Sleep

Question 1

Age related changes of sleep

Answer 1

• more time spent in bed awake before falling asleep
• awakenings are frequent increasing after 50 years of age
• daytime napping
• early to bed, early to rise
• sleep is subjectively and objectively lighter
• REM sleep is short and less intense
• frequency of abnormal breathing events
• frequency of leg movements increased

Question 2

OSA

Answer 2

• Affects approximately 25% of older adults with obstructive sleep apnea (OSA) being the most common form.
• Untreated OSA is related to heart failure, cardiac dysrhythmias, stroke, type 2 diabetes, osteoporosis, and even death
• Age-related decline in the activity of the upper airway muscles, resulting in compromised pharyngeal patency, predisposes older adults to OSA

Question 3

Assessment of OSA

Answer 3

• The individual may present with complaints of insomnia or daytime sleepiness, and assessment should include assessment of insomnia complaints
• If OSA is suspected, a referral for a sleep study should be made
• Recognition of OSA in older adults may be more difficult because they may not have a sleeping partner

Question 4

Interventions for OSA

Answer 4

• Therapy depends on the severity and type of sleep apnea, as well as the presence of comorbid illness
• Continuous positive airway pressure is recommended as initial therapy
• Teaching should include the effects of untreated OSA and emphasize the need for treatment

Question 5

pharmacological interventions

Answer 5

• Benzodiazepines or other sedative hypnotics should not be used in older adults as a first choice of treatment for insomnia
• Pharmacological interventions and behavioral interventions should be used together