As we get older, we need less sleep. This reduced
requirement for sleep may result in the older person complaining that they suffer
from insomnia when, in fact, this is a normal consequence of ageing. Reduced
activity levels or mobility may also make the older person more likely to take
naps during the day which, of course, will result in needing less sleep at night.
The relatives of many older people often attribute
daytime sleeping to the fact that older people need more sleep and are napping
because they are tired. They may not consider that the sleeping may be a symptom
of boredom or just a habit after eating.
Putting an older relative to bed early so that
they can get some rest and give the family a break does not mean they will spend
the following 12 hours asleep! The answer to this problem is not sleeping tablets
but an attempt to identify and cope with altered sleep patterns and needs.
of the sleep patterns of older people
- Fragmented sleep associated with frequent wakening.
- A longer time is needed to get off to sleep.
- REM sleep is unchanged but occurs earlier in
the night than in younger people.
- Night-time sleep loss is usually compensated
for by daytime napping. Patients and relatives often don't count this as sleep.
One in four male 60-65 year olds needs to get out
of bed at night to urinate. This rises to 90% of the very old. The rate also
increases for women, but not as substantially. Many elderly people will not
consider this a cause of poor sleep, thinking that they should be able to return
to sleep immediately, as they did when younger.
The pain of arthritis may also keep an elderly
person awake. Judicious use of pain relief may be more effective than sleeping
tablets in the long term.
Fear, anxiety, bereavement and depression will
cause sleeplessness at any age. They are more commonly found in older age groups
and thus these issues must be addressed. Conditions such as angina and palpitations
may lead to insomnia due to secondary anxiety.
Poor sleep patterns are a predictor of depression
in the elderly and changed surroundings may cause insomnia, which is usually
causes of sleep disturbance
- Shortness of breath (dyspnoea).
- Generalised itching (pruritus).
- Prostate gland enlargement in men (benign prostatic
- Leg cramps.
- No serious medical consequences or complications.
- Depression and anxiety over not sleeping enough.
- Inappropriate day sleep, eg. during social events.
for patients to avoid sleeplessness
- Avoid napping by day.
- Do not go to bed until tired.
- A pre-sleep ritual is important. It should be
calming and familiar.
- Try a pre-bed warm drink (no caffeine), a bath,
an easy reading novel or magazine.
- Try a new electric blanket to ensure that the
bed is warm and safe.
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