Chapter 19 A.Z., a 65-year-old woman, was having a follow-up visit with her physician. She was...

Chapter 19

A.Z., a 65-year-old woman, was having a follow-up visit with her physician. She was concerned about a change in her sleeping habits, including taking at least 30 minutes to fall asleep. She woke up after only about 5 to 6 hours of sleep and found herself unable to fall asleep again. She consequently got sleepy in the afternoon and took frequent naps.

What are some causes of age-associated sleep disorders?
What are the typical changes in sleep patterns that occur in response to age?
What causes age-related changes in sleep patterns?
What are the risks related to the use of pharmacologic sleeping aids in the elderly?
What non-pharmacologic strategies can be used to help promote sleep

Expert Solution

Causes of age associatied sleeping disorders :

Heart failure
Sleep apnea
Restless leg syndrome
Osteoarthritis
Alzheimer's disease

Changes in sleep pattern with age :

With aging, sleep patterns tend to change. Most people find that aging causes them to have a harder time falling asleep. They awaken more often during the night and earlier in the morning. Total sleep time stays the same or is slightly decreased. It may be harder to fall asleep and you may spend more total time in bed. The transition between sleep and waking up is often abrupt, which makes older people feel like they are a lighter sleeper than when they were younger. They wake up in the middle of the night and have trouble going back to sleep.

Cause of age related changes in sleep :

As people get older, their sleep changes due to effects of an aging SCN(Suprachiasmatic Nucleus). Deterioration in the function of the SCN can disrupt circadian rhythms, directly influencing when people feel tired and alert.Changes in production of hormones, such as melatonin and cortisol, may also play a role in disrupted sleep in older adults. As people age, the body secretes less melatonin, which is normally produced in response to darkness that helps promote sleep by coordinating circadian rhythms.

Risks of using pharmacological sleeping aid in elderly :

potential side effects include drowsiness, light-headedness, memory loss and poor concentration
Addiction and withdrawal effects occur with long term use.
feel drowsy, lethargic, less alert or less able to focus the next day
Mixing with other drugs or alcohol increases side effects.
Some drugs cause sleep walking and abnormal sleep related behaviour.

Non-pharmacological strategies for sleep ;

Avoid large meals shortly before bedtime.
Avoid stimulants such as caffeine after mid-afternoon.
Get regular exercise early in the day.
Go to bed early and wake up early every day.
DO NOT take naps.

Nightingale answered 7 months ago

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