Sleep is essential for proper functioning of every individual, regardless of age. However, eight hours of uninterrupted and undisturbed sleep is exceptionally more important in elderly due to following reasons.
- Sleep is believed to be reduced as a normal process and component of aging. This is true for normal elderly too, who don’t have any organic disease process. Both quality and duration of sleep is altered and marked reduced with advancing age. In normal elderly, following changes are seen in the normal pattern of sleep:
- Increase time to fall asleep after lying in bed.
- Frequent awakening accompanied by increase time taken to fall asleep again as opposed to a normal young adult who requires minutes to fall asleep again.
- Loss of NREM pattern of sleep, Non Rapid Eye Movement is an important component of normal sleep rhythm. Actual relaxation attributed to sleeping is achieved in NREM sleep as it is only during this phase that the brain shut down its processes completely (obviously all processes other than those that are required for life like breathing). Loss of NREM leads to subjective feeling of giddiness and incomplete relaxation, one of the most important complaint elderly have with their sleep.
- Early awakening in the morning which cannot be attributed to any cause. Overall sleep duration, quality and depth is reduced naturally in elderly.
Causes of disturbed sleep in elderly:
A number of causes both organic and inorganic can be attributed to this disturbance in natural rhythm and pattern of sleeping over time. Few of these are listed below:
- Loss of physical activity: physical activity and feeling of tiredness is an important reason why people feel sleepy towards the end of the day; however, in case of elderly who are mostly retired, don’t have much of the physical activity and so are obviously not tired and sleepy at nights.
- Loss of tone in respiratory muscles leading to collapse: With advancing age, all muscles get relaxed and laxed, same is seen in respiratory muscles that loses their tone. In day hours, when people are wide awake and in sitting or standing posture, voluntary brain efforts and body postures don’t let the relaxed muscle to make any noticeable difference in breathing pattern, but at night, when person is sleeping, weight of gastric contents further push upon lungs and further decreases the tone of respiratory muscles. This is another important cause of sleep disturbance, called as sleep apnea.
- Number of diseases and health issues: With advancing age, person becomes more vulnerable to a number of organic and inorganic ailments. All health issues affect sleep at first.
Why sleep is important in elderly?
Sleep affects day to day functioning in a normal adult but in elderly, effects of disturbed sleep remain hidden until consequences of sleep disturbance begin to appear. A number of health issues associated with impaired sleep are discussed as under:
All scientific studies conducted on elderly and on mechanics of hypertension have shown clear association of sleep disturbances to development of hypertension. Let alone, disturbed sleeps itself a very stressing event that irritates people and impair their ability to fight different stressors. Sleep deprivation or chronic insomnia
b. Alzheimer’s Disease:
Alzheimer’s disease is also associated with chronic sleep disturbance. This is especially true if sleep apnea is the cause of disturbed sleep. During sleep apnea, low oxygen delivery to brain tissue leads to early development of Alzheimer’s disease.
In young healthy adult, chronic sleep deprivation affects cognitive thinking and problem solving capabilities. However, in young adults, sleep deprivation is normally short term and symptoms resolves by its own without leaving any permanent sequelae. However, in elderly symptoms remain hidden until permanent changes are seen in brain functioning. Sound sleep is required to function properly especially cognition and intellect is greatly affected by poor sleep.
Diabetes type 2 diabetes mellitus is associated with sleep deprivation. In type 2 diabetes mellitus peripheral resistance to the action of insulin is conferred, that is believed to be associated with chronic insomnia. Moreover, it has both cause and effect relationship, sleep disturbances leads to diabetes mellitus and once full blown diabetes is established, any further sleep disturbance will further aggravates blood sugar levels and functioning of insulin.
Sleeping Tips for Adults:
Issues pertinent to sleep in elderly are broadly classified as:
- Issues in falling asleep
- Issues in maintain sleep
Tips to induce sleep
Below tips will help to induce sleep. In simple words, using these tips will reduce the time required to fall asleep.
- Exercise: Exercise evokes the subjective feeling of tiredness and helps in initiating sleep.
- Use of aromatherapy: This helps in forgetting stress and reduces the incidence of developing depression in elderly by providing a calming and soothing effect.
- Comfortable bedding: This is especially true for elderly who have joint problems or other neuromuscular issues.
- Use of eye covers: Most elderly use eye masks and covers, this not only helps to prevent entry of light in the eye, but also help melatonin to be produced in significant amounts.
Tips to maintain sleep:
Following tips will help in maintaining sleep to ensure uninterrupted 8 hours of sleep.
- Avoidance of alcohol and caffeinated beverages before bed time
- Avoidance of drinking plenty of water before going to bed.
- Sleeping in an environment which has no disturbance like noise or light.
- Maintenance of room temperature before sleeping.