Why are sleep disorders so common in the elderly? There are some explanations for this. The first of these is the typical routine change of this age group. Mobility decreases, and the elderly no longer produce as in the past. Staying longer at home, having no fixed times for meals, meetings or other activities interferes with daytime routine and, consequently, affects sleep quality.
I often say that sleep is prepared from the moment we wake up. If the activities are not ruled, sleep will not be. Another important change is the physiological change itself that the elderly entails: the elderly becomes more morning, that is, tends to sleep early and wake up earlier.
In addition, sleep fragmentation and day naps become more frequent. These physiological changes occur mainly due to the reduction in melatonin production. Finally, it is noteworthy that, in this age group, there is a greater likelihood of sleep disorders, such as insomnia and sleep apnea, due to the relaxation of the neck muscles. These two conditions contribute to a more interrupted sleep.
The impacts of poor sleep on the health of the elderly
The fact that the elderly wake up several times at night can contribute to the exacerbation of the sympathetic autonomic nervous system. In other words, it is as if, at night, the individual repeatedly activates the warning system, the same one that comes into action when we are frightened. This mechanism generates increased heartbeat and respiratory rate, as well as releasing substances such as adrenaline and norepinephrine.
These effects can have cardiovascular consequences, such as greater risk of hypertension, arrhythmias and acute myocardial infarction. In addition, sleep deprivation compromises the efficiency of the glymphatic system, responsible for brain cleaning. This system “sweeps” proteins resulting from brain activity, and the accumulation of some of them, such as beta-amyloid and tau, is associated with neurodegenerative diseases such as Parkinson and Alzheimer.
Cognitive changes are common in this age group, and it is up to the doctor carefully to evaluate whether they are expected for age or whether a pathological picture that requires early intervention. Depression in the elderly, often caused by changes in family relationships and sometimes by social exclusion, can be aggravated by poor sleep quality.
Strategies to improve sleep quality in the elderly
- The elderly must respect their sleep times;
- Sleep and always wake up at the same time, including weekends, helps keep the rhythm circadian;
- Avoid stimuli such as cell phones and computers before bed;
- Attention to medications in use. Some may interfere with sleep, reducing their duration or causing greater muscle relaxation, which increases the risk of sleep apnea. Avoid over use of medications without medical advice;
- Create a relaxing routine before bed: listening to calm music, taking a warm shower or a chamomile or leaning tea can help with natural sleep induction;
- Avoid consuming too much water before bed. In addition, routine examinations are essential, as increased prostate (in men) and decompensated diseases such as hypothyroidism and diabetes can fragment sleep;
- Opt for light meals at night and avoid eating near bedtime, as difficult digestion can interfere with sleep and aggravate gastroesophageal reflux;
- Avoid stimulating substances such as caffeine and chocolate;
- Reduce or avoid alcohol consumption at night as it can cause excessive muscle relaxation and increase the chance of sleep apnea;
- Exposing yourself to natural light in the morning favors the adjustment of the circadian rhythm and improves the quality of sleep at night;
- Practicing physical activities within your limitations, but while exercising.
*Text written by otolaryngologist and sleep physician Danilo Sguillar (CRM 130.313 / RQE 148609), Professor of the Sleep Institute and Secretary of the Sleep Medicine of the Brazilian Association of Otorhinolaryngology
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This content was originally published in sleep in old age: how to improve quality and avoid health risks on CNN Brazil.
Source: CNN Brasil

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