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Primary sleep disorders in the elderly

Views: 114     Author: Site Editor     Publish Time: 2019-08-02      Origin: Site

Sleep disorder increases with age, from 9.0% (20 to 29 years old) to 21.0%(60 to 69 years old). One study found difficulty falling asleep and maintaining sleep. Those who woke early range from 23.0%(18 to 30 years old) to 38%(51 to 80 years old). Nearly half of the sleep pills are for the elderly. Besides the influence of age and primary sleep disorders, the sleep disorder of old people basically is secondary to some kind of body and mental disease, alcohol and medicines etc.

1. Sleep Changes in the Elderly

As people age incresing , the quality and quantity of sleep decreases, but the need of sleep does not decrease. It's just that the distribution of circadian rhythms changes. Although the bed time is prolonged, the number of waking up is increased and the time is prolonged, the number of conscious naps during the day is often used to make up for the lack of sleep at night, and the total sleep time is unchanged: from the perspective of sleep structure, the proportion of shallow sleep is increased (stage 1 and 2 sleep) and the proportion of deep sleep is decreased (stage 3 and 4 sleep). REM sleep (rapid eye movement sleep) time decreased, the latency period shortened, but REM sleep percentage only slightly reduced or no change. On polysomnography, the integrity and amplitude of the sleep spindle waves decrease with age.

2. Behavioral Insomnia

This type of insomnia is caused by excessive alertness or anxiety, such as excessively thinking problems and bad sleep habits. Such patients tend to go to bed when they are not sleepy, or when they are sleepy before going to bed and not sleepy when they are ready for sleep, lying awake for a long time. Patients stay in bed for more than 8.5 hours per night. Because of poor sleep, the old people get up late as compensation and wake up times vary. Retirements and the death of a spouse increase the incidence of behavioral insomnia in patients, as retired and lonely people may go to bed earlier because of boredom. Behavioral therapy is effective for this type of sleep disorder, including controlling stimuli before bedtime, restricting sleep time, regular rest, changing bad habits before bedtime, biofeedback therapy, muscle relaxation training and so on.

3. Insomnia Sleep Caused by SAS

SAS is a syndrome characterized by repeated apnea during sleep, each time ≥10 s, resulting in hypoxic episodes, brief wakefulness during sleep, daytime sleepiness, and impaired daytime function. Obese people are prone to appear. Apnea is classified as obstructive apnea and central apnea. Obstructive sleep apnea is often associated with snoring and obesity, both of which are often seen together. Patients often have apnea, followed by asthma. It has been reported that the incidence of the elderly is 18.0%~73.0%. In addition to excessive daytime sleepiness, the syndrome can cause cognitive dysfunction, arrhythmia, pulmonary or systemic hypertension stroke, right heart failure, sexual dysfunction, mental disorders, etc.

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