Sleep In Elderly People Research Articles

The effect of progressive muscle relaxation education on the quality of sleep in elderly people with hypertension at the South Cilacap Community Health Center

Background: The elderly experience a decreased sleep phase as a result of poor sleep, meaning that they tend to be restless and easily awakened, which can interfere with sleep quality. It can result in physical tension, which affects the increase in blood pressure. Progressive muscle relaxation therapy can improve sleep quality and control tension and anxiety by training patients to consciously relax their body muscles. Purpose: To analyze the effect of progressive muscle relaxation education on the quality of sleep in elderly people with hypertension at the South Cilacap Community Health Center. Methods: This research was conducted on elderly people with hypertension at the South Cilacap Community Health Center using a quasi-experimental research design with a non-equivalent control group design. Simple random sampling was used with a total of 46 respondents. The data were analyzed using a T-test. Results: The results of the study found an increase in the average score on the sleep quality scale, and after progressive muscle relaxation education, the intervention group found a mean pre-test score of 15.57 and in the post-test section a mean score of 5.57. In the control group, the pre-test had a mean value of 14.52, and in the post-test section, the mean value was 12.70. and the results of further analysis of the independent t-test between the intervention group and the control group showed p = 0.000. Conclusion: There was an effect of progressive muscle relaxation therapy on the sleep quality of elderly people in the intervention group among elderly people with hypertension at the South Cilacap Community Health Center. There was a significant difference in the average PSQI score in the post-test measurements of both the intervention and control groups. Progressive muscle relaxation is an alternative therapy designed to reduce muscle tension, which can then relax muscles ranging from facial muscles to leg muscles

Factors Affect the Quality of Sleep in Elderly People with Metabolic Syndrome

Factors Affect the Quality of Sleep in Elderly People with Metabolic Syndrome

Sleep Duration, Health Promotion Index, sRAGE, and ApoE-ε4 Genotype Are Associated With Telomere Length in Healthy Australians.

Significant alterations in sleep duration and/or quality of sleep become more pronounced as people get older. Poor sleep in elderly people is associated with adverse health outcomes and cellular aging. We examined the relationship between telomere length (TL) and sleep duration, Health Promotion Index (HPI), and tested whether the presence of Apolipoprotein-E4 (ApoE-ε4) allele affects both sleep and TL. The present study was carried out in 174 healthy participants (21% male; mean age 53.79 years) from South Australia. Lymphocyte TL was measured by real-time quantitative PCR (qPCR) and ApoE genotype was determined by TaqMan assay. HPI was calculated from a questionnaire regarding 8 lifestyle habits, including sleeping hours. Multivariate regression analysis was used to establish these associations adjusted for specified confounders. TL was found to be inversely associated with age (r = -0.199; p = .008) and body mass index (r = -0.121; p = .11), and was significantly shorter in participants who slept for less than 7 hours (p = .001) relative to those sleeping ≥7 hours. TL was positively correlated with HPI (r = 0.195; p = .009). ApoE-ε4 allele carriers who slept for less than 7 hours had shortest TL (p = .01) compared to noncarriers. Plasma soluble receptor for advanced glycation end product (sRAGE) level was significantly (p = .001) lower in individuals who sleep less than 7 hours and ApoE-ε4 carriers. Our results suggest that inadequate sleep duration or poor HPI is associated with shorter TL in cognitively normal people and that carriage of APOE-ε4 genotype may influence the extent of these effects.

The effects of auricular acupressure on the sleep of the elderly using polysomnography, actigraphy and blood test: Randomized, single-blind, sham control

AimThis study was conducted to examine the effects of auricular acupressure on sleep in elderly people with sleep disorders. MethodsThis was a randomized, double-blind, sham-controlled study. The participants aged over 65 years old were randomly assigned to the experimental group (n = 21) and the sham control group (n = 21). The participants in the experimental group and the sham control group received auricular acupressure on sleep-disorder-related points or to sleep-disorder-unrelated points, respectively. The intervention was implemented for a total of eight weeks. To validate the effects of the treatment, polysomnography with the Alice portable sleep diagnostic system; actigraphy with Fitbit Alta; and melatonin, serotonin, and cortisol blood tests were conducted. ResultsNon-Rapid Eye Movement sleep stage 3 duration change (Z = −2.187, p = .029) and Non-Rapid Eye Movement sleep stage 3 ratio change (Z = −2.423, p = .014), measured by polysomnography, of the experimental group showed a significant increase over time compared to the sham control group. ConclusionsAuricular acupressure applied for eight weeks was found to be effective in increasing Non-Rapid Eye Movement sleep stage 3 duration and Non-Rapid Eye Movement sleep stage 3 ratio among sleep stages of the elderly. Consequently, it showed that auricular acupressure can be used as a proven nursing intervention method for sleep disorder in elders to increase deep sleep duration and ratio.

Mixed methods-onderzoek om beweging en slaap van ouderen in kaart te brengen

Mixed methods to measure movement and sleep in the elderly Movement and sleep are both crucial for the elderly in terms of healthy ageing. Staying physically active as people age is positively associated with better sleep and health outcomes. But despite the growing attention to healthy ageing, the elderly don’t always keep up with the applicable guidelines in terms of movement. Furthermore, health workers don’t always know how to measure movement and sleep in elderly in order to advise and help them to better adhere to guidelines. Literature lacks a summary of accessible objective and subjective ways to measure movement and sleep in the elderly. This study combines both objective and subjective measuring methods and elaborates on the practical aspects of their use. This paper highlights the advantages of mixed methods when measuring movement and sleep in elderly people and aims to inform health workers who want to evaluate their patients’ movement and sleep in order to guide them towards a healthier lifestyle.

Gentle rocking movements during sleep in the elderly.

Vestibular stimulation in the form of rocking movements could be a promising non‐pharmacological intervention for populations with reduced sleep quality, such as the elderly. We hypothesized that rocking movements influence sleep by promoting comfort. We assessed whether gentle rocking movements can facilitate the transition from wake to sleep, increase sleep spindle density and promote deep sleep in elderly people. We assessed self‐reported comfort using a pilot protocol including translational movements and movements along a pendulum trajectory with peak linear accelerations between 0.10 and 0.20 m/s2. We provided whole‐night stimulation using the settings rated most comfortable during the pilot study (movements along a pendulum trajectory with peak linear acceleration of 0.15 m/s2). Sleep measures (polysomnography) of two baseline and two movement nights were compared. In our sample (n = 19; eight female; mean age: 66.7 years, standard deviation: 3 years), vestibular stimulation using preferred stimulation settings did not improve sleep. A reduction of delta power was observed, suggesting reduced sleep depth during rocking movements. Sleep fragmentation was similar in both conditions. We did not observe a sleep‐promoting effect using settings optimized to be comfortable. This finding could imply that comfort is not the underlying mechanism. At frequencies below 0.3 Hz, the otoliths cannot distinguish tilt from translation. Translational movement trajectories, such as used in previous studies reporting positive effects of rocking, could have caused sensory confusion due to a mismatch between vestibular and other sensory information. We propose that this sensory confusion might be essential to the sleep‐promoting effect of rocking movements described in other studies.

Oscillatory EEG Activity During REM Sleep in Elderly People Predicts Subsequent Dream Recall After Awakenings.

Several findings underlined that the electrophysiological (EEG) background of the last segment of sleep before awakenings may predict the presence/absence of dream recall (DR) in young subjects. However, little is known about the EEG correlates of DR in elderly people. Only an investigation found differences between recall and non-recall conditions during NREM sleep EEG in older adults, while—surprisingly—no EEG predictor of DR was found for what concerns REM sleep. Considering REM sleep as a privileged scenario to produce mental sleep activity related to cognitive processes, our study aimed to investigate whether specific EEG topography and frequency changes during REM sleep in elderly people may predict a subsequent recall of mental sleep activity. Twenty-one healthy older volunteers (mean age 69.2 ± 6.07 SD) and 20 young adults (mean age 23.4 ± 2.76 SD) were recorded for one night from 19 scalp derivations. Dreams were collected upon morning awakenings from REM sleep. EEG signals of the last 5 min were analyzed by the Better OSCillation algorithm to detect the peaks of oscillatory activity in both groups. Statistical comparisons revealed that older as well as young individuals recall their dream experience when the last segment of REM sleep is characterized by frontal theta oscillations. No Recall (Recall vs. Non-Recall) × Age (Young vs. Older) interaction was found. This result replicated the previous evidence in healthy young subjects, as shown in within- and between-subjects design. The findings are completely original for older individuals, demonstrating that theta oscillations are crucial for the retrieval of dreaming also in this population. Furthermore, our results did not confirm a greater presence of the theta activity in healthy aging. Conversely, we found a greater amount of rhythmic theta and alpha activity in young than older participants. It is worth noting that the theta oscillations detected are related to cognitive functioning. We emphasize the notion that the oscillatory theta activity should be distinguished from the non-rhythmic theta activity identified in relation to other phenomena such as (a) sleepiness and hypoarousal conditions during the waking state and (b) cortical slowing, considered as an EEG alteration in clinical samples.

Lower-limb warming improves sleep quality in elderly people living in nursing homes.

Sleep disturbances are common in older people. This study was conducted to examine the effects of a hot pack, which was used to warm the lower limbs, on the sleep of elderly people living in a nursing home. This is a prospective cohort involving seven elderly women. Subjects aged 74-93 years old were treated by warming the lower limbs for 40 minutes using hot packs every night over 8 weeks. A hot pack made of a dense polymer and warmed in a microwave oven was used as a warming device. In the first and last week, the subjects were required to wear an activity monitor to determine their sleep-awake status. During the second to ninth week, they received limb-warming treatment by a hot pack heated to 42ºC for 40 min every night. Surface skin temperature data were collected by thermographic measurement. As a result, lower-limb warming by a hot pack significantly improved the quality of sleep in the subjects. During warming, the surface temperature of the hands and face rose by approximately 0.5-1.5ºC. This study showed that lower-limb warming with a hot pack reduced sleep latency and wake episodes after sleep onset; thus, improving the quality of sleep in elderly people living in a nursing home.

Effectiveness of Cognitive Behavior Therapy on the Quality of Sleep in Elderly People with Insomnia Disorder

Effectiveness of Cognitive Behavior Therapy on the Quality of Sleep in Elderly People with Insomnia Disorder

Effects Of An Increased Exercise Program On Sleep In Elderly People

Effects Of An Increased Exercise Program On Sleep In Elderly People

Association between ongoing pain intensity, health-related quality of life, disability and quality of sleep in elderly people with total knee arthroplasty.

The scope of this paper was to study the relationship between pain intensity, health-related quality of life, disability, sleep quality and demographic data in elderly people with total knee arthroplasty (TKA). 24 subjects who had been subjected to TKA the previous month (4 females; 66 ± 9years) and 21 comparable controls (8 male; 70 ± 9years) participated in the study. Intensity of pain, and highest and lowest pain intensity experienced in the preceding week were collected. The Western Ontario and McMaster Universities index function, quality of life (Medical Outcomes Study Short Form 36), and Pittsburgh Sleep Quality Index were assessed. Age, gender, weight, height, body mass index were also collected. Individuals with TKA presented worse physical function (P < 0.01), social role (P = 0.01), physical performance (P < 0.01), pain (P = 0.04), disability (P = 0.04) and sleep quality (P = 0.03) than the controls. Higher intensity of pain was associated with lower physical function, social role, mental health, vitality and general health, and with higher disability and sleep quality. Disability and sleep quality were negatively associated with several quality of life domains. The associations between the intensity of pain, disability, quality of life and sleep reveal the multidimensional experience of TKA.

Moderate exercise training modulates cytokine profile and sleep in elderly people

Aging causes several physiological alterations, including alterations in sleep. It is possible that difficulty sleeping can be exacerbated by increased inflammation in older individuals. Moderate exercise training may be a modality of non-pharmacological treatment for sleep disorders and inflammation. We aimed to assess the effects of moderate exercise training on sleep in elderly people as well as their cytokine profiles. Additionally, we examined the effect of exercise training on quality of life parameters using a SF-36 questionnaire. Twenty-two male, sedentary, healthy, elderly volunteers performed moderate training for 60min/day, 3days/week for 24week at a work rate equivalent to their ventilatory aerobic threshold. The environment was kept at a temperature of 23±2°C, with a humidity of 60±5%. Blood and polysomnograph were collected twice: at baseline (1week before training began) and after 6months of training. Training increased aerobic capacity parameters (p<0.0001), decreased REM latency (p<0.02), and decreased time awake (p<0.05). After training, the levels of IL-6 (p<0.0001) and TNF-α (p<0.0001) and the ratio of TNF-α/IL-10 (p<0.0001) were decreased, whereas IL-10 levels were increased after training (p<0.001). Furthermore, exercise training was shown to improve quality of life parameters. Our results suggest that 6months of training can improve sleep in the elderly and is related to the anti-inflammatory effect of moderate training, which modifies cytokine profiles.

Diminished Capability to Recognize the Optimal Temperature for Sleep Initiation May Contribute to Poor Sleep in Elderly People

Sleep propensity and skin temperature are functionally related. In young adults, changes of skin temperature within the comfortable thermoneutral zone affect sleep-onset latency and vigilance performance. Aging is associated with both decreased thermosensitivity and poorer sleep. Our goal was to test whether subtle manipulations of core body and skin temperature affect sleep onset in elderly people without sleep complaints and in elderly insomniacs and whether the subjective perception of these mild body temperature manipulations is preserved with aging and insomnia. In a 2-day semiconstant-routine protocol, 288 sleep-onset latencies were polysomnographically determined while manipulating core body and skin temperatures differentially in warm and cold directions within a comfortable thermoneutral range. Sleep laboratory of the Netherlands Institute for Neuroscience. Eight elderly subjects without sleep complaints (65.8 +/- 2.8 years, mean +/- SEM) and 8 elderly insomniacs (59.1 +/- 1.9 years). Warming the proximal skin by 0.4 degrees C facilitates sleep onset equally effective in healthy elderly (by 18% ie, by 1.84 minutes [95% confidence interval [CI], 0.76-2.92]) and elderly insomniacs (28%, 2.85 minutes [CI: 2.55-3.18]). These effects were comparable to the results in healthy young subjects, in spite of a marked decrease in the subjective perception of temperature changes in elderly subjects, especially in insomniacs. The findings show that mild changes in skin temperature have an effect on sleep propensity in elderly and indicate that elderly insomniacs may have a diminished capability to recognize that a slight increase in bed temperature facilitates the initiation or reinitiation of sleep.

Beyond the Usual Suspects: Approaching Sleep in Elderly People

HERE are now numerous reports in the literature to support the high prevalence of sleep difficulties and excessive daytime sleepiness in elderly persons. However, as the saying goes, acknowledging the problem is just the first step. Currently, both the fields of Sleep and Geriatric Medicine are faced with the more difficult task of sifting through potential causes and assessing the impact of sleep problems in elderly people. Although sleep patterns appear to alter as we age, by far, in elderly people, most sleep problems are not the result of biologic shifts in circadian rhythmicity but rather result from increasing disease burden, medication effects, depression and anxiety, and limited mobility (1,2). These issues, along with changes in a person’s living situation, make elderly nursing home residents even more vulnerable to sleep disorders. The large number of factors affecting sleep in elderly individuals creates a challenge for both the geriatrician and sleep specialist. Both

SLEEP DISTURBANCES IN ELDERLY: A SUBJECTIVE EVALUATION OVER 65

Sleep in elderly people shows progressive changes caused by general aging processes. Several alterations are described in medical literature: changes of sleep/wake rhythm and modifications both in sleep duration and in sleep architecture. The aim of our study was to evaluate sleep disturbances in elderly people, with and without cognitive impairment,through a sleep questionnaire. Our population included 1000 subjects, over 65 years of age, stratified by sex and age. The first 600 interviews were included in this report. All patients underwent a mini mental state examination (MMSE) and a questionnaire concerning excessive daytime sleepiness. In our total sample, we found a high prevalence of excessive daytime sleepiness, insomnia, nighttime awakenings, snoring, restlessness and periodic leg movements during sleep. Patients with cognitive dysfunctions showed less difficulty in falling asleep and fewer nighttime awakenings; they snored less frequently and were the only ones to present enuresis and to fall off the bed. Moreover, patients with cognitive impairment presented excessive daytime sleepiness with variable intensity and frequency. In conclusion, our results indicate significant differences in sleep disorders between healthy subjects and patients cognitively impaired. Besides, our subjective evaluation seems to be a useful method to perform an assessment of sleep disturbances in elderly people.

Sleep disorders in older people

Sleep is an essential physiological process, occurring in all higher animals and even those as simple as the roundworm. Whilst some animals have adapted their sleep to specific circumstances e.g. the dolphin sleeping with each side of its brain alternately, no animal has evolved to survive completely without sleep. Animals completely deprived of sleep eventually die as a consequence, usually from immunological collapse and sepsis. Adult humans require between 7.0 and 8.4 hours sleep daily and inadequate sleep is associated with increased mortality, morbidity, reduced quality of life and, in the older people, an increased rate of institutionalization. Even when corrected for comorbidities, men sleeping less than 6 hours a night have a mortality significantly greater that of their peers [1]. Although the population group with the highest prevalence of sleep disorders is those over 65 years there is relatively little published specifically concerning sleep in elderly people. Sleep disorders can be markers for other systemic diseases, yet a recent study found that a routine sleep history is taken in less than 10% of medical cases [2].

Manipulating neuropeptidergic pathways in humans: a novel approach to neuropharmacology?

Given the tremendous number of neuropeptides, which are synthesized in the central nervous system, the brain can be viewed as one of the most prominent endocrine organs. Elucidation of the functions of these peptides is hampered by the facts that after intravenous administration access to brain receptors is prevented or impaired by the blood–brain barrier. Here, we provide evidence that intranasal administration can be a way to circumvent the blood–brain barrier. Selected experiments will be reported indicating that peptides after intranasal administration in humans can specifically alter a great variety of brain functions. For vasopressin, we demonstrated improving effects of long-term intranasal treatment on sleep in elderly people. Insulin showed improving effects of short-term memory functions. For adrenocorticotropin/melanocyte stimulating hormone, ACTH/MSH-(4–10), a twofold action was isolated: The melanocortin fragment diminished selective attention and, with subchronic administration, reduced body fat. These results could provide the basis for developing a new, specific, and “soft” neuropharmacology.