Sleep disorder - obsession of the elderly

This article is expertly consulted by Master, Doctor Bui Ngoc Phuong Hoa - General Internal Medicine - Department of Medical Examination & Internal Medicine - Vinmec Danang International General Hospital.

The elderly experience true sleep only about 4 hours a day, which represents insufficient sleep. Going to bed often tossing and turning, so I slept very late but woke up very early.
Insomnia, trouble sleeping are common symptoms in all age groups, but women experience more than men, especially in the elderly. It is estimated that 48% of people over the age of 50 have insomnia.

It is difficult to fall asleep, difficult to maintain sleep, often wake up early, wake up in the middle of the night difficult to go back to sleep, or toss and turn until morning to suddenly see, not feel well after sleep, ..
In the elderly, it is also easy to have a sleep disturbance, not being able to sleep at night but sleeping during the day. Some patients even cannot sleep at night and during the day. At night, the patient is very awake, the body works normally.

Sleep disorders in the elderly are divided into two main categories: insomnia and sleep disturbance.
2.1. Causes of insomnia The cause of insomnia is due to the quiet surroundings, using stimulant substances before sleeping such as tea, coffee, carbonated soft drinks ... or some drugs such as Amphetamine , Methylphenidate... Some people have a habit of drinking a little alcohol before going to bed until they stop suddenly, which can also cause insomnia, or in cases of long-term use of sedatives when stopping suddenly, they also cause insomnia. Sleep apnea (25% - 35%) in people over 60 years old, obese, more men than women, especially more in people with signs of mental decline. In addition, the elderly or insomnia are also caused by chronic pain in the joints or spine (osteoarthritis, osteoporosis, ..), allergies at night, difficulty breathing while sleeping (heart failure, asthma, .. .), leg twitching during sleep (restless leg syndrome), ventricular arrhythmias, heart failure, reflux oesophagitis, nocturia (due to prostatic hyperplasia, diabetes, etc.). .), endocrine diseases such as cushing's syndrome, hyperthyroidism...

Insomnia also occurs due to side effects of medical drugs such as antihypertensive drugs (groups acting on the central nervous system), antidepressants... In middle-aged and elderly people, depression It is the cause of insomnia, especially in the early morning. Other causes are chronic long-term anxiety, nightmares occurring during rapid sleep, physical inactivity, not exercising or playing sports, inattentive mental workers attention to physical training... 2.2. Causes of sleep disturbance Sleep disturbance is common in the elderly due to dysfunction in brain activity due to aging process or occurs after a cerebrovascular accident or a serious illness...

Sleep disorders affect cognitive activities (including recording, understanding, judging and processing work), affecting the body's health, the quality of life of the elderly and with the elderly. relatives, children...
In patients with long-term sleep disorder, the recovery process is not effective, making the patient often feel tired, weak and have other symptoms such as: easily irritable, depressed, dizzy, forgetful, pessimistic, anorexia, dementia,...
Prolonged sleep disturbance causes physical weakness, nervous breakdown. Insomnia often exacerbates psychotic symptoms and, if persistent, should be considered as a contributing factor to suicidal thoughts.

Treatment to return to normal sleep by preventing the patient from sleeping during the day. If the patient cannot sleep at night, the patient can take more sedatives, then reduce the sedation dose for a few days to a few weeks until normal sleep, then stop the sedation. Need to consult a doctor to use sedatives for sleep, do not use drugs indiscriminately. Practice regular physical activities, balance between mental and physical activities. Sleep in an absolutely quiet environment, with no light. Incorporating physical factors to facilitate falling asleep easier such as steady noises, falling rain, rustling leaves, lullabies, etc. Self-relieve conflicts, obsessive thoughts Daily routine helps to relax, rest, entertain according to habit, use warm, light food that is easy to digest, go to bed when sleepy... If you wake up, just do light exercise, increase exercise in the morning. shining. Actively relax, do not think endlessly, focus on breathing, count 1 - 2 - 3 to self-inhibit the cerebral cortex, easy to fall asleep. Treatment of insomnia in the elderly also requires treatment of comorbid medical conditions (thyroid disease, urinary system disease, diabetes, and psychiatric disorders), which "contribute" to The cause of insomnia, if not treated for these diseases, it is not possible to effectively solve insomnia.