).
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7. Causes of Insomnia
● Significant life stress (job loss or change,
death of a loved one, divorce, moving)
● Illness
● Emotional or physical discomfort
● Environmental factors like noise, light, or
extreme temperatures (hot or cold) that
interfere with sleep
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8. Treatment Of Insomnia
Medical treatments for insomnia include:
● prescription sleeping pills
● antidepressants
● sleep aids available online or over-
the-counter
● antihistamines
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9. Home remedies for insomnia
include:
● Improving "sleep hygiene": Not sleeping too much or
too little, exercising daily, not forcing sleep,
maintaining a regular sleep schedule,
● Using relaxation techniques: Examples include
meditation and muscle relaxation.
● Stimulus control therapy - only go to bed when
sleepy. Avoid watching TV, reading, eating, or worrying
in bed.
● Sleep restriction: Decreasing the time spent in bed
and partially depriving the body of sleep can increase
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10. Sleep-Disordered Breathing
Sleep apnea and snoring are two
examples of sleep-disordered
breathing -- conditions that make it
more difficult to breathe during
sleep. When severe, these disorders
may cause people to wake up often
at night and be drowsy during the
day.
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11. Snoring is a very common condition affecting nearly 40 percent of
adults. It is more common among older people and those who are
overweight. When severe, snoring not only causes frequent
awakenings at night and daytime sleepiness, it can also disrupt a bed
partner's sleep.
SNORING
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12. Sleep Apnea
Sleep apnea is a common but
serious sleep disorder where your
breathing is briefly interrupted
when you’re asleep. If you have
sleep apnea, you’re probably not
aware of these short breathing
pauses that occur hundreds of
times a night, jolting you out of
your natural sleep rhythm
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13. Types of sleep apnea
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14. Signs and symptoms of sleep
apnea
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15. Treatments of Sleep Apnea
Lose weight. People who are overweight have extra tissue in the back of
their throat, which can fall down over the airway and block the flow of air
into the lungs while they sleep. Even a small amount of weight loss can
open up your throat and improve sleep apnea symptoms.
Quit smoking. Smoking contributes to sleep apnea by increasing
inflammation and fluid retention in your throat and upper airway.
Avoid alcohol, sleeping pills, and sedatives, especially before bedtime,
because they relax the muscles in the throat and interfere with breathing.
Exercise regularly. As well as helping you lose weight, regular exercise can
have a major effect on the duration and quality of sleep.
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16. Movement Disorders
Two movement disorders that can
make it harder to sleep include restless
legs syndrome, or RLS, and periodic
limb movement disorder, or PLMD. Both
of these conditions cause people to
move their limbs when they sleep,
leading to poor sleep and daytime
drowsiness. Often, both conditions
occur in the same person.
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17. Restless legs syndrome is a common condition
in older adults and affects more than 20
percent of people 80 years and older. People
with RLS experience uncomfortable feelings in
their legs such as tingling, crawling, or pins and
needles.
This often makes it hard for them to fall asleep
or stay asleep, and causes them to be sleepy
during the day.
Restless Legs Syndrome
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18. What are common signs and
symptoms of restless legs?
● Strange itching, tingling, or "crawling" sensations occurring deep within the
legs; these sensations may also occur in the arms.
● A compelling urge to move the limbs to relieve these sensations
● Restlessness -- floor pacing, tossing and turning in bed, rubbing the legs
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19. What causes restless legs
syndrome?
● use of alcohol, nicotine, and caffeine
● pregnancy, especially in the last trimester;
● neuropathy (nerve damage).
● end-stage renal disease and hemodialysis
● iron deficiency
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20. ● Try baths and massages. Soaking in a warm bath and massaging
your legs can relax your muscles.
● Apply warm or cool packs. Use of heat or cold, or alternating use of
the two, may lessen your limb sensations.
● Establish good sleep hygiene. Fatigue tends to worsen symptoms of
RLS/WED, so it's important that you practice good sleep hygiene.
● Exercise. Getting moderate, regular exercise may relieve symptoms of
RLS/WED
● Avoid caffeine. Sometimes cutting back on caffeine may help restless
legs.
Treatment for Restless Legs
Syndrome
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21. Periodic limb movement disorder, or
PLMD, is a condition that causes
people to jerk and kick their legs
every 20 to 40 seconds during sleep.
As with RLS, PLMD often disrupts
sleep -- not only for the patient but
the bed partner as well. One study
found that roughly 40 percent of
older adults have at least a mild form
of PLMD.
Periodic limb movement
disorder
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22. Periodic Limb Movement
Disorder Causes
● Diabetes mellitus
● Iron deficiency
● Spinal cord tumor
● Spinal cord injury
● Sleep apnea syndrome - Breathing difficulties that disrupt sleep, causing
daytime sleepiness and a number of other problems
● Narcolepsy - A sleep disorder involving excessive sleepiness and
overpowering urge to sleep during waking hours
● Uremia - Build-up of waste products in the blood because of poor kidney
function
● Anemia - Low level of hemoglobin, the substance that carries oxygen in
the blood
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23. ● Benzodiazepines: These drugs suppress muscle contractions.
● Dopaminergic agents: These drugs increased the levels of an
important neurotransmitter (brain chemical) called dopamine, which
is important in regulating muscle movements.
● Anticonvulsant agents: These medications reduce muscle
contractions in some people. The most widely used anticonvulsant in
PLMD is gabapentin(Neurontin).
● GABA agonists: These agents inhibit release of certain
neurotransmitters that stimulate muscle contractions. The result is
relaxation of contractions.
Treatments For Limb Movement
Disorder
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24. Methods To Improve Sleep
Habits
Encourage better sleep at night
Don’t read from a backlit device at night (such as an
iPad).
Make sure your bedroom is quiet, dark, and cool,
and your bed is comfortable.
Keep a regular bedtime routine for better
sleep
Go to bed earlier.
Limit sleep aids and sleeping pills.
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25. Use diet to improve sleep
● Limit caffeine late in the day. Avoid coffee,
tea, soda, and chocolate late in the day
● Avoid big meals or spicy foods just before
bedtime
Use Exercise to Improve Sleep
● Swimming/water exercise
● Dancing: If you love to move to music, go
dancing or take a dance class.
● Cycling or running: If you are in good shape,
you can run and cycle until late in life
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26. THANK YOU
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