But as people age, the quality of their sleep is often adversely affected. In many cases, this is due to insomnia that may cause people to feel tired during the day. In other cases, older people may be diagnosed with other sleep disorders.
A recent survey by the National Sleep Foundation found that older people in good health, with a high quality of life, may actually sleep better than younger people. However, many other older people do not get quality sleep on a consistent basis. This is especially true of those who have various physical and mental health conditions.
- Insomnia. Nearly half of all adults age 60 and older experience some form of insomnia. There are many potential insomnia triggers, but the need to use the bathroom is the most common insomnia source among older adults. Increased prostate size typically causes older men to have to urinate more often, whereas incontinence often occurs in older women. When older adults wake frequently at night, they are also at increased risk of falling.
- Breathing problems. Many older people experience breathing problems during sleep that interfere with the ability to get proper rest. Snoring and sleep apnea (in which patients temporarily stop breathing during sleep) are examples of breathing problems that are more likely to occur in older people. Among people over age 65, 28 % of males and 24 % of females experience sleep apnea, according to the National Sleep Foundation.
- Movement disorders. Older adults are more likely to experience involuntary movement disorders, such as restless leg syndrome (RLS) and periodic limb movement disorder (PLMD). RLS causes feelings of discomfort in the legs that occur continuously when the body is at rest. It affects more than 20 % of people age 80 and older, according to the NIH. PLMD causes patients to periodically and rapidly move their legs when the body is asleep. About 80 percent of people with RLS also have PLMD, according to the National Sleep Foundation.
Types and differences of sleep disorders
According to the National Institutes of Health, more than 100 disorders of sleeping and waking have been identified.
They may fall into one of the following categories:
i. Dyssomnias. Disturbances in the amount, timing or quality of sleep resulting in excessive daytime sleepiness or insomnia. Common dyssomnias include:
- Insomnia. Condition of inadequate or poor sleep that may include difficulty falling asleep, waking up frequently during the night with difficulty falling back asleep, waking up too early in the morning or unrefreshing sleep. This is the most common type of sleep disorder.
- Sleep apnea. Sleep disorder that causes breathing to become shallow or stop while sleeping. Each pause in breath usually lasts 10 to 20 seconds. Pauses can occur 20 to 30 times in an hour. This is the second most common sleep disorder. Left untreated, sleep apnea can be life-threatening. Excessive daytime sleepiness can cause people to fall asleep at inappropriate times, such as while driving. Sleep apnea also appears to increase a person's risk of numerous health conditions including high blood pressure (hypertension), heart attack, stroke and diabetes.
- Hypersomnia. Excessive daytime sleepiness after adequate nighttime sleep.
Restless legs syndrome (RLS). Sleep disorder characterized by unpleasant sensations in the legs that are described as creeping, crawling, tingling, pulling or painful.
- Narcolepsy. Chronic sleep disorder characterized by excessive and overwhelming daytime sleepiness and short “sleep attacks,” even after adequate nighttime sleep. According to the National Center on Sleep Disorders Research, about 250,000 Americans have narcolepsy . Its cause is unknown.
- Periodic limb movement disorder (nocturnal myoclonus). Characterized by periodic episodes of repetitive jerking and kicking during sleep.
- Circadian rhythm sleep disorders. Involves disruption of the body's natural sleep cycle. Common examples include jet lag (traveling quickly across numerous time zones) and sleep problems associated with shift work. Other examples: delayed sleep phase disorder, in which people go to bed and wake up at least two hours later than is desired, and advanced phase sleep disorder, in which people fall asleep and wake up several hours earlier than is desired.
- Parasomnias. Disorders that involve abnormal behavioral or physiological events during sleep. They involve partial arousal or interference with sleep stage transition. Examples include:
Arousal disorders. Disorders that involve partial arousal, such as sleepwalking and night terrors, which are characterized by sudden arousal from sleep and increased pulse and breathing rate. They occur during the first third of the sleep cycle.
- Sleep-wake transition disorders. Disorders that interfere with sleep stage transition. Examples are sleep talking, nocturnal leg cramps, sleep starts (sudden contraction in a leg, sometimes an arm or the head, at the start of sleep) and rhythmic movement disorder (consists of recurrent head banging, head rolling and body rocking).
Some common signs and symptoms of dyssomnias include difficulty falling asleep and excessive daytime drowsiness. Some signs and symptoms of parasomnias include abnormal behaviors that occur during sleep, such as walking, head banging and head rolling. Signs and symptoms of sleep disorders that are caused by medical or psychiatric conditions vary and may include difficulty falling asleep or irritability.
Condition Symptoms
Insomnia : - Difficulty falling asleep
Difficulty staying asleep : - Waking up feeling tired,
even after a full night's sleep
Sleep apnea : - Breathing that stops during sleep
- Choking or gasping during sleep
- Loud snoring
Hypersomnia : - Recurrent episodes of daytime
sleepiness or prolonged nighttime sleep
- Anxiety
- Decreased energy
Narcolepsy : - Sudden episodes of loss of muscle function
- Sleep paralysis (temporary inability to talk or -
move when falling asleep or waking up)
- Hypnagogic hallucinations (vivid, often frightening
dream-like experience)
Circadian rhythm sleep disorders : - Difficulty falling and staying asleep and/or
late night insomnia
- Lack of energy in the morning
- Increase of energy/mood in the evening
Nightmares : - Abrupt awakening from sleep, usually later in the
sleep period
- Memory of a frightening dream
- Little confusion or disorientation upon waking
Night terrors : - Abrupt awakening from sleep, usually earlier in
the sleep period
- No memory of episode
- Confusion or disorientation upon waking
*Sleep disorders associated with psychiatric conditions like Anxiety, depression, psychosis and many other psychiatric disorders can result in excessive sleepiness or insomnia.
*Sleep disorders associated with neurological disorders. Common examples include headaches, dementia (progressive loss of intellectual function) and Parkinson's disease.
*Sleep disorders associated with other medical disorders. Common examples include alcoholism, peptic ulcers, gastroesophageal reflux disease (GERD), asthma, hay fever, chronic obstructive pulmonary disease (COPD), chronic fatigue syndrome and chronic pain (e.g., fibromyalgia).
*Proposed sleep disorders. Sleep problems for which there is insufficient information to establish them as distinct disorders. Common examples include: Short sleepers. People who sleep less than 75% of the sleep time typically required for their age group, but who experience no negative impacts.
*Long sleepers. People who routinely sleep more than 10 hours a night.
*Fragmentary myoclonus. Brief, involuntary jerks or twists during sleep.
*Sleep hyperhydrosis. Night sweats.
Emotional and physical illness.
People with health problems tend to report poorer sleep than healthy individuals. In addition, people who experience physical pain frequently have difficulty falling asleep and have a poorer sleep quality. Sleep disorders can precipitate or exacerbate many medical conditions including diabetes and cardiac disease and mental disorders including depressive and anxiety disorders.
Use of certain medicines. Older people are more likely than younger people to take medications regularly. Some of these medications are known to interfere with sleep, including asthma medications, blood pressure drugs, corticosteroids, cardiovascular drugs, decongestants and gastrointestinal drugs.
Alzheimer’s disease often affects the sleep patterns of older people with the illness. Some patients with Alzheimer’s may sleep excessively, whereas others do not sleep enough. Alzheimer’s patients often awaken frequently at night and may be found wandering around or yelling in the middle of the night.
Other conditions that may cause sleeping problems in older adults include:
Sedentary lifestyle, Arthritis, rheumatism, Asthma, Cancer, Chronic heartburn, Emotional disorders (e.g., depression), Enlarged prostate, Gastroesophageal reflux disease (GERD), Heart problems (e.g., heart failure, Incontinence, Lung disease (e.g., chronic obstructive pulmonary disease), Menopause, Osteoporosis, Neurological disorders (e.g., Parkinson’s disease, dementia)
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