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Fall 2004

Inadequate Sleep Can Lead to Health Risks in the Elderly

Physiological changes with age make sleep-related problems more likely, and cause for concern

“Inadequate sleep at night leads to daytime fatigue and mental cloudiness. In the elderly, that can result in being less engaged socially to being at greater risk for falls and fractures,” says Ammar Sakkour, M.D., director, UCLA’s Pulmonary Fitness and Rehabilitation Program.

Two medical disorders— sleep apnea and restless leg syndrome—are more common in older persons and can contribute to inadequate restful sleep and daytime drowsiness.

Obstructive sleep apnea, in which partial or complete obstruction of the airway during sleep causes loud snoring and periodic breathing stoppages, can, if untreated, cause problems beyond daytime sleepiness. The disorder is associated with heart problems resulting from the stress to the cardiovascular system of the constant cycles of snoring, airway collapse and arousal. Older obese men are at the highest risk, but approximately half of obstructive sleep apnea patients are not obese. The most common treatments for the disorder range from weight management to use of a specially designed mask worn during sleep to provide mechanical breathing assistance.

Restless leg syndrome involves involuntary leg movements or discomfort during still periods that can make falling asleep difficult, or causes wakening that produces fragmented sleep. “Often, as with obstructive sleep apnea, the person with this disorder is tired during the day and can’t figure out why,” says Dr. Sakkour, who notes that the syndrome does respond to medication.

Other factors leading to sleep problems in the elderly include depression, medications that can cause insomnia, and poor sleep habits. Dr. Sakkour recommends exercising early in the day rather than later, refraining from naps, and avoiding big meals, caffeine or alcohol. “Older people require less sleep,” he notes. “The test is how fatigued they feel during the day.”

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