Older Adults Not Getting Enough Healthy Sleep
Many seniors deal with several health problems related to aging. Patients managing chronic disease, complex health concerns and pain quite often are not getting enough sleep. Sleep patterns change with aging, and because of sleep disorders or sleep disturbances, older adults do not get healthy deep sleep. Common sleep disorders can include having trouble falling asleep, restlessness during the night, inability to tell night from day, and waking up too early in the morning. Some common health issues that prevent seniors from getting healthy sleep include chronic pain (e.g. arthritis), substance abuse, depression, neurological problems, diet, and nutrition.
Sleep allows our body to rest and to restore energy levels. Seniors require 7-9 hours of sleep each night. There are two types of sleep. The first is non-rapid-eye-movement (NREM) which progresses through four stages, from light sleep to deep sleep. This type of sleep is when the body starts to drift off or nod. Rapid eye movement (REM) is the next stage where breathing becomes irregular and shallow, the eyes move rapidly, limb muscles become immobile, and dreaming occurs. The body cycles through NREM-REM stages of sleep approximately every 90 minutes.
Difficulty falling asleep and/or staying asleep is called insomnia. More than half of adults 60 and older experience insomnia which if not properly treated can be debilitating, cause irritability and anxiety, and affect memory loss. Sleep apnea is a life-threatening sleep disorder which often goes undiagnosed or is diagnosed simply as snoring. Almost half of seniors with sleep apnea or obstructed sleep are not diagnosed. Patients with sleep apnea temporarily stop breathing during sleep and may do so at least five times an hour for approximately 10 seconds each time. This forces the body to gasp for air repeatedly even while remaining asleep. Sensitivity to light and sound, irregular body temperature regulation, and fear of safety for seniors living alone can also contribute to restlessness and unease during the night.
Monthly Chronic Care Managers can monitor for sleep patterns. CCM Care Managers can inform caregivers and healthcare providers when a patient isn’t getting enough sleep. They can also help identify the risk factors affecting sleep patterns. Care Managers can assess for insomnia and sleep apnea and include in a care plan. Routinely, Care Managers can ask about tossing and turning, nighttime choking, night sweats, and daytime drowsiness. These symptoms can affect patient safety, increasing risks for falls or accidents, add stress to the body, and limit the enjoyment of daily activities.
Healthy sleep is important for rejuvenating the body. The absence of restful sleep increases the likelihood of high blood pressure, stroke, heart attack, obesity, and depression. Care Managers support patients in discovering common causes of poor sleep. They can encourage and remind seniors to make important lifestyle changes such as exercising daily, balancing diet and nutrition, and being aware of which medications or pains keep them awake during the night. Fatigue and poor sleep do not necessarily have to be a part of getting older. The right care management can ensure for more restful and healthier days ahead.
About the Author
Joseph F. West, ScD, is a population health and data analytics leader with over 10 years of research and enterprise consulting experience. He is a recognized leader in the development of outcomes-based healthcare. Joseph has served as Chief Population Health Officer, Senior Epidemiologist, Program Director, and Adjunct Assistant Professor. As a consultant and content creator, his current work focuses on population health management (PHM), health information technology (HIT), care coordination innovation, and healthcare risk management.