Addressing Sleep Disorders in Senior Patients: Strategies for Diagnosis and Treatment

Sleep-related complaints are common for seniors. Inadequate sleep not only affects their quality of life but also their long-term health if it continues for a long time. While sleep is often not considered as important an issue as other health considerations, addressing sleep-related complaints effectively can improve the quality of life for seniors and decrease their long-term health problems.

Understanding Sleep Disorders in Seniors

As people age, sleep patterns often change, making them more susceptible to sleep disorders. There are several reasons for changes in sleep patterns: biological, environmental, societal, behavioral, or any combination of these factors. Retirement, changes in living arrangements, the loss of a spouse, or chronic health conditions are all common causes of these factors for seniors; however, many other potential causes can also contribute.

Seniors may be more likely to experience fragmented sleep or find it difficult to initially get to sleep, leading to daytime sleepiness and other health concerns. In medicine, there is often a lack of awareness and an underdiagnosis of sleep disorders in this population, further complicating management. Sleep disruptions may incorrectly be seen as an inevitable part of the aging process instead of a disorder that requires intervention.

Common Causes of Sleep Disruption in Seniors

Seniors commonly experience a wide range of sleep disorders. Insomnia, the difficulty of falling or staying asleep, is by far the most common of these; however, it often coexists with other disorders. Understanding the underlying cause of insomnia is essential for effectively treating sleep disruptions in seniors.

Some of the most common reasons for sleep disruption in seniors experience include:

• Alcohol use
• Alzheimer’s disease
• Chronic pain
• Depression
• Frequent nocturia
• Medication side effects
• Obstructive sleep apnea
• Restless leg syndrome

Understanding the cause of sleep disruptions can help primary care doctors understand if treatment of the underlying cause of sleep disruption can result in the restoration of healthy sleep patterns or if management of sleep disruptions will be part of the long-term management of the condition.

The Role of Primary Care Physicians in Addressing Sleep Disorders

Primary care physicians are often the first point of contact for seniors experiencing sleep issues. They are uniquely positioned to first identify sleep disorders through routine screenings or physical exams and to provide initial interventions when these issues are identified. By integrating sleep health assessments into their routine care, primary care doctors can facilitate the early diagnosis and management of these disorders, enhancing the overall health outcomes for their patients.

While primary care doctors are the clinicians most likely to initially identify sleep disorders, their role may include referrals to sleep specialists or other physicians who can treat underlying issues. Primary care physicians should provide education on sleep hygiene and how to promote effective sleep when possible but may need to consult with others if an underlying condition like sleep apnea is present. They may also need to consult with specific specialists in some situations. For example, sleep disruptions caused by frequent nocturia require a urology consult.

Effective Treatment Strategies

Effectively treating sleep disorders requires a methodological approach. By using effective treatment strategies, physicians will be best equipped to help their patients achieve their sleep-related goals and improve their overall well-being.

Treat Any Underlying Conditions

If there is an identifiable cause of sleep disruptions, physicians should treat these causes first. Other measures to promote high-quality sleep will be ineffective if the underlying cause of insomnia is not addressed.

Provide Teaching on Good Sleep Hygiene

Poor sleep hygiene can have a significant impact on patients’ sleep patterns. Teaching patients how to maintain good sleep hygiene can be an effective yet simple method for improving their sleep. Good sleep hygiene measures include:

• Avoiding caffeine or alcohol before bed
• Avoiding screens in the hour before bed
• Going to sleep and waking up at the same time each day
• Keeping the bedrooms as dark as possible
• Keeping the bedroom cool
• Only using the bedroom for sleeping or intercourse
• Using white noise to mask other sounds

Treating Insomnia

Treating underlying conditions and promoting sleep hygiene may not always be sufficient for managing insomnia. In some situations, using treatments may be necessary. These may be pharmacological, such as using melatonin or stronger sleep aids. This may also require using other treatments, like CPAP machines, to treat sleep apnea and the insomnia that it brings.

Conclusion

Sleep is an essential component of holistic health, and addressing sleep disorders in senior patients is critical for their overall health and well-being. Primary care physicians are the frontline clinicians when recognizing and treating these sleep-related issues.

At ChenMed, we are committed to providing patients with holistic care by empowering physicians to take the time they need to understand each patient’s unique needs. Our culture prioritizes the physician-patient relationship and encourages doctors to focus on preventive care and wellness.

We invite you to learn more about our unique approach and how we can help to practice medicine the way it was meant to be.