Sleep Health for the Older Adult

Created by: Christine Foster

Objective: What do I need to know?

Sleep is critical to your health and well-being!

Most adults need 7–9 hours of sleep each night according to the Centers of Disease Control and Prevention.

However, 50% of individuals aged 65 and older report poor sleeping patterns. Many disturbances of sleep result due to a link with depression, functional impairment, cognitive decline, and lower quality of life (Pa 2014).

Sleep is a necessity not only for renewing energy but also for fighting infection, controlling metabolism, and giving you the energy to work effectively and safely with the Activities of Daily Living (ADLs). Without an adequate sleep pattern, you can become at risk for many sleep disorders and chronic diseases such as heart disease, high blood pressure, obesity, and diabetes (Healthy People 2020).

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Assessment: What should I know more about?

Sleep-Disordered Breathing (SDB)

- It is characterized by intermittent airway obstruction or pauses in breathing.

- Those untreated can have a 2-4x risk of a heart attack or stroke.

- Affects 20-40% of older adults with an increase of mortality if left untreated.

(Tarasiuk 2008)

Obstructive Sleep Apnea (OSA)

- It affects 30-80% of the older adult population.

- Seen with an increased risk of cardiovascular disease (CVD).

- Patients are more likely to have been diagnosed with CVD and hyperlipidemia.

(Tarasiuk 2008)

Insomnia

- The inability to initiate or maintain sleep.

- May take the form of waking up several hours earlier and then marked by excessive daytime sleepiness.

(CDC)

Narcolepsy

- Excessive daytime sleepiness marked by sudden muscle weakness.

- Episodes describes as "sleep attacks."

(CDC)

Restless Leg Syndrome

- Characterized by an unpleasant creeping sensation in the legs with aches and pains.

- Relieved by moving the legs such as walking or kicking.

- Associated with abnormalities of the neurotransmitter called dopamine.

(CDC)

Overcoming Barriers: What can I do?

There are sleep aids out on the market for consumer use, however, there are significant side effects and risk of falls related to these medications and are not typical for long-term use.

The non-pharmacological route of improving sleep lies within exercise, Cognitive- Behavioral Therapy (CBT), and lifestyle interventions. According to Effect of Exercise and Cognitive Activity on Self-Reported Sleep Quality in Community-Dwelling Older Adults with Cognitive Complaints: A Randomized Controlled Trial, those who participated in low-intensity physical and mental activities reported a significantly improved quality in sleep. Other methods to improving sleep include sleep restrictions, mindfulness relaxation, and stimulus control therapy (Pa 2014).

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Motivation: How will this help me?

Exercise is known to improve not only cardiovascular health but also physical functional abilities related to Activities of Daily Living (ADLs), better moods, and benefits in improving sleep patterns. Cognitive-Behavioral Therapy can improve sleep-related features such as sleep latency, sleep duration, and waking time (Pa 2014).
Impact of Sleep on Health Video -- Brigham and Women's Hospital

Action Steps: How can I take action?

Join your local gym! Take a walk in the park. Find a yoga studio. Meditate on a daily basis.


Good sleep practices are important for achieving healthy sleep!


Sleep hygiene tips according to the Centers for Disease Control (CDC):

  • Go to bed at the same time each night and rise at the same time each morning.
  • Moderate physical activity may help promote sleep, but avoid vigorous exercise in the few hours before going to bed.
  • Avoid large meals before bedtime.
  • Avoid caffeine and alcohol close to bedtime.
  • Avoid nicotine.


The sleep environment according to the CDC:

  • Your bedroom should be a quiet, dark, and relaxing environment, that is neither too hot nor too cold.
  • Remove all TVs, computers, and other "gadgets" from the bedroom.
  • Your bed should be comfortable and used only for sleeping and not for other activities, such as reading, watching TV, or listening to music.

Community Resources: Where can I go for help?

Mercy Health Sleep Centers

- "Our board-certified physicians and credentialed technologists have many years of experience in the field of sleep medicine and are highly trained in the diagnosis and treatment of sleep disorders."

- http://www.e-mercy.com/sleep-center.aspx


Tri-Health Sleep Centers

- "We are accredited by the American Academy of Sleep Medicine and are staffed with board-certified sleep doctors who will collaborate with you to assess and treat your individual sleeping problems."

- http://www.trihealth.com/institutes-and-services/sleep-centers/


UC Health Sleep Medicine

- "As a comprehensive care center, our physicians work together across many disciplines to diagnose and treat a variety of sleep disorders."

- http://uchealth.com/services/sleep-medicine/


The Christ Hospital Sleep Disorder Treatment

- "If you are suffering from a sleep disorder such as sleep apnea, it’s time to explore treatment options and find more energy, improved health and a better quality of life."

- https://www.thechristhospital.com/services/heart/sleep



Visit these websites below for more in depth information and tips about healthy sleep habits:

https://sleep.org/

http://www.sleepeducation.org/healthysleep/seven-and-up-healthy-sleep-duration

http://www.sleepapnea.org/do-i-have-sleep-apnea.html

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Sources


About Sleep. Centers for Disease Control and Prevention. (2015). Retrieved February 09, 2016, from http://www.cdc.gov/sleep/about_sleep/index.html


Impact of Sleep on Health Video -- Brigham and Women's Hospital. (n.d.). Retrieved February 08, 2016, from https://www.youtube.com/watch?v=VY76T7jQ9pE


Pa, J., Goodson, W., Bloch, A., King, A. C., Yaffe, K., & Barnes, D. E. (2014). Effect of Exercise and Cognitive Activity on Self-Reported Sleep Quality in Community-Dwelling Older Adults with Cognitive Complaints: A Randomized Controlled Trial. Journal Of The American Geriatrics Society, 62(12), 2319-2326 8p. doi:10.1111/jgs.13158


Sleep Health. Office of Disease Prevention and Health Promotion. (n.d.). Retrieved February 08, 2016, from http://www.healthypeople.gov/2020/topics-objectives/topic/sleep-health


Tarasiuk, A., Greenberg-Dotan, S., Simon-Tuval, T., Oksenberg, A., & Reuveni, H. (2008). The effect of obstructive sleep apnea on morbidity and health care utilization of middle-aged and older adults. Journal Of The American Geriatrics Society, 56(2), 247-254 8p. doi:10.1111/j.1532-5415.2007.01544.x