Views:131 Author:Site Editor Publish Time: 2019-08-12 Origin:Site
1. Evaluation and Diagnosis of Sleep Disorders
The causes of elder’s sleep disorders are complex, it can be the result of normal sacs, chronic diseases, bad sleep habits, certain undiscovered diseases, or the combined effects of these factors. Therefore, it is necessary to comprehensively consider all these factors.
Doctors should be informed in detail about the patient's past medical history, medication, side effects of drugs, usage of alcohol and caffeine and whether there are psychosocial factors that cause sleep disorders. Talk with the patient's lover to determine the patient's sleep habits, daytime sleep, snoring during sleep, breathing and abnormal behavior. Patients should do psychological tests , neuropsychiatric assessment and physical examination if necessary. In addition, the polysomnography has a certain help for the determination of sleep. Certainly, it is necessary to comprehensively assess the total bedtime, the choice of sleep timing, and the daytime function.
According to the patient's complaint, the observation of relatives and the results of polysomnography, the diagnosis of sleep disorders is not difficult to establish. However, whether it is an independent situation or a symptom of other obstacles should be determined according to its clinical phase, course of disease, treatment reasons, and medical treatment. In general, it is best to juxtapose specific sleep disorder diagnoses with as many other relevant diagnoses as possible to adequately describe the psychopathological and pathophysiological conditions of the case.
2. Non-medication Treatment
Elder’s normal sleep changes do not need special treatment. Just explain clearly to them. Non-pharmacological methods should be tried first before applying sedative hypnotics. Many behavioral therapies are effective in treating insomnia, including relaxation training, biofeedback, control of thorns, and sleep restrictions. In addition, sleep hygiene, phototherapy and cognitive therapy can produce certain effects.
Control and stimulation therapy includes limiting excessive excitement before bedtime, over-thinking problems, and more. The practice of sleep restriction is to avoid over-beding, snoring during the day, and getting up in time. These practices, along with daytime activities and sunlight exposure, stabilize and activate the time rhythm system. Therefore, the sleep can be improved. Good sleep hygiene includes paying attention to the use of alcohol, smoking caffeine and other drugs that affect sleep, and changing if necessary.
3. Application of Sedative Hypnotics in the Elder
The proportion of elder taking hypnotics is relatively high, accounting for 10. 0% to 27.0%, and long-term users account for the majority. Although the use of cough medicine can temporarily relieve sleep disorders, long-term use can lead to dependence, loss of function and drug-induced sleep disorder. When stopping the drug, it produces ruminating insomnia and nightmares. For those patients with apnea syndrome, the use of sedative hypnotics can increase the time and severity of seizures. The side effects of hypnotics include cognitive impairment, obsessive mental function, and increased likelihood of trauma due to falls. It can also affect the energy function. Therefore, it should not routinely give the elder sedative hypnotics. If it is short-term use, start lower than the young people's dosage, gradually increase to the required amount, pay attention to the effect and side effects regularly to assess the medication situation. Avoid using benzodiazepines with alcohol and other central nervous system drops to avoid danger. People with nerves, heart, liver and kidney disease may suffer from accumulated poisoning if they use slow-discharging drugs. Therefore, drugs with short half-life and little effect on drug metabolism should be applied as much as possible.
Well, the elder also can choose a good memory foam pillow to improve sleep.