Sleep disorders in the elderly: Diagnosis and management

Suzuki, Keisuke; Miyamoto, Masayuki; Hirata, Koichi

doi:10.1002/jgf2.27

Cited by 182 publications

(148 citation statements)

References 68 publications

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“…Key words: poor sleep quality; peptic ulcer disease recurrence; older patients P oor sleep quality 1 and peptic ulcer disease (PUD) 2 are both major public health problems affecting physical and psychological well-being of older adults. Poor sleep quality is partially attributable to age-related increases in comorbid conditions, medication use, and sleep behavior changes, which affect approximately one-third of older adults worldwide.…”

Section: Discussionmentioning

confidence: 99%

“…Poor sleep quality is partially attributable to age-related increases in comorbid conditions, medication use, and sleep behavior changes, which affect approximately one-third of older adults worldwide. 1 Plausibly due to reduced prostaglandin levels and blood supply to the gastric mucosa resulting from aging, PUD formation and its recurrence are also prevalent among older adults. 3 Although Helicobacter pylori eradication therapy has effectively reduced the rate of PUD recurrence from over 40% to 5% to 25%, 4,5 recent clinical findings revealed that only a proportion of H. pylori-reinfected patients experienced PUD recurrence and that few of the PUD recurrent patients were reinfected with H. pylori.…”

Section: Discussionmentioning

confidence: 99%

“…Poor sleep quality and peptic ulcer disease (PUD) are both major public health problems affecting physical and psychological well‐being of older adults. Poor sleep quality is partially attributable to age‐related increases in comorbid conditions, medication use, and sleep behavior changes, which affect approximately one‐third of older adults worldwide . Plausibly due to reduced prostaglandin levels and blood supply to the gastric mucosa resulting from aging, PUD formation and its recurrence are also prevalent among older adults .…”

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confidence: 99%

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Effect of Subjective and Objective Sleep Quality on Subsequent Peptic Ulcer Recurrence in Older Adults

Fang¹,

Liu²,

Yang

et al. 2019

J American Geriatrics Society

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OBJECTIVE To examine the effect of subjective and objective sleep quality on subsequent recurrence of peptic ulcer disease (PUD) among older patients after Helicobacter pylori eradication. SETTING Eight grade A hospitals in China. PARTICIPANTS Of 1689 older Chinese with H. pylori–infected PUD recruited between January 2011 and October 2014, H. pylori were eradicated and PUD was cleared in 1538 patients by the end of 2014; 1420 of these patients were followed up for up to 36 months. MEASUREMENTS Using multiple measures at 6‐month intervals, PUD recurrence was determined with esophagogastroduodenoscopy. Subjective sleep quality was measured using the Pittsburgh Sleep Quality Index. Objective sleep quality domains were measured using an accelerometer, including sleep onset latency, sleep efficiency, total sleep time, and number of awakenings. RESULTS This study documented a 36‐month cumulative PUD recurrence of 8.3% (annual rate = 2.8%). Multivariate analyses showed that participants who reported poorer sleep quality were more likely to experience PUD recurrence during the 36‐month follow‐up period (hazard ratio [HR] = 1.895; 95% confidence interval [CI] = 1.008‐3.327). Regarding objective sleep quality domains, longer sleep onset latency (HR = 1.558; 95% CI = 1.156‐2.278) and more nighttime awakenings (HR = 1.697; 95% CI = 1.168‐2.665) increased the risk of PUD recurrence. However, a longer total sleeping time protected against PUD recurrence (HR = 0.768; 95% CI = 0.699‐0.885). CONCLUSIONS Poor sleep quality predicts a greater risk of PUD recurrence. Accurate diagnosis and effective treatments should, therefore, be provided for older adults afflicted with poor sleep, particularly for those who previously had PUD. It is equally important to include sleep assessment as an integral part while dealing with these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Effect of Subjective and Objective Sleep Quality on Subsequent Peptic Ulcer Recurrence in Older Adults

Fang¹,

Liu²,

Yang

et al. 2019

J American Geriatrics Society

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“…The importance of sleep for the overall health and well‐being of the elderly has been increasingly recognized . Psychiatrists, neurologists, and geriatricians, general practitioners should have sound knowledge about the changing pattern of sleep from infancy to old age.…”

Section: Introductionmentioning

confidence: 99%

“…The importance of sleep for the overall health and well-being of the elderly has been increasingly recognized. 1,2 Psychiatrists, neurologists, and geriatricians, general practitioners should have sound knowledge about the changing pattern of sleep from infancy to old age. Additionally, the sleep problems faced by the elderly, and the consequences of inadequate and inappropriate sleep in determining the quality of their life, have gained recognition recently.…”

Section: Introductionmentioning

confidence: 99%

Sleep disorders in the elderly: a growing challenge

2018

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In contrast to newborns, who spend 16-20 h in sleep each day, adults need only about sleep daily. However, many elderly may struggle to obtain those 8 h in one block. In addition to changes in sleep duration, sleep patterns change as age progresses. Like the physical changes that occur during old age, an alteration in sleep pattern is also a part of the normal ageing process. As people age, they tend to have a harder time falling asleep and more trouble staying asleep. Older people spend more time in the lighter stages of sleep than in deep sleep. As the circadian mechanism in older people becomes less efficient, their sleep schedule is shifted forward. Even when they manage to obtain 7 or 8 h sleep, they wake up early, as they have gone to sleep quite early. The prevalence of sleep disorders is higher among older adults. Loud snoring, which is more common in the elderly, can be a symptom of obstructive sleep apnoea, which puts a person at risk for cardiovascular diseases, headaches, memory loss, and depression. Restless legs syndrome and periodic limb movement disorder that disrupt sleep are more prevalent in older persons. Other common medical problems of old age such as hypertension diabetes mellitus, renal failure, respiratory diseases such as asthma, immune disorders, gastroesophageal reflux disease, physical disability, dementia, pain, depression, and anxiety are all associated with sleep disturbances.

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Treatment of sleep disturbance in older adults

Reynolds

Adams

2019

Pharmacy Practice and Res

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Sleep and circadian rhythm disturbances are prevalent in older populations. Numerous factors can affect sleep, including medications, living environment and physical, mental and psychosocial factors (e.g. loneliness and stress). Sleep architecture changes with aging, with less deep sleep (slow wave sleep) and an increased frequency of awakenings after sleep onset. Benzodiazepines, Z-drugs and low doses of the tricyclic antidepressant doxepin have modest positive benefits for sleep complaints, but side effects are a concern in older people because they include an increased risk of falls, fractures and cognitive impairment. Somnolence can be prolonged in older adults. Melatonin has very modest effects on sleep initiation in older adults, although appears safe. Overall, the effects of pharmacological treatments are modest and there are concerns about the efficacy and safety of their ongoing use. There is strong evidence for non-pharmacological interventions, including cognitive and behavioural strategies, to improve sleep. These have at least comparable efficacy to pharmacological interventions, fewer adverse effects and are more likely to have longer-term, sustained benefits. Sleep complaints in older adults need to be approached on a patient-by-patient basis, and medication should be reviewed frequently, with preference to limit pharmacological intervention as far as practicable.

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Sleep disorders in the elderly: Diagnosis and management

Cited by 182 publications

References 68 publications

Effect of Subjective and Objective Sleep Quality on Subsequent Peptic Ulcer Recurrence in Older Adults

Effect of Subjective and Objective Sleep Quality on Subsequent Peptic Ulcer Recurrence in Older Adults

Sleep disorders in the elderly: a growing challenge

Treatment of sleep disturbance in older adults

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