According to the American Psychiatric Association, sleep disorders are major disturbances of normal sleep patterns that lead to distress and disrupt functioning during the day. Not only are sleep disorders extremely common, affecting virtually everyone at some point in their lives, but they can also lead to serious stress and other health consequences.
Sleep needs change with age, and sleeping problems generally increase with aging. Sleep disorders and sleeping difficulties are among the most pervasive and poorly addressed problems of aging. Primary sleep disorders can be associated with significant medical, psychological, and social disturbances.
Sleep disturbances in the elderly can lead to changes in the physiological systems, such as a reduction in the production of appropriate hormones, like the growth hormones, and also a decline in the metabolic functioning.
Most people accept sleep difficulties as a fact of the aging process. Most often sleep problems in the elderly are due to disease, environment, or lifestyle and not due to the “the normal aging” process.
Irrespective of age, it remains essential to get the proper amount of restorative sleep for a person’s physical health and emotional well-being.
Sleep is as important to well-being as food and water. Getting enough sleep can have a significant impact on daily function, alertness, and overall quality of life. Adults need 7 to 8.4 hours of sleep a night to carry out normal physiologic processes each day. Aging is associated with a decrease in the quality of nighttime sleep, and 30% of aged persons may experience chronic insomnia. Age-related insomnia has been linked to changes in the strength of the circadian regulation of sleep, which leads to increased fragmentation of the sleep-wake cycle
Insomnia is by far the most common sleep disorder, affecting nearly 60 percent of the US adults at least one night each week. Common symptoms of insomnia include difficulty getting to sleep and waking before it is time to get up. There are many factors that can contribute to insomnia including stress and underlying medical conditions. Typical treatments include sleeping pills and behavior therapy. Practicing good sleep habits can often be effective for treating mild cases of insomnia.
Certain antidepressants may be used to treat insomnia in geriatric patients. If the patient has coexisting depression, that disorder should be addressed with the appropriate antidepressant drug. Antidepressants as hypnotics are not typically a first-choice treatment regimen, as these drugs may cause significant daytime sleepiness and postural hypo-tension, among other adverse reactions. For sleep disorders, this category of drugs may be helpful in older adults who have not had success with other measures, have a history of substance abuse, or have insomnia resulting from antidepressants that cause central nervous system stimulation. In this class, atypical antidepressants include trazodone (Desyrel) and nefazodone (Serzone), as well as tricyclic antidepressants such as amitriptyline and nortriptyline (Aventyl). These drugs may be prescribed as adjunct agents to the other “daytime” antidepressant the individual is already taking. As a result, adverse reactions and drug interactions can be numerous, and it is necessary to take a careful health and drug history prior to prescribing any sleep agents for elderly patients.