Sleep Disorders

Number of people affected:
Ten million

Who gets it:
People of any age can have sleep disorders.

Symptoms:
Trouble falling asleep or staying asleep, pauses in breathing, snoring, tingling or jerking in legs

Treatments:
Medication, C-PAP machine, dental device, surgery, sleep techniques

Doctors to see:
Pulmonologist, Neurologist, Geriatric Psychiatrist

Common sleep disorders among the elderly include:

Insomnia. Insomnia is the most common sleep problem in adults age 60 and older. People with insomnia have trouble falling and staying asleep. Insomnia can last for days, months or even years.

Sleep Apnea. A person with sleep apnea pauses in his or her breathing while sleeping. These pauses may happen many times during the night. Waking up over and over each night makes you feel very tired the next day. If not treated, sleep apnea can lead to other problems such as high blood pressure, stroke, or memory loss.

Movement Disorders. Restless legs syndrome and periodic limb movement disorder are common in older adults. Some people have both problems. These movement disorders can rob seniors of needed sleep. People with restless legs syndrome, or RLS, feel tingling, crawling, or pins and needles in one or both legs. It’s worse at night.

Insomnia - People with insomnia have trouble falling asleep, have trouble staying asleep, or awakening frequently or lie awake in the middle of the night.

Sleep apnea - People suffering from sleep apnea snore loudly, gasp for air, temporarily stop breathing and awake with headaches or sore throats.

Restless leg syndrome - Tingling, crawling, pins and needles in one or both legs, or an overwhelming urge to move. Related to restless leg syndrome is Periodic Limb Movement Disorder, or PLMD, which causes people to jerk and kick their legs every 20 to 40 seconds during sleep.

Some common tests are:

Epworth Sleepiness Scale - Answers to this sleep questionnaire assist doctors in providing a formal diagnosis.

Overnight sleep study - Sleep centers use the latest technology to monitor your loved one while he/she sleeps. A variety of monitoring devices is connected to the body at bedtime. Sleep specialists observe sleep patterns, monitor brain waves, check heart rate, record rapid eye movements, and more.

Multiple Sleep Latency Test (MSLT) - The test measures how long it takes to fall asleep during the day and the quality of the nap. Sleep specialists analyze brain waves (EEG), heart rate (EKG), muscle activity, and eye movements.

Repeated test of sustained wakefulness (RTSW) - This test measures how long it takes to fall asleep in a situation that challenges you to stay awake. During the test, the patient is placed in a quiet room with dim lighting, told to close their eyes, and asked to stay awake.

Blood test - A blood test can determine the possibility and probability of certain sleep disorders.

Treatments include:

Insomnia - Sleep Restriction therapy reduces the amount of non-sleeping time a person spends in bed to strengthen the connection of the bed with sleep. In addition, learning to be physically and mentally relaxed before going to bed will help your loved one fall asleep more quickly.

Sleep Apnea - Treatment may include learning to sleep in a way that keeps airways open. Sometimes a medical device called Continuous Positive Air Pressure (CPAP), a dental device, or surgery can help.

RLS - Common treatments include medication, warm baths, exercise, and learning to relax. For those with severe RLS, where the disorder disrupts sleep or daily activities, medications may be the proper treatment approach. Lastly, if Restless Legs Syndrome is caused by an underlying condition, a doctor can treat that condition.

Causes and risk factors of sleep apnea include:

• Shape of head and neck may create a smaller than normal airway
• Large tonsils or adenoids, or a deviated septum, enlarged tongue, or receding chin
• Being overweight or obese
• Throat muscles and tongue relax more than normal during sleep
• Snoring can cause the soft palate to lengthen, which in turn can obstruct the airway
• Smoking or exposure to secondhand smoke
• Nasal congestion, nasal blockages, and nasal irritants
• Family history of sleep apnea
• Other disorders and syndromes including hypothyroidism, acromegaly, amyloidosis, vocal cord paralysis, post-polio syndrome, neuromuscular disorders, Marfan's syndrome, and Down Syndrome

Causes of insomnia include:

• Mental barriers, such as stress or poor mental attitude about sleep
• Food, alcohol and supplements, such as caffeine, nicotine, alcohol and herbal supplements that boost energy
• Drugs, including prescription medications, and over-the-counter sleeping pills
• Poor sleep hygiene, including shift work, naps and eating too close to bedtime
• Sleep environment, such as noise, light, room temperature, comfort and size of bed, disruptive sleep partner or family members
• Medical and physical obstacles, such as pain, depression, anxiety, menstruation, pregnancy, menopause and ADD/ADHD

Causes of RLS include:

• A central nervous system disorder
• Genetics or family history
• Psychiatric conditions or stress
• An underlying medical problem, such as diabetes mellitus, kidney disease, Parkinson’s Disease, or rheumatoid arthritis
• Iron deficiency anemia
• Neurologic lesions, spinal cord tumors, peripheral nerve lesions, or spinal cord injury
• Medications including tricyclic antidepressants, anti-nausea and anti-seizure drugs, selective serotonin reuptake inhibitors (SSRIs), lithium, and some cold and allergy drugs may increase or trigger RLS symptoms.
• Varicose veins
• Thyroid problems
• Trouble with the nerves in the hands or feet

There are many things you can do to help your loved one get a good night's sleep.

• Follow a regular schedule. Go to sleep and get up at the same time each day, even on weekends. Napping in the late afternoon or evening may keep them awake at night.
• Develop a bedtime routine. About 30 to 45 minutes before bedtime each night, do the same things so the body will know that it’s time to sleep. Some people watch television, read a book, listen to soothing music, or soak in a warm bath.
• The bedroom should be dark, not too hot or too cold, and as quiet as possible.
• Get a comfortable mattress, a pillow they like, and enough blankets for the season.
• Exercise at regular times each day but not within 3 hours of bedtime.
• Make an effort to get outside in the sunlight each day.
• Be careful about when and how much your loved one eats. Large meals close to bedtime may keep them awake, but a light snack in the evening can help them sleep.
• Stay away from caffeine late in the day. Caffeine (found in coffee, tea, cola, and hot chocolate) is a stimulant that can keep you awake.
• Drink less liquid in the evening. Waking up to go to the bathroom and turning on a bright light breaks up sleep.
• Avoid alcohol. Even small amounts make it harder to stay asleep.
• Use the bedroom only for sleeping.