Sleep Disorders In Older Adults Research Articles

Sleep quality and sex-related differences in an older adult population: a web-based cross-sectional study

Introduction: Aging has significant economic and social implications leading to an increase in chronic diseases and reduced autonomy of the elderly. Sleep disorders are common in the elderly, manifesting reduced sleep quality. Objective/Purpose: The study aimed to measure the prevalence of sleep disorders in older adults and assess sex differences in sleep quality and sleep problems. Method: A cross-sectional study based on an online survey was performed according to the STROBE checklist, using pre-validated questionnaires (Pittsburgh Sleep Quality Index) distributed to a sample of older adults. This is the first study evaluating sex differences in sleep quality and problems in the Italian population context using the Pittsburgh Sleep Quality Index assessment tool. The study was conducted in a university hospital in Rome from October 2020 to November 2020, on patients aged >65 years, independent in activities of daily living, with comorbidities and on treatment with up to 2 medications. Results: 59 patients were included in the study, with an average age of 71.12 years. The results show that among males, the prevalence of poor sleep quality was 51.9%, while among females, the prevalence of poor sleep quality was 62.5%. According to Shapiro-Wilk, the Pittsburgh Sleep Quality Index was not normally distributed. Pittsburgh Sleep Quality Index total scores in males did not differ significantly from females. Conclusions: Considering scientific literature, recent studies have highlighted the prevalence of sleep disorders in the elderly population and their underreporting. Providing early intervention not only improves the sleep quality of these people but may also reduce the risk of experiencing adverse health outcomes and susceptibility to frailty.

A Risk Correlative Model for Sleep Disorders in Chinese Older Adults Based on Blood Micronutrient Levels: A Matched Case-Control Study.

The physical abilities of older adults decline with age, making them more susceptible to micronutrient deficiency, which may affect their sleep quality. This study aimed to construct a risk correlative model for sleep disorders in Chinese older adults based on blood micronutrient levels. In this matched case-control study, we recruited 124 participants with sleep disorders and 124 matched controls from the Tianjin Elderly Nutrition and Cognition cohort in China. Micronutrient levels in whole blood were measured using the dried blood spot technique. We compared the differences in micronutrient levels between the two groups and also constructed a receiver operating characteristic (ROC) model and nomogram for sleep disorders. In comparison to the control group, the sleep disorders group showed lower levels of blood vitamin A, vitamin E (VE), folate, magnesium, copper, iron, and selenium (Se) in the univariate analysis (p < 0.05). The ROC curve analysis indicated that the combination of VE + folate + Se may have an excellent diagnostic effect on sleep disorders, with an area under the curve of 0.964. This VE + folate + Se was integrated into a nomogram model to demonstrate their relationship with sleep disorders. The consistency index of the model was 0.88, suggesting that the model assessed sleep disorders well. The sleep disorders risk correlative model constructed by the levels of VE, folate, and Se in whole blood might show good performance in assessing the risk of sleep disorders in older adults.

Bridging Gaps in Sleep Health and Dementia: Linking Sleep Disorders and Neurocognitive Health

There is growing evidence of a bidirectional relationship between sleep disturbances and disorders and cognitive function in normal and pathological aging. Not only do sleep disturbances and disorders predict and contribute to a decline in neurocognitive function, but neurodegenerative disorders impair sleep. Furthermore, sleep and rhythm disturbances may be some of the earliest symptoms of neurodegenerative disorders such as MCI, AD, and Parkinson's disease. However, the potential effects of improving sleep on mitigating decline in cognitive function are still unknown. While some of the classes of pharmaceutical agents may improve subjective sleep, they have variable effects on sleep oscillations and cognition. The effects of other approaches, such as cognitive behavioral therapy and neuromodulation, on neurodegenerative processes are not yet fully understood.The goal of this session and panel is to educate participants about changes in sleep patterns and sleep oscillations that occur in aging and neurodegenerative disorders, mechanisms for associations between poor sleep and sleep disorders and cognitive decline and contribution to dementia, and the potential benefits of identifying and treating sleep disorders in older adults who may be at risk of developing dementia. In addition, the discussion will highlight the lack of standardized care pathways for diagnosing and treating sleep problems in older adults.

Progress in the causes of sleep disorders during the early-stage Alzheimer’s disease

The most prevalent chronic disease among senior people, and its prevalence rises with age, is Alzheimer’s disease (AD). One study predicts that the prevalence of dementia will triple globally by 2050. Sleep disorder (sleep disturbance) is a condition that also often occurs in the elderly population. More than about 25%~60% of AD patients have sleep disturbances or circadian rhythm changes. But the sleep disorders during the early stage of AD have not been uniformly recognized. Of the stages of AD, those experiencing the early stage have the most patients. Therefore, this paper summarises the conditions and types of sleep disorders in the first stage of AD, and the articles of sleep disorders of that time lesions are retrieved and analysed. This paper also deals with two pathological mechanisms during early AD: beta amyloid (Aβ) accumulation and tau protein entanglement. By describing the effects of two western drugs and a Chinese herbal medicine, this paper shows that sleep disorders in older adults may suggest mild cognitive impairment and that more attention needs to be paid to what current research suggests. Early AD lesions can lead to sleep disorders and the search for more accurate biomarkers will be a major driver in the development of diagnostics that may delay AD onset.

Relationship between metabolic syndrome, sleep quality and cognitive impairment

AbstractBackgroundMetabolic syndrome is a risk factor for cardiovascular diseases, which have been related to cognitive impairment and Alzheimer disease. Sleep disorders in older adults have a negative impact on cognitive performance. However, a link between metabolic syndrome, sleep, and cognitive decline has not been established.MethodA retrospective cross‐sectional study was carried out. Information was collected from clinical histories about demographic, metabolic parameters, sleep diaries, neurocognitive evaluation and neuroimaging studies. For statistical analyses, chi‐square tests of association were included for categorical variables (age, sex, educational level, social economy status (SES), hypertension, diabetes, BMI, depression, anxiety, smoking, sedentary lifestyle) for each memory problem. A binary logistic regression model was used to predict the probabilities of memory problems. Which was built including each variable independently.ResultsThe logistic regression revealed that women and low educational level were associated with increased memory difficulties over time (odds ratio [OR] = 5.3, p &lt; 0.001). Depression was associated with increased odds of memory problems (OR = 3.8, p &lt;0.001). When the sleep quality variable was added, it was observed that the poor sleep quality partially reduced the impact of age, gender, and depression on memory. However, all continued to present an OR greater than 1. Of the medical conditions, type 2 diabetes and hypertension showed a significant interaction (OR = 1.7, p &lt; 0.001).ConclusionWe believe that there is an association between metabolic state, sleep quality and cognitive impairment. in such a way that those with metabolic disorders and poor sleep quality have decreased cognitive performance.

Current Insights into the Risks of Using Melatonin as a Treatment for Sleep Disorders in Older Adults.

Exogenous melatonin is commonly used for sleep disorders in older adults, and its use is increasing over time. It appears to have modest efficacy in treating insomnia and circadian rhythm sleep-wake disorders. Melatonin is commonly perceived to be a safe alternative to other hypnotics and is available without prescription in some jurisdictions. New evidence suggests that endogenous melatonin has pleomorphic effects on multiple organ systems, many of which are poorly understood. This narrative review summarizes the current evidence regarding the safety of melatonin in older adults (defined by age over 65 years). Melatonin appears to have a favorable safety profile in this population, however there is a dearth of evidence regarding the safety of prolonged use. There are several factors which increase the risk of adverse effects of melatonin in older adults, and these should be taken into consideration when prescribing to this population.

Common Sleep Disorders Affecting Older Adults.

Sleep disorders in older adults increase with aging, likely due to increased sleep latency, decreased sleep efficiency, and total sleep time. Common sleep issues include chronic insomnia, circadian rhythm sleep-wake disorders, sleep-related movement disorders, and sleep-disordered breathing. Diagnostic tools, such as a comprehensive sleep history and questionnaires, or a sleep log for more specific complaints, are commonly used. Polysomnography is not recommended as a routine test; however, it can be used for abnormal behaviors during sleep or if treatment fails. Sleep disorder management is based on the etiology and may include nonpharmacological and pharmacological alternative treatments. For example, nonpharmacological management for chronic insomnia and some sleep disorders may consist of cognitive behavioral therapy, sleep hygiene education, relaxation therapy, sleep restriction, light therapy, and stimulus control therapy. Because the quality of evidence for pharmacological treatment is poor, the medication choice should be based on shared decision-making between the practitioner and the patient, with limited prescription.

Changes in Sleep Disorders in Older Adults produced by the COVID-19 Pandemic

Changes in Sleep Disorders in Older Adults produced by the COVID-19 Pandemic

Morbidities Worsening Index to Sleep in the Older Adults During COVID-19: Potential Moderators.

Older adults were considered a vulnerable group for the COVID-19 infection and its consequences, including problems with sleep.AimTo evaluate the prevalence of sleep disorders in older adults, to describe their sleep patterns, as well as to analyse if there were any changes in comparison with the period pre-pandemic.Materials and MethodsOnline survey used for data collection received answers from 914 elderly age range 65–90 years, from April to August 2020. Results: 71% of the sample reported a pre-existent sleep disorder, and some of them worsened during the pandemic, especially Insomnia in women and Obstructive Sleep Apnea in men. No difference in sleep duration before and during the pandemic was found, although there was a worsening of some aspects related to sleep, such as sleep quality, sleep efficiency, awakening quality, sleep latency and nocturnal awakenings, especially in the female gender. Educational level influenced sleep latency, indicating higher sleep latency among those with primary education when compared with the ones with Ph.D.ConclusionThe pandemic had influenced sleep patterns among the elderly, as well as worsening of pre-existent sleep disorders. Female gender and low educational level were considered risk factors for sleep alterations, and high educational level, on its turn, appeared to be a protective factor.

Evaluation of the Clinical Effects of Insomnia and Excessive Daytime Sleepiness in Older Adults

Background: Insomnia and excessive daytime sleepiness (EDS) are common sleep disorders in older adults. Both are associated with numerous adverse health conditions. Objectives: The aim of our study is to evaluate the effects of insomnia and/or EDS on functionality, gait-balance functions, cognition, mood, falls and fear of falling (FoF) in older adults, to determine its importance in terms of nursing practice and to raise awareness on the subject. Methods: A cross-sectional study design was used. A total of 661 outpatients were included, aged ≥ 65 years. All patients underwent comprehensive geriatric assessment. Comorbidities, falls in the last year and drugs used were recorded. The Falls Efficacy Scale–International (FES-I) was used to determine and classify FoF. MMSE was applied to all patients for neurocognitive evaluation. Activities of daily living were assessed by Basic Activities of Daily Living Scale (BADL) and Instrumental Activities of Daily Living (IADL) scales. Insomnia Severity Index (ISI) with scores of 8 and over indicated insomnia. The Epworth Sleepiness Scale score of ≥ 11 points indicated EDS. Results: The mean age was 77.78 ± 7.73 years. The prevalences of EDS, insomnia, and EDS+insomnia were 5.45%, 50.38%, and 12.56%, respectively. As a result of bivariate and multivariate logistic regression analysis, there was a significant relationship between EDS+insomnia with moderate and high FoF (OR=2.24, 95% CI: 1.74 to 2.89), polypharmacy (OR=1.20, 95% CI: 1.09 to 1.30), BADL (OR=0.94, 95% CI: 0.93 to 0.96) ), IADL (OR=0.87, 95% CI: 0.84 to 0.91) and MMSE (OR=0.91, 95% CI: 0.86 to 0.98) (p&amp;lt;.05). Conclusions: There is a close relationship between EDS+insomnia and FoF, polypharmacy, activities of daily living and cognition in older adults.

Sleep disorders in older adults

Early treatment of these complex disorders can greatly improve patients’ quality of life.

Prevalence of sleep disorders, daytime sleepiness and clinical symptomatology in older adults

IntroductionWith ageing, changes occur that affect the quality and quantity of sleep. These changes could cause sleep disorders in older adults, causing severe consequences for health and quality of life. However, in Mexico there are no studies addressing the prevalence of sleep disorders in older adults. ObjectiveTo determine the prevalence of sleep disorders, daytime sleepiness and clinical symptomatology in older adults seen at the UNAM Sleep Disorder Clinic in the General Hospital of México. Materials and methodsA retrospective analysis of 191 medical records and 148 polysomnographic records from adults over 65 years old who were seen at the UNAM School of Medicine Sleep Disorder Clinic from 2009 to 2013 was performed. Results82.2% of patients were diagnosed with Obstructive Sleep Apnoea Syndrome (OSAS). The associated factors found were night-time awakenings (89%), medical comorbidities (84.5%), difficulty waking (70.7%), being overweight or obese (69.1%), among others. Of the total sleep time, they spent 14.2% in N1, 53.8% in N2, 16.1% in N3 and 15.4% in REM. Moreover, a REM sleep latency of 160min was found. DiscussionCaring for the elderly is a challenge for healthcare systems. The study of sleep disorders is important because of its effects on health and quality of life, so understanding the clinical characteristics of this population will improve the diagnosis, management and referral of these patients.

Screening and evaluation tools for sleep disorders in older adults

The negative effects of impaired sleep on physical and mental well-being in older adults have recently been recognized by health care professionals. However, researchers and clinicians may be unaware of reliable and valid screening and evaluation tools for evaluating sleep disorders in older adults. The purpose of this article is to present subjective and objective instruments that measure sleep quality, excessive daytime sleepiness, obstructive sleep apnea, insomnia and restless leg syndrome that are appropriate for use in adult and older adult patients.

Pulsing blue light through closed eyelids: effects on acute melatonin suppression and phase shifting of dim light melatonin onset.

Circadian rhythm disturbances parallel the increased prevalence of sleep disorders in older adults. Light therapies that specifically target regulation of the circadian system in principle could be used to treat sleep disorders in this population. Current recommendations for light treatment require the patients to sit in front of a bright light box for at least 1 hour daily, perhaps limiting their willingness to comply. Light applied through closed eyelids during sleep might not only be efficacious for changing circadian phase but also lead to better compliance because patients would receive light treatment while sleeping. Reported here are the results of two studies investigating the impact of a train of 480 nm (blue) light pulses presented to the retina through closed eyelids on melatonin suppression (laboratory study) and on delaying circadian phase (field study). Both studies employed a sleep mask that provided narrowband blue light pulses of 2-second duration every 30 seconds from arrays of light-emitting diodes. The results of the laboratory study demonstrated that the blue light pulses significantly suppressed melatonin by an amount similar to that previously shown in the same protocol at half the frequency (ie, one 2-second pulse every minute for 1 hour). The results of the field study demonstrated that blue light pulses given early in the sleep episode significantly delayed circadian phase in older adults; these results are the first to demonstrate the efficacy and practicality of light treatment by a sleep mask aimed at adjusting circadian phase in a home setting.

Self-care options for sleep disorders in older adults

Providing self-care options for older adults with sleep complaints can be challenging. One study found that 57% of individuals older than 65 years experience some level of chronic sleep disturbance.1 Two types of sleep disturbance typically are seen: sleep initiation (diffi culty falling asleep) and sleep maintenance (diffi culty staying asleep). Sleep maintenance can be more troubling for older adults because they typically stay awake longer when waking compared with younger adults.1 Navigating the many available sleep aids can be confusing for any patient.

Sleep Disorders in Older Adults

Sleep pattern changes are considered normal as individuals age. However, changes in sleep patterns can ultimately affect the quality of life of many older adults. In addition, many sleep conditions are associated with an increase in morbidity and mortality. It is essential for clinicians to recognize sleep changes to lead to appropriate treatment. This article will focus on the assessment and interventions of sleep disorders in older adults.

Factors Associated With Sleep Disturbance Among Older Adults in Inpatient Rehabilitation Facilities

The purpose of this article is to provide an overview of changing sleep patterns and common sleep disorders in older adults and to discuss treatment options of sleep disturbances within inpatient rehabilitation facilities (IRFs). Through extensive review of the existing literature, common sleep disorders among older adults and several key factors that may impact sleep in older adults in inpatient rehabilitation facilities, such as behavioral and environmental factors, psychosocial and emotional factors, medical conditions, and medications were identified. Current literature on the factors associated with sleep disturbance in older adults in IRFs is based on work with community-dwelling older adults and those in long-term care facilities. While interventions to address these disorders and research investigation key factors associated with sleep problems among older adults appear in the literature, there is very little work that applies these interventions within IRFs. Research is needed to examine the impact of sleep problems on older adults in IRFs, including work that focuses on intervention trials to identify successful treatments for these problems and translate those approaches into practice.

Sleep and Sleep Disorders in Older Adults

A common but significant change associated with aging is a profound disruption to the daily sleep-wake cycle. It has been estimated that as many as 50% of older adults complain about difficulty initiating or maintaining sleep. Poor sleep results in increased risk of significant morbidity and mortality. Moreover, in younger adults, compromised sleep has been shown to have a consistent effect on cognitive function, which may suggest that sleep problems contribute to the cognitive changes that accompany older age. The multifactorial nature of variables affecting sleep in old age cannot be overstated. Changes in sleep have been thought to reflect normal developmental processes, which can be further compromised by sleep disturbances secondary to medical or psychiatric diseases (e.g., chronic pain, dementia, depression), a primary sleep disorder that can itself be age-related (e.g., Sleep Disordered Breathing and Periodic Limb Movements During Sleep), or some combination of any of these factors. Given that changes in sleep quality and quantity in later life have implications for quality of life and level of functioning, it is imperative to distinguish the normal age-related sleep changes from those originating from pathological processes.

Insomnia in Adults: Etiology and Management

Insomnia is a significant problem in adults that frequently goes undiagnosed and untreated. Untreated insomnia is often associated with undiagnosed medical or psychiatric disorders that increase morbidity and mortality. Sleep patterns change with aging, and the presence of comorbid conditions leads to a higher prevalence of sleep disorders in older adults. Practitioners should inquire about sleep disorders with every patient encounter to increase diagnosis and treatment. Effective treatment of insomnia is available with nonpharmacologic and pharmacologic treatment modes.

Sleep disorders and their impacts on healthy, dependent, and frail older adults.

Sleep disorders differ widely in the heterogeneous older adult population. Older adults can be classified into three groups based upon their overall level of disability: healthy, dependent, and frail. Frailty is an emerging concept that denotes older persons at increased risk for poor outcomes. The aim of this consensus review is to describe the sleep disorders observed in healthy and dependent older adults and to discuss the potential sleep disorders associated with frailty as well as their potential consequences on this weakened population. A review task force was created including neurologists, geriatricians, sleep specialists and geriatric psychiatrists to discuss age related sleep disorders depending on the three categories of older adults. All published studies on sleep in older adults on Ovid Medline were reviewed and 106 articles were selected for the purpose of this consensus. Many healthy older adults have complains about their sleep such as waking not rested and too early, trouble falling asleep, daytime napping, and multiple nocturnal awakenings. Sleep architecture is modified by age with an increased percentage of time spent in stage one and a decreased percentage spent in stages three and four. Insomnia is frequent and its mechanisms include painful medical conditions, psychological distress, loss of physical activity and iatrogenic influences. Treatments are also involved in older adults' somnolence. The prevalence of primary sleep disorders such as restless legs syndrome, periodic limb movements and sleep disordered breathing increases with age. Potential outcomes relevant to these sleep disorders in old age include mortality, cardiovascular and neurobehavioral co-morbidities. Sleep in dependent older adults such as patients with Alzheimer Disease (AD) is disturbed. The sleep patterns observed in these patients are often similar to those observed in non-demented elderly but alterations are more severe. Nocturnal sleep disruption and daytime sleepiness are the main problems. They are the results of Sleep/wake circadian rhythm disorders, environmental, psychological and iatrogenic factors. They are worsened by other sleep disorders such as sleep disordered breathing. Sleep in frail older adults per se has not yet been formally studied but four axes of investigation should be considered: i) sleep architecture abnormalities, ii) insomnia iii) restless legs syndrome (RLS), iv) sleep disordered breathing. Our knowledge in the field of sleep disorders in older adults has increased in recent years, yet some groups within this heterogeneous population, such as frail older adults, remain to be more thoroughly studied and characterized.