Article Posted: 04/30/2008
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Sleep and Aging
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By the National Institute on Health Senior Health

Contents

About Sleep

We all look forward to a good night's sleep. Sleep allows our body to rest and to restore its energy levels. Without enough restful sleep, not only can we become grumpy and irritable, but also inattentive and more prone to accidents. Like food and water, adequate sleep is essential to good health and quality of life.

There are two types of sleep: non-rapid eye movement -- or NREM sleep -- and rapid eye movement -- or REM sleep. NREM sleep includes four stages, ranging from light to deep sleep. We cycle through these four stages of sleep approximately every 90 minutes. Then we go into REM sleep, the most active stage of sleep when dreaming often occurs. During REM sleep, the eyes move back and forth beneath the eyelids and muscles become immobile.

Researchers believe that two body systems -- the sleep-wake process and our circadian biologic clock -- regulate our sleep. They program our bodies to feel sleepy at night and awake during the day.

The sleep-wake process works by balancing the amount of sleep a person needs based on the time spent awake. Our circadian biologic clock is a 24-hour body rhythm affected by sunlight. It regulates hormones such as melatonin, which is secreted during the night and promotes sleep, and other processes like body temperature. Sleeping at a time that is in sync with this rhythm is important for healthy sleep.

Diagram of changes in sleep patterns as we age.Sleep needs change over a person's lifetime. Children and adolescents need more sleep than adults. Interestingly, older adults need about the same amount of sleep as younger adults -- seven to nine hours of sleep per night.

Unfortunately, many older adults often get less sleep than they need. One reason is that they often have more trouble falling asleep. A study of adults over 65 found that 13 percent of men and 36 percent of women take more than 30 minutes to fall asleep.

Also, older people often sleep less deeply and wake up more often throughout the night, which may be why they may nap more often during the daytime. Nighttime sleep schedules may change with age too. Many older adults tend to get sleepier earlier in the evening and awaken earlier in the morning.

There are many possible explanations for these changes. Older adults may produce and secrete less melatonin, the hormone that promotes sleep. They may also be more sensitive to -- and may awaken because of -- changes in their environment, such as noise.

Older adults may also have other medical and psychiatric problems that can affect their nighttime sleep. Researchers have noted that people without major medical or psychiatric illnesses report better sleep.

Not sleeping well can lead to a number of problems. Older adults who have poor nighttime sleep are more likely to have a depressed mood, attention and memory problems, excessive daytime sleepiness, more nighttime falls, and use more over-the-counter or prescription sleep aids. Poor sleep is also associated with a poorer quality of life.

Many people believe that poor sleep is a normal part of aging, but it is not. In fact, many healthy older adults report few or no sleep problems. Sleep patterns change as we age, but disturbed sleep and waking up tired every day are not part of normal aging. If you are having trouble sleeping, see your doctor or a sleep specialist. There are treatments that can help.

Quiz

1. Older adults require less sleep than younger adults.

FALSE is the correct answer. we age, our sleep requirements remain similar to those of younger adults. That is, most people need the same seven to nine hours of sleep per night.

2. Poor sleep is a normal part of aging.

FALSE is the correct answer. Many people believe that poor sleep is a normal part of aging, but it is not. In fact, many healthy older adults report having no or few sleep problems. Sleep patterns change as we age, but disturbed sleep and waking up tired every day are not part of normal aging.

3. People without major medical or psychiatric problems tend to sleep better.

TRUE is the correct answer. Researchers have noted that persons without major medical or psychiatric illnesses tend to sleep better.

4. Poor sleep can lead to attention and memory problems.

TRUE is the correct answer. Older adults who have poor nighttime sleep are more likely to have a depressed mood, attention and memory problems, excessive daytime sleepiness, more nighttime falls, and use more over-the-counter or prescription sleep aids.

 

Sleep Disorders

If you have a sleep disorder it can be hard to get a good night's sleep. Sleep disorders can make it hard to fall asleep or stay asleep during the night and can make you drowsy during the day. The most common sleep disorders among older adults are insomnia, sleep-disordered breathing, such as snoring and sleep apnea, and movement disorders like restless legs syndrome.

Sleep Disorders - Insomnia

Insomnia is the most common sleep complaint at any age. It affects almost half of adults 60 and older.

If you have insomnia, you may experience any one or any combination of the following symptoms.

  • taking a long time -- more than 30 to 45 minutes -- to fall asleep
  • waking up many times each night
  • waking up early and being unable to get back to sleep
  • waking up feeling tired

Short-term insomnia, lasting less than one month, may result from a medical or psychiatric condition. Or it may occur after a change in personal circumstances like losing a loved one, relocating, or being hospitalized. If insomnia lasts longer than a month, it is considered chronic, even if the original cause has been resolved.

Many factors can cause insomnia. However, the most common reason older adults wake up at night is to go to the bathroom. Prostate enlargement in men and continence problems in women are often the cause. Unfortunately, waking up to go to the bathroom at night also places older adults at greater risk for falling.

Disorders that cause pain or discomfort during the night such as heartburn, arthritis, menopause, and cancer also can cause you to lose sleep. Medical conditions such as heart failure and lung disease may make it more difficult to sleep through the night, too.

Neurologic conditions such as Parkinson's disease and dementia are often a source of sleep problems, as are psychiatric conditions, such as depression. Although depression and insomnia are often related, it is currently unclear whether one causes the other.

Many older people also have habits that make it more difficult to get a good night's sleep. They may nap more frequently during the day or may not exercise as much. Spending less time outdoors can reduce their exposure to sunlight and upset their sleep cycle. Drinking more alcohol or caffeine can keep them from falling asleep or staying asleep.

Also, as people age, their sleeping and waking patterns tend to change. Older adults usually become sleepier earlier in the evening and wake up earlier in the morning. If they don't adjust their bedtimes to these changes, they may have difficulty falling and staying asleep.

Lastly, many older adults take a variety of different medications that may negatively affect their sleep. Many medications have side effects that can cause sleepiness or affect daytime functioning.

Quiz

1. One symptom of insomnia is

A. waking up tired.

B. dreaming every night.

C. sleeping through the night.


A is the correct answer.

Waking up tired is one of the symptoms of insomnia. Other symptoms include

  • waking up many times each night
  • waking up early and being unable to get back to sleep
  • taking a long time -- more than 30 to 45 minutes -- to fall asleep.

 

2. Short-term insomnia may be caused by

A. grieving after losing a spouse or loved one.

B. moving to a new area.

C. being in the hospital.

D. all of the above


D is the correct answer. Short-term insomnia, lasting less than one month, may result after a medical or psychiatric condition. Or it may occur after a change in personal circumstances like losing a loved one, relocating, or being hospitalized. If insomnia lasts longer than a month, it is considered chronic, even if the original cause has been resolved.

 

3. The most common reason older people wake up at night is because

A. they hear a strange noise.

B. they have to go to the bathroom.

C. they are in pain.


B is the correct answer. Although many factors can cause insomnia, the most common reason older adults wake up at night is to go the bathroom. Disorders that cause pain or discomfort during the night such as heartburn, arthritis, menopause, and cancer also can cause older adults to lose sleep. Medical conditions such as heart failure and lung disease may make it more difficult to sleep through the night, too.

 

4. As people age, they tend to

A. fall asleep later in the evening.

B. wake up later in the morning.

C. nap more often during the day.


C is the correct answer. As people age, they tend to nap more often during the day. Also, they usually get sleepier earlier in the evening and wake up earlier in the morning. These habits can make it more difficult to get a good night's sleep.

 

Sleep Disorders - Sleep-disordered Breathing

Sleep apnea and snoring are two examples of sleep-disordered breathing -- conditions that make it more difficult to breathe during sleep. When severe, these disorders may cause people to wake up often at night and be drowsy during the day.

SnoringSnoring is a very common condition affecting nearly 40 percent of adults. It is more common among older people and those who are overweight. When severe, snoring not only causes frequent awakenings at night and daytime sleepiness, it can also disrupt a bed partner's sleep.

Image of the anatomy of snoring.Snoring is caused by a partial blockage of the airway passage from the nose and mouth to the lungs. The blockage causes the tissues in these passages to vibrate, leading to the noise produced when someone snores.

Image of the anatomy of sleep apnea.There are two kinds of sleep apnea: obstructive sleep apnea and central sleep apnea. Obstructive sleep apnea occurs when air entering from the nose or mouth is either partially or completely blocked, usually because of obesity or extra tissue in the back of the throat and mouth. If these episodes occur frequently or are severe, they may cause a person to awaken frequently throughout the night. This may disrupt their sleep and make them sleepy during the day.

Central sleep apnea is less common. It occurs when the brain doesn't send the right signals to start the breathing process. Often, both types of sleep apnea occur in the same person.

What Can You Do About Sleep Apnea?Obstructive sleep apnea is more common among older adults and among people who are significantly overweight. Obstructive sleep apnea can increase a person's risk for high blood pressure, strokes, heart disease, and cognitive problems. However, more research is needed to understand the long-term consequences of obstructive sleep apnea in older adults.

Quiz

1. Snoring is more common among

A. older adults and people who are overweight.

B. young adults and people who are underweight.

C. people of normal weight.


A is the correct answer. Snoring is a very common condition affecting nearly 40 percent of adults. It is more common among older people and those who are overweight.

 

2. Snoring is caused by

A. a complete blockage of the airway.

B. a partial blockage of the airway.

C. lower levels of oxygen in the blood.


B is the correct answer. Snoring is caused by a partial blockage of the airway passage from the nose and mouth to the lungs. The blockage causes the tissues in these passages to vibrate, leading to the noise produced when someone snores.

 

3. If you have obstructive sleep apnea, you may

A. have a complete blockage of the airway passage.

B. have lower levels of oxygen in the blood.

C. wake up repeatedly during the night.

D. all of the above


D is the correct answer. If you have obstructive sleep apnea, you may experience complete blockage of your airways and lower levels of oxygen in the blood. You may also wake up frequently during the night.

 

4. In older adults, sleep apnea

A. is extremely rare.

B. has consequences that are more severe than in younger adults.

C. causes daytime sleepiness if severe.


C is the correct answer. When severe, sleep apnea may cause people to wake up often at night and be drowsy during the day.

 

Sleep Disorders - Movement Disorders

Two movement disorders that can make it harder to sleep include restless legs syndrome, or RLS, and periodic limb movement disorder, or PLMD. Both of these conditions cause people to move their limbs when they sleep, leading to poor sleep and daytime drowsiness. Often, both conditions occur in the same person.

Restless legs syndrome is a common condition in older adults and affects more than 20 percent of people 80 years and older. People with RLS experience uncomfortable feelings in their legs such as tingling, crawling, or pins and needles. This often makes it hard for them to fall asleep or stay asleep, and causes them to be sleepy during the day.

Although scientists do not fully understand what causes restless legs syndrome, it has been linked to a variety of conditions. Some of these conditions include iron deficiency, kidney failure and dialysis, pregnancy, and nerve abnormalities.

Periodic limb movement disorder, or PLMD, is a condition that causes people to jerk and kick their legs every 20 to 40 seconds during sleep. As with RLS, PLMD often disrupts sleep -- not only for the patient but the bed partner as well. One study found that roughly 40 percent of older adults have at least a mild form of PLMD.

Another condition that may make it harder to get a good night's sleep is rapid eye movement sleep behavior disorder, also known as REM sleep behavior disorder. It is somewhat more common in men over the age of 50.

REM sleep, or rapid eye movement sleep, is the most active stage of sleep where dreaming often occurs. During normal REM sleep, the eyes move back and forth beneath the eyelids, and muscles cannot move. In more severe forms of REM sleep behavior disorder, the muscles become quite mobile and sufferers often act out their dreams.

Quiz

1. Restless legs syndrome and periodic limb movement disorder are very rare in older adults.

FALSE is the correct answer. Restless legs syndrome is a common condition in older adults and affects more than 20 percent of those 80 and older. Roughly 40 percent of older persons have at least a mild form of periodic limb movement disorder.

2. Scientists understand what causes restless legs syndrome.

FALSE is the correct answer. Scientists do not fully understand what causes restless legs syndrome, but it has been linked to a variety of conditions. Some of these conditions include iron deficiency, kidney failure and dialysis, pregnancy, and nerve problems.

3. Restless legs syndrome and periodic limb movement disorder only affect the person with the condition.

FALSE is the correct answer. Restless legs syndrome and periodic limb movement disorder often disrupt sleep, not only for the patient but the bed partner as well.

4. During REM sleep behavior disorder muscles cannot move.

FALSE is the correct answer. During REM, or rapid eye movement sleep, the body is immobile and unable to move during dreaming episodes. However, in more severe forms of REM sleep behavior disorder, muscles become quite mobile and sufferers often act out their dreams.

 

Diagnosis and Treatment

If you are often tired during the day and don't feel that you sleep well, you should discuss this with your doctor or healthcare provider. Many primary care providers can diagnose sleep disorders and offer suggestions and treatments that can improve your sleep.

Diagnosis and Treatment - Diagnosis

Before you visit the doctor, it may be very helpful for you to ask for and keep a sleep diary for a week or more. A sleep diary will give you and your doctor a picture of your sleep habits and schedules and help determine whether they may be affecting your sleep.

During your appointment your doctor will ask you about your symptoms and may have you fill out questionnaires that measure the severity of your sleep problem. It is also helpful to have your bed partner come with you to your appointment since he or she may be able to report symptoms unknown to you like loud snoring, breathing pauses, or movements during sleep.

Since older people are more likely to take medications and to have medical problems that may affect sleep, it is important for your doctor to be aware of any health condition or medication you are taking. Don't forget to mention over-the-counter medications, coffee or caffeine use, and alcohol since these also may have an impact on your sleep.

The doctor will then perform a physical examination. During the exam the doctor will look for signs of other diseases that may affect sleep, such as Parkinson's disease, stroke, heart disease, or obesity. If your doctor feels more information is needed, he or she may refer you to a sleep center for more testing.

Image of woman undergoing a sleep study.Sleep centers employ physicians and others who are experts in problems that affect sleep. If the sleep specialist needs more information, he or she may ask you to undergo an overnight sleep study, also called a polysomnogram, and/or a sleepiness, or a nap test. A polysomnogram is a test that measures brain waves, heart rate, breathing patterns and body movements.

A common sleepiness test is the multiple sleep latency test. During this test, the person has an opportunity to nap every two hours during the daytime. If the person falls asleep too quickly it may mean that he or she has too much daytime sleepiness.

Quiz

1. Bed partners may report symptoms unknown to the sleeper, such as

A. loud snoring.

B. breathing pauses.

C. unusual movements during sleep.

D. all of the above


D is the correct answer. It is helpful to have your bed partner come with you to your appointment since they may be able to report symptoms unknown to you like loud snoring, breathing pauses, or movements during sleep.

 

2. An overnight sleep study, or polysomnogram, measures

A. heart rate, body movements and brain waves.

B. blood pressure and blood sugar.

C. bone density.


A is the correct answer. A polysomnogram is an overnight test that measures brain waves, heart rate, breathing patterns, blood oxygen, and body movements.

 

3. Which test requires a person to nap several times in one day?

A. a sleep log

B. a multiple sleep latency test

C. a polysomnogram

D. a sleep diary


B is the correct answer. A multiple sleep latency test requires a person to nap several times in one day. During this test, the person is given daytime opportunities to nap every 2 hours. If the person falls asleep too quickly, it may represent excessive daytime sleepiness.

 

4. What things should you be sure to mention when talking with the doctor in a sleep evaluation?

A. caffeine intake

B. over-the-counter and prescription medications

C. medical conditions

D. all of the above.


D is the correct answer. Since older persons are more likely to take medications and have medical problems that may affect sleep, it is important for your doctor to be aware of any medical problems or medications you are taking. Don't forget to mention over-the-counter medications, coffee or caffeine use, and alcohol since these also may adversely affect a person's sleep.

 

Diagnosis and Treatment - Treatment

Based on your sleep evaluation, your doctor or sleep specialist may recommend individual treatment options. It is important to remember that there are effective treatments for most sleep disorders.

If you are diagnosed with a sleep disorder, your doctor may suggest specific treatments. You should ask for information to find out more about your condition and ways to improve your sleep.

There are a number of therapies available to help you fall asleep and stay asleep. You may want to try limiting excessive noise and/or light in your sleep environment. Or, you could limit the time spent in bed while not sleeping, and use bright lights to help with circadian rhythm problems. Circadian rhythm is our 24-hour internal body clock that is affected by sunlight.

Some specialists believe medications also can be useful early in your treatment, and if necessary, you can use them from time to time if you have trouble falling asleep.

People who are diagnosed with sleep apnea should try to lose weight if possible, but often they may need other treatments as well. Adjusting your body position during the night may benefit you if you experience sleep apnea more often when you lie on your back.

What Can You Do About Sleep Apnea?The most effective and popular treatment for sleep apnea is nasal continuous positive airway pressure, or CPAP. This device keeps your air passages open by supplying a steady stream of air pressure through your nose while you sleep.

To use the CPAP, the patient puts on a small mask that fits around the nose. Air pressure is delivered to the mask from a small, quiet air pump that sits at the bedside. The patient not only wears the mask at night but also during naps, since obstructions can occur during these times as well.

If you have a mild case of sleep apnea, sometimes a dental device or appliance can be helpful. If your condition is more severe and you don't tolerate other treatments, your doctor may suggest surgery to increase the airway size in the mouth and throat. One common surgical method removes excess tissue from the back of the throat.

Very often, people who suffer from movement disorders during sleep such as restless legs syndrome or periodic limb movement disorder are successfully treated with the same medications used for Parkinson's disease. People with restless legs syndrome often have low levels of iron in their blood. In such cases doctors often prescribe supplements.

Medications can also treat people with REM behavior disorder. If there are reports of dangerous activities such as hitting or running during these episodes, it may be necessary to make changes to the person's sleeping area to protect sufferers and their bed partners from injury.

Quiz

1. Most sleep disorders can be treated effectively.

TRUE is the correct answer. Although many sleep disorders are not diagnosed, it is important to remember that most sleep problems can be treated effectively.

2. All sleep apnea patients are best treated by changing their body position when they sleep.

FALSE is the correct answer. Changing your body position only helps if you experience sleep apnea more often when you lie on your back.

3. Continuous positive airway pressure, or CPAP, is the most effective treatment for sleep apnea.

TRUE is the correct answer. The most effective and popular treatment for sleep apnea is nasal continuous positive airway pressure, or CPAP. This device creates airway pressure that keeps the airway passages open.

4. Restless legs syndrome is often associated with high levels of iron in the blood.

FALSE is the correct answer. People with restless legs syndrome often have low levels of iron in their blood. In these cases, doctors will often prescribe supplements.

 

 

Sleeping Well

A good night's sleep can make a big difference in how you feel. Here are some suggestions to help you.

  • Image of man sleeping.Follow a regular schedule -- go to sleep and wake up at the same time, even on weekends. Sticking to a regular bedtime and wake time schedule helps keep you in sync with your body's circadian clock, a 24-hour internal rhythm affected by sunlight.
  • Try not to nap too much during the day -- you might be less sleepy at night.
  • Try to exercise at regular times each day. Exercising regularly improves the quality of your nighttime sleep and helps you sleep more soundly. Try to finish your workout at least three hours before bedtime.
  • Try to get some natural light in the afternoon each day.
  • Image of things to avoid in order to promote good sleep.Be careful about what you eat. Don't drink beverages with caffeine late in the day. Caffeine is a stimulant and can keep you awake. Also, if you like a snack before bed, a warm beverage and a few crackers may help.
  • Don't drink alcohol or smoke cigarettes to help you sleep. Even small amounts of alcohol can make it harder to stay asleep. Smoking is dangerous for many reasons, including the hazard of falling asleep with a lit cigarette. Also, the nicotine in cigarettes is a stimulant.
  • Create a safe and comfortable place to sleep. Make sure there are locks on all doors and smoke alarms on each floor. A lamp that's easy to turn on and a phone by your bed may be helpful. The room should be dark, well ventilated, and as quiet as possible.
  • Develop a bedtime routine. Do the same things each night to tell your body that it's time to wind down. Some people watch the evening news, read a book, or soak in a warm bath.
  • Image of a bed.Use your bedroom only for sleeping. After turning off the light, give yourself about 15 minutes to fall asleep. If you are still awake and not drowsy, get out of bed. When you get sleepy, go back to bed.
  • Try not to worry about your sleep. Some people find that playing mental games is helpful. For example, think black -- a black cat on a black velvet pillow on a black corduroy sofa, etc. Or, tell yourself it's five minutes before you have to get up and you're just trying to get a few extra winks.
  • If you are so tired during the day that you cannot function normally and if this lasts for more than 2 to 3 weeks, you should see your family doctor or a sleep disorders specialist.

Quiz

1. Going to sleep and waking up at the same time each day helps you sleep more soundly.

TRUE is the correct answer. It is important to follow a regular bedtime and wake time schedule. Try to go to sleep and get up at the same time, even on weekends. This helps keep you in sync with your body's circadian clock, a 24-hour internal rhythm affected by sunlight.

2. If you find that you cannot get to sleep after lying in bed more than 15 minutes, you should continue to lie there until you fall asleep.

FALSE is the correct answer. After turning off the light, give yourself about 15 minutes to fall asleep. If you are still awake and not drowsy, get out of bed. When you get sleepy, go back to bed.

3. Regular physical exercise can help you sleep better.

TRUE is the correct answer. Exercising regularly improves the quality of your nighttime sleep and helps you sleep more soundly. Try to finish your workout at least three hours before bedtime.

4. Drinking alcohol before bedtime is a good way to help you fall asleep.

FALSE is the correct answer. Don't drink alcohol to help you sleep. Even small amounts of alcohol can make it harder to stay asleep.

 

 

Frequently Asked Questions

 

1. Do older adults need as much sleep as younger people?

Amount of sleep needed by different age groups.Sleep needs change over a person's lifetime. Children and adolescents need more sleep than adults. Interestingly, older adults need about the same amount of sleep as younger adults -- seven to nine hours of sleep per night.

2. What are the consequences of poor sleep for older adults?

Older adults who have poor nighttime sleep are more likely to have attention and memory problems, a depressed mood, excessive daytime sleepiness, more nighttime falls, and use more over-the-counter or prescription sleep aids. Poor sleep is also associated with a poorer quality of life.

3. I have trouble falling asleep at night. Is that just a normal part of aging?

Many people believe that poor sleep is a normal part of aging, but it is not. In fact, many healthy older adults report few or no sleep problems. Sleep patterns change as we age, but disturbed sleep and waking up tired every day are not part of normal aging.

4. What is the most common reason older adults wake up at night?

The most common reason older adults wake up at night is to go to the bathroom. Prostate enlargement in men and continence problems in women are often the cause. Unfortunately, waking up to go to the bathroom at night also places older adults at greater risk for falling.

5. As I get older, why do I tend to become tired earlier in the evening?

As people age, their sleeping and waking patterns tend to change. Older adults usually become sleepier earlier in the evening and wake up earlier in the morning. If they don't adjust their bedtimes to these changes, they may have difficulty falling and staying asleep.

6. Do older adults get enough sleep?

Unfortunately, many older adults often get less sleep then they need. One reason is that they often have more trouble falling asleep. A study of adults over 65 found that 13 percent of men and 36 percent of women take more than 30 minutes to fall asleep.

7. How many types of sleep are there?

There are two types of sleep: non-rapid eye movement -- or NREM sleep -- and rapid eye movement -- or REM sleep. NREM sleep has four stages ranging from light to deep sleep. We cycle through these four stages of sleep approximately every 90 minutes. Then we go into REM sleep, the most active stage of sleep when dreaming often occurs. During REM sleep, the eyes move back and forth beneath the eyelids and muscles become immobile.

8. What are the most common sleep disorders among older adults?

Chart with sleep problems that occur by age.The most common sleep disorders among older adults are insomnia, sleep-disordered breathing, such as snoring and sleep apnea, as well as movement disorders like restless legs syndrome.

9. What are the symptoms of insomnia?

If you have insomnia, you may experience any one or any combination of the following symptoms.

  • taking a long time -- more than 30 to 45 minutes -- to fall asleep
  • waking up many times each night
  • waking up early and being unable to get back to sleep
  • waking up feeling tired

10. What are some suggestions for getting a good night's sleep?

Image of man sleeping.A good night's sleep can make a big difference in how you feel. Here are some suggestions to help you.

  • Follow a regular schedule -- go to sleep and wake up at the same time, even on weekends.
  • Try not to nap too much during the day -- you might be less sleepy at night.
  • Try to exercise at regular times each day. If possible, finish your workout at least three hours before bedtime.
  • Try to get some natural light in the afternoon each day.
  • Don't drink beverages with caffeine late in the day. Caffeine is a stimulant and can keep you awake.
  • Don't drink alcohol to help you sleep. Even small amounts of alcohol can make it harder to stay asleep.
  • Don't smoke to help you sleep. Smoking is dangerous for many reasons, including the hazard of falling asleep with a lit cigarette. Also, the nicotine in cigarettes is a stimulant.
  • Create a safe and comfortable place to sleep. The room should be dark, well ventilated, and as quiet as possible.
  • Develop a bedtime routine. Do the same things each night to tell your body that it's time to wind down. Some people watch the evening news, read a book, or soak in a warm bath.
  • After turning off the light, give yourself about 15 minutes to fall asleep. If you are still awake and not drowsy, get out of bed. When you get sleepy, go back to bed.

11. What causes a person to snore?

SnoringSnoring is caused by a partial obstruction, or blockage, of the airway passage from the nose and mouth to the lungs. The blockage causes the tissues in these passages to vibrate, leading to the noise produced when someone snores.

12. What is obstructive sleep apnea?

Diagram of the anatomy of sleep apnea.Obstructive sleep apnea occurs when air entering from the nose or mouth is either partially or completely blocked, usually because of obesity or extra tissue in the back of the throat and mouth. If these episodes occur frequently or are severe, they may cause a person to wake up frequently throughout the night. This may disrupt their sleep and make them sleepy during the day.

What Can You Do About Sleep Apnea?Obstructive sleep apnea is more common among older adults and among people who are significantly overweight. Obstructive sleep apnea can increase a person's risk for high blood pressure, strokes, heart disease, and cognitive problems. However, more research is needed to understand the long-term consequences of obstructive sleep apnea in older adults.

13. What is central sleep apnea?

Central sleep apnea occurs when the brain doesn't send the right signals to start the breathing process. It is less common than obstructive sleep apnea. Often, both types of sleep apnea occur in the same person.

14. How is sleep apnea usually treated?

What Can You Do About Sleep Apnea?The most effective and popular treatment for sleep apnea is nasal continuous positive airway pressure or CPAP. This device creates airway pressure that keeps the airway passages open.

To use the CPAP, the patient puts on a small mask that fits around the nose. Air pressure is delivered to the mask from a small, quiet air pump that sits at the bedside. The patient not only wears the mask at night but also during naps, since obstructions can occur during these times as well.

15. Are there other treatments for sleep apnea?

People who are diagnosed with sleep apnea should try to lose weight if possible. Also, adjusting your body position during the night may benefit you if you experience sleep apnea more often when you lie on your back.

If you have a mild case of sleep apnea, sometimes a dental device or appliance can be helpful. If your condition is more severe and you don't tolerate other treatments, your doctor may suggest surgery to increase the airway size in the mouth and throat. One common surgical method removes excess tissue from the back of the throat.

16. What are movement disorders and how do they affect sleep?

Movement disorders cause people to move their limbs when they sleep, leading to poor sleep and daytime drowsiness. These disorders include restless legs syndrome, or RLS, periodic limb movement disorder, or PLMD, and REM sleep behavior disorder. Often, restless legs syndrome and periodic limb movement disorder occur in the same person.

17. What are the symptoms of periodic limb movement disorder?

Periodic limb movement disorder, or PLMD, is a condition that causes people to jerk and kick their legs every 20 to 40 seconds during sleep. PLMD often disrupts sleep -- not only for the patient but the bed partner as well. One study found that roughly 40 percent of older adults have at least a mild form of PLMD.

18. What are the symptoms of restless legs syndrome?

People with RLS experience uncomfortable feelings in their legs such as tingling, crawling, or pins and needles. This often makes it hard for them to fall asleep or stay asleep, and causes them to be sleepy during the day.

19. What is REM sleep behavior disorder?

Another condition that may make it harder to get a good night's sleep is rapid eye movement sleep behavior disorder, also known as REM sleep behavior disorder. It is somewhat more common in men over the age of 50.

REM sleep, or rapid eye movement sleep, is the most active stage of sleep when dreaming often occurs. During normal REM sleep, the eyes move back and forth beneath the eyelids, and muscles cannot move. In more severe forms of REM sleep behavior disorder, the muscles become quite mobile and sufferers often act out their dreams.

20. How are movement disorders treated?

Very often, people who suffer from movement disorders during sleep such as restless legs syndrome or periodic limb movement disorder are successfully treated with the same medications used for Parkinson's disease. People with restless legs syndrome often have low levels of iron in their blood. In such cases doctors often prescribe supplements.

Medications can also treat people with REM sleep behavior disorder. If there are reports of dangerous activities such as hitting or running during these episodes, it may be necessary to make changes to the person's sleeping area to protect sufferers and their bed partners from injury.

21. At what point should I see a doctor about a sleeping problem?

If you are often tired during the day and don't feel that you sleep well, you should discuss this with your doctor or healthcare provider. Many primary care providers can diagnose sleep disorders and offer suggestions and treatments that can improve your sleep.

22. What can I expect during my visit to the doctor?

During your appointment, your doctor will ask you about your symptoms and may have you fill out questionnaires that measure the severity of your sleep problem. It is also helpful to have your bed partner come with you to your appointment since he or she may be able to report symptoms unknown to you like loud snoring, breathing pauses, or movements during sleep.

Since older people are more likely to take medications and to have medical problems that may affect sleep, it is important for your doctor to know about all of your health conditions and medicines. Don't forget to mention over-the-counter medications, coffee or caffeine use, and alcohol since these may also have an impact on your sleep.

The doctor will then perform a physical examination. During the exam the doctor will look for signs of other diseases that may affect sleep, such as Parkinson's disease, stroke, heart disease, or obesity. If your doctor feels more information is needed, he or she may refer you to a sleep center for more testing.

23. How does a sleep center diagnose sleep problems?

Image of woman undergoing a sleep study.Sleep centers employ physicians and others who are experts in problems that affect sleep. If the sleep specialist needs more information, he or she may ask you to undergo an overnight sleep study, also called a polysomnogram, and/or a sleepiness, or a nap test. A polysomnogram measures brain waves, heart rate, breathing patterns, and body movements.

A common sleepiness test is the multiple sleep latency test. During this test, the person has an opportunity to nap every 2 hours during the daytime. If the person falls asleep too quickly it may mean that he or she has too much daytime sleepiness.

Internet Citation: http://nihseniorhealth.gov/sleepandaging/aboutsleep/01.html

 

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