Cambridge Health Alliance Older Adult e-Newsletter

Greetings! ,
 
roberta

We've always been told we need 8 hours of sleep a night. But some people just can't sleep for that long. There are many reasons for this - changing natural rhythms, noise at night, foods we have eaten, or a sleep disorder (some of which are common in older adults). 

 

This month, we explore sleep disorders with Dr. Jason Strauss, a geriatric psychiatrist here at CHA. I have had the pleasure of presenting with Dr. Strauss many times at local events, and he is truly a gem. Here's what he has to say about addressing sleep disorders in older adults we work with. 

 

Be Well,

Roberta

 


Up All Night

 

From Jason Strauss, MD

Director, CHA Geriatric Psychiatry Fellowship Program and Instructor in Psychiatry, Harvard Medical School

 

 

 

 

  

As we age, we often sleep less than we did in the past and also have more difficulty getting to sleep. It's not realistic to expect to sleep as well at 75 as we do at 20. But some sleep disorders are common for older adults, and illnesses and medication can contribute to the problem.

 

You may feel powerless in helping older adults with sleep problems. But a basic understanding of the issues can go a long way. Here's some information you can use to talk to your patients or clients about sleep related issues.

 

 

What are common sleep disorders in older adults?

Two common sleep disorders affecting older adults are obstructive sleep apnea and restless legs syndrome. 

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Obstructive sleep apnea occurs when there is a blockage of the upper airways during sleep, leading to brief but frequent awakenings and next-day fatigue. This is often related to heavy snoring. 

 

People with restless legs syndrome experience uncomfortable sensations in their lower limbs and have a strong urge to move their legs to relieve these sensations. If your patients or clients are experiencing the symptoms described above, you should set up an appointment for them to be evaluated by their doctor.

  

 

Can depression or other illnesses play a part in issues with sleep? And what about medication?

All psychiatric illnesses including depression can affect sleep. People who are depressed often wake up early and cannot get back to sleep. Depressed individuals may also spend their days in bed, making it difficult to fall asleep at night. Other medical problems that can affect sleep are urinary frequency issues, gastroesophageal reflux disease (GERD), and chronic obstructive pulmonary disease (COPD).

 

Medications may also adversely affect sleep. Psychiatric medications, blood pressure medications, pain medications, and medications used to treat Alzheimer's dementia and Parkinson's disease are all known to impact sleep. In addition, other factors such as interactions between medications and dosing changes may keep you awake.

  

 

How many times is waking up during the night "normal" for an older adult?

It depends.If there are any environmental 

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factors that may be negatively impacting sleep, these should be addressed. You should always treat medical conditions (such as urinary frequency) that may contribute to multiple nighttime awakenings. It really comes down to how alert a person feels the next day and how well they believe they are able to function.

 

   

Do you have any suggested habits that could help older adults with sleep disorders?

It is important for older adults to maximize their "sleep hygiene." Lifestyle changes that may improve sleep include:

 

1. Decreasing late-day fluid intake to minimize nighttime urination

 

2. Exercise regularly, but not within three hours of bedtime

 

3. Minimizing caffeine, alcohol, and tobacco use prior to bedtime

 

4. Eat a light snack for dinner instead of a heavy meal if you struggle with GERD symptoms at night

 

 

There are also ways to improve environmental conditions that affect sleep:

 

1. Use dark curtains or a sleep mask to minimize noise and light

 

2. Maintain a consistent sleep schedule

 

3. Use the bed only for sleeping, not for reading or watching TV. Do not sleep with the TV or radio on

 

4. Use relaxation strategies such as meditation tapes and deep abdominal breathing before bed

 

 

I hope this will help you discuss sleep related issues with your patients or clients. If you have any questions about the information above, feel free to contact me via email at [email protected].

 

 

 



CAMBRIDGE HEALTH ALLIANCE is a vital and innovative community health system that provides essential services to Cambridge, Somerville, and Boston's metro-north communities. It includes three hospital campuses, a network of primary care and specialty practices, and the Cambridge Public Health Dept. CHA is a Harvard Medical School teaching affiliate and is also affiliated with Harvard School of Public Health, Harvard School of Dental Medicine, and Tufts University School of Medicine.  For more information, visit www.challiance.org.


This newsletter provides general information for educational purposes only. The information provided in this newsletter, or through linkages to other sites, is not a substitute for medical or professional care, and you should not use the information in place of a visit, call consultation or the advice of your physician or other healthcare provider. 
Thank you.


 

  

Does your patient or client have cognitive issues?


CHA's Neuropsychiatry and Memory Center offers consultative services to help evaluate adults of any age with cognitive impairment, memory loss, or related behavioral problems. The center brings together experts from Psychiatry, Neurology, Psychology, Social Services and Internal Medicine. 

 

Find out more - click here or call 617-591-4350. A referral from a PCP is needed. Most health insurance is accepted.

 

          
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