Medical Concerns That Affect Sleep in Older Adults
Medical Concerns That Affect Sleep in Older Adults-By McKenzie Hyde Certified Sleep Coach
In general, some National Institute of Health studies have found older adults spend less time per night in deep, dreamless sleep, which are periods during which the brain replenishes itself, assimilates information, and stores memories. Those who don’t get enough sleep may suffer from confusion, problems concentrating, distortion of memory, depression, or decreased mental capacity. Long-term insomnia can even affect a person’s ability to react to stress appropriately, which can increase the risk of developing a mental illness.
A sustained lack of sleep is also associated with a number of physical ailments, such as diminished coordination, reduced muscle strength, endurance, increased wear and tear on the organs, heightened pain sensitivity, disruption of insulin production and sugar metabolism, and an increased risk of diabetes. Possibly the most dangerous physical effect is a weakened immune system, which decreases the body’s defenses against illnesses on all fronts.
In your journey back to better sleep, make your first step a visit to your doctor. Discuss your symptoms and ask them to diagnose any conditions that might be interfering with your sleep. A doctor could find numerous factors are negatively impacting your ability to get solid rest, such as insomnia, sleep apnea, and more.
Insomnia and Hypersomnia
Both a symptom and disorder,insomnia is simply the inability to fall asleep. Existing conditions like depression, anxiety, and dementia can increase a person’s risk of experiencing insomnia. The flipside of this condition ishypersomnia, which is intense sleepiness and an urge to sleep, especially during daytime hours.
Snoring and Sleep Apnea
Loud snoringcan be a symptom of obstructive sleep apnea and is associated with high blood pressure and other health problems.Sleep apneais a general condition in which a person’s breathing stops during sleep, resulting in long periods without breath that can cause levels of blood oxygen to drop significantly.
There are three different types of apnea: obstructive sleep apnea (OSA), central sleep apnea, and complex sleep apnea. Obstructive sleep apnea occurs when the airway passage relaxes until it collapses shut, obstructing the airway and stopping a person from breathing, sometimes for as long as 10-60 seconds.
With central sleep apnea, the problem occurs instead between the brain and the muscles that control breathing. Complex sleep apnea is a combination of both obstructive and central sleep apnea. Any type of untreated sleep apnea puts a person at risk for headaches, memory loss, depression, and cardiovascular disease, among others.
Restless Leg Syndrome
A neurological disorder also known as Willis-Ekbom disease,restless legs syndrome creates unpleasant sensations in the legs and an accompanying urge to move them to find relief. The urge generally becomes more intense during relaxation and at bedtime, interfering with the ability to fall asleep and ultimately leading to daytime sleepiness and fatigue.
Arthritis, Joint Pain or Muscle Pain
The connection here is pretty straightforward: pain can keep you from sleeping, and poor sleep quality can make your pain worse.
For people witharthritis or other conditions that cause aching, stiff, and sometimes swollen joints, it can seem nearly impossible to get comfortable, doze off, and stay asleep. Studies show that as many as 80% of arthritis patients have trouble sleeping.
Other types of pain can also interfere with sleep, with symptoms ranging from generalized muscle tightness or fatigue to more chronic conditions.Myofascial pain syndrome involves mainly muscular pain.Fibromyalgia includes more widespread body pain, along with headaches, bowel problems, fatigue, and mood changes. In both of these chronic pain disorders, the pain lasts for long periods of time and can interfere with sleep.
Heart and Lung Conditions
A regular night’s sleep can be interrupted repeatedly by spikes in blood pressure or heart rate. Blood flow throughout the body varies widely during sleep, as does blood vessel elasticity and electrical activity in the heart. People with coronary artery disease or otherheart conditions sometimes wake up because of central sleep apnea or trouble breathing from fluid buildup in the lungs. Some people wake with angina (chest pain), and others with bouts of atrial fibrillation or palpitations (a racing or pounding heart).
Also, breathing patterns normally become more shallow and less regular during sleep due to reduced brain activity— but reduced pulmonary capacity can make it even more difficult to inhale and exhale optimally at night.Asthma, COPD, or any other lung conditions that obstruct breathing are likely to cause sleep interruptions as the body wakes up and fights to take in more oxygen.
Urinary Conditions
A common cause of sleep loss among older adults is the need to frequently get up and urinate at night. Aging bodies produce less of an anti-diuretic hormone that enables fluid retention, prompting them to produce more urine. Cconcurrently, the bladder can lose holding capacity as we age. Callednocturia, or overactive bladder, this condition is often a symptom of other medical conditions including urological infection, a bladder or prostate tumor, bladder prolapse, or disorders affecting sphincter control. It’s also common in people with sleep apnea, heart failure, liver failure, diabetes, and pregnancy, as well as those taking diuretic medications.
Digestive Problems
During sleep, the digestive system works at a much slower rate than during waking. Digestive tissues also grow, repair, and rebuild themselves at night, using glucose consumed during the day to fuel the rebuilding. If you eat a large meal immediately before going to bed, you deprive the digestive system of its opportunity to rest. This may result in sleep-disrupting symptoms. Any number of digestive problems can make it difficult to sleep, includingindigestion, heartburn, constipation, gastroesophageal reflux disease, irritable bowel syndrome, ulcerative colitis, andChrohn's disease.
Allergies
Allergic reactions can manifest in several ways depending on the allergen and how you come into contact with it. The nose and respiratory system will react to an allergen that has been inhaled, such as pollen or chemicals. The skin will react to something allergenic that touches it, as in the case of poison oak, poison ivy, or an insect sting. If you have food allergies, the stomach and digestive system will react negatively to something you’ve eaten; for example, many people are allergic to eggs or peanuts.
Nasal allergiesespecially can cause breathing problems that result in sleep deprivation. A reaction can be signaled by sneezing, itching, runny nose or nasal congestion, and swelling of the mucous membranes. These conditions can make sleeping impossible when you can’t breathe through your nose and must breathe through your mouth instead. This can lead to snoring and restless sleep. Also, allergies can trigger post-nasal drip, where mucus collects in the throat and causes coughing and often a sore throat. After a night of snoring, coughing, tossing, and turning, you awaken exhausted and irritable.
Medication Side Effects
Medications interact with our bodies in ways that are sometimes unpredictable and undesirable. Medicines can disrupt sleep, keep you up all night with insomnia, or cause daytime drowsiness. In fact, sleepiness is one of the most common side effects of medications.
Medications that can affect sleep include:
Anti-arrhythmics (for heart rhythm problems)
Antihistamines (for allergy symptoms)
Beta-blockers (for high blood pressure)
Bronchodilators (for asthma or COPD)
Clonidine (for high blood pressure)
Corticosteroids (for inflammation or asthma)
Decongestants (for colds and allergies)
Diuretics (for high blood pressure)
Cough, cold, and flu medications that contain alcohol
Headache and pain medications that contain caffeine
Sedating antihistamines (for colds and allergies)
Selective serotonin reuptake inhibitors or SSRIs (for depression or anxiety)
Sympathomimetic stimulants (for attention deficit disorder)
Theophylline (for asthma)
Thyroid hormone (for hypothyroidism)
Tricyclic antidepressants (for depression, bipolar disorder, or chronic pain)
If you believe your medication is affecting your sleep or making you feel drowsy during the day, first discuss the situation with your doctor. They may be able to reduce your dosage, switch you to a different drug, or suggest a different type of treatment. However, don’t stop taking any medication until an alternative treatment has been identified; otherwise, you could experience dangerous side effects.