Sleep disorders in the elderly and senile. Clinical treatment guidelines

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35% of older people have problems sleeping. The older you are, the more often such disorders occur. These may include difficulty falling asleep, waking up early, or interrupted or shallow sleep. A person may be disturbed by vivid, unpleasant dreams, he may experience fear of the night or dreams, and may not feel rested in the morning. Problems gradually accumulate: anxiety and tension increase, which makes it more difficult to fall asleep, and the period of night rest lasts less. To normalize the regime, you need to determine the reasons why it was violated.

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When are medications needed?

After 65 years, sleep disorder is considered a common ailment. It is associated with a deficiency of melatonin, a hormone produced in the pineal gland of the brain. When the substance enters the bloodstream, a person begins to feel sleepy. The destruction of the hormone occurs in the light. Hence the waking up in the morning.

With a normal amount of melatonin, a person sleeps soundly. And in the morning he feels cheerful, being in a great mood. Infants produce more melatonin than adults. That's why babies sleep for 16-18 hours. As the body ages, hormone levels decrease. This is due to hormonal changes, metabolic disorders, and malfunctions of internal organs and systems in an elderly person.

Elderly people sleep poorly due to:

• changes in daily routine;
• experiences and stress;
• feelings of loneliness;
• chronic diseases;
• drug abuse;
• lack of comfort in the bedroom.

Every person over the age of sixty should know how to regain normal sleep.

Features of the hormone melatonin

The role of the sleep hormone is:

• regulation of the immune and endocrine systems, which leads to increased resistance to infections, cancer and other diseases;
• normalization of blood pressure;
• reducing blood cholesterol levels;
• protecting cells from free radicals that accumulate in the body under the influence of unfavorable environmental conditions;
• helping a person cope with stress and excessive physical activity;
• slowing down the aging of the body.

It is important to restore normal production of the hormone melatonin by the pineal gland in order to feel great even in old age.

How to cope

“You need to see a specialist and not self-medicate. A somnologist will study the details and identify provoking factors. This may require consultation with other specialists, for example, a geriatrician who deals with age-associated diseases and uses an integrated approach to treating the elderly,” notes Ruslan Isaev.

It is important to remember that in people over 65 years of age, the risk of side effects and complications increases when taking medications, especially when self-medicating. Therefore, first of all, preference is given to non-medicinal methods. These include seemingly trivial but effective recommendations for sleep hygiene, which include a number of measures to maintain a sleep schedule and lifestyle that promotes normal sleep. If they are followed, insomnia in most cases in the elderly can be treated without sleeping pills.

“The so-called cognitive behavioral therapy, which is the work of a psychotherapist aimed at creating a positive association between bed and sleep, also shows high effectiveness. In case of insufficient effectiveness of non-drug approaches, drugs are selected taking into account high safety for an elderly person. Chronic insomnia is effectively treated with a number of antidepressants that have hypnotic, sedative and anti-anxiety effects. For acute insomnia, short-acting sleeping pills are prescribed. Treatment is carried out with great caution, taking into account concomitant diseases,” says the specialist.

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Consequences of insomnia

Elderly people find it difficult to fall asleep, they often wake up at night because they are overcome by thoughts or pain does not let go. As a result of constant lack of sleep, irritability and tearfulness appear. Next, irreversible processes occur in the state of the psyche and nervous system.

Over time, they only get worse, leading to senile dementia and Alzheimer's syndrome. Along with the deterioration of thought processes, memory and attention suffer. The changes also affect the quality of sleep. Strange dreams and night hallucinations are disturbing.

Those who sleep little tend to consume more sweets and high-starch foods rather than vegetables and fruits. Worried about the lack of rest, the brain “looks” for simple carbohydrates to normalize its diet. To avoid the consequences of insomnia, it is necessary to start treatment in a timely manner.

Sleep Basics

Sleep requirements change throughout the life cycle. Babies require about 16 hours of sleep per day. The transition to a later sleep-wake cycle occurs during adolescence, and 9 hours of sleep is sufficient. Adults require 7-9 hours of sleep every night. Surprisingly, older adults also need the same 7-9 hours, although they shift to an earlier sleep cycle.

The quality of sleep is just as important as the quantity. When we begin to fall asleep, our body gradually enters NREM (non-rapid eye movement) sleep and goes through four stages, starting with light sleep, progressing to deeper sleep. During the fifth stage, known as REM (rapid eye movement), breathing becomes irregular and shallow, our eyes move quickly, the muscles of the limbs become rigid, and in such conditions dreams can occur. The entire NREM-REM cycle lasts about 90-110 minutes and usually occurs 4-5 times during normal sleep.

Research shows that older people tend to sleep lighter for shorter periods, spending less time in REM sleep. This change is attributed to the aging process, but may also be the result of other health problems.

The best sleeping pills without a prescription

When all methods of psychotherapy have been tried, it is worth turning to medications. It is better to choose sleeping pills for older people without prescriptions. The composition of such medications is suitable for the aging body and does not cause severe side effects.

Sleeping pills after stroke

After a stroke, a feeling of fear, anxiety, and restlessness arises, which will become an obstacle to sound sleep. And this condition does not allow the body to recover completely. Therefore, medications are prescribed to promote sleep and relieve increased excitability.

How to treat insomnia?

The best ones:

• Diazepam. The tranquilizer reduces the excitation of the cerebral cortex and has a relaxing effect on the human muscles. Long-term treatment is addictive.
• Glycine. The amino acid has an inhibitory type of action. Therefore, sublingual tablets are used as a sedative. The medicine has a positive effect on metabolism in brain tissue. It is useful for patients with muscular dystrophy to take it. After a stroke, it reduces brain disorders.
• Donormil. As a blocker of H1-histamine receptors, it has a hypnotic effect. A good remedy that reduces the time it takes to fall asleep, increases the duration of sleep without changing its phases. Sleeping pills are used only as prescribed by a doctor. In older people, it can cause dizziness and slow reactions when waking up at night. The period of elimination of the substance increases in persons with renal and liver failure.
• Zolpidem. One of the best remedies shortens the recovery period after a stroke. Despite the sedative effect, the tablets do not have a significant relaxing effect on the central nervous system. Take the tablet immediately before bedtime with liquid. Conditions of addiction occur after 3-4 weeks of treatment with the drug.

You cannot restore sleep on your own. Many of the medications are prescribed only by a doctor, especially for patients after a stroke.

Take medications according to instructions

Herbal preparations

Lightweight remedies for older people that will help them sleep soundly should consist of natural ingredients. It is better to use the safe remedy Motherwort Forte rather than potent sleeping pills based on synthetic substances. In addition to motherwort herb, the tablets contain magnesium and vitamin B6.

With the help of the drug you can achieve anticonvulsant, sedative, cardiotonic, diuretic effects. The downside of the drug is the appearance of allergic reactions and discomfort in the digestive tract after it. Novo-Passit contains herbal extracts that promote better sleep and sound sleep.

The drug Passidorm is based on the passionflower plant. It contains substances and vitamins that calm, relieve stress, and prolong sleep. Neurosed is classified as a homeopathic medicine. The granules are dissolved before meals half an hour or 1 hour after meals. Persen contains valerian, lemon balm, and peppermint herbs. The tablets can be taken for a long time, as they are not addictive.

Taking this tincture will help improve sleep:

• evading peony;
• valerian officinalis;
• blood red hawthorn.

For insomnia, take tablets of the drug Beloid with belladonna vulgaris. Tea made from linden flowers, chamomile, hop cones, infusion of fragrant dill seeds, flowers and leaves of fragrant violet are very soothing.

Sleeping pills and chronic diseases

For an elderly person, it is important that medications for insomnia also help with other diseases of vital organs. Valocordin is needed to normalize blood pressure in hypertension. Bromine and Hexamidine during epileptic seizures have a drowsy effect on the body of the elderly.

Benzodiazepine tablets help to recover from a stroke. But long-term use will lead to undesirable consequences. Diabetes mellitus often develops in old age, in which the supply of glucose to the cells is disrupted. Diabetics should not take sleeping pills, as the patient often gets up at night with a feeling of hunger when the blood sugar level drops sharply.

An elderly person with developing Alzheimer's disease should definitely get enough sleep. Therefore, the doctor prescribes mild sleeping pills.

Complications

Taking sleeping pills once does not have a harmful effect on the body of older people. But if you constantly use sleeping pills, the accumulation of chemicals will lead to complications. Sleepwalking and apnea may develop. The danger of these conditions lies in the development of diseases of the respiratory and nervous systems. A short cessation of breathing can lead to more frequent attacks and death.

All sleeping pills cause headaches, dizziness, nausea, and coordination problems. Some of the drugs are prohibited for older people. Therefore, a specialist will help you determine which medicine to choose. You cannot treat sleep disorders on your own.

Determining whether you need to take sleeping pills or completely abandon them can only be done by a complete examination of the body. After all, people often sleep poorly due to psychological problems. There is no need to worry about poor sleep if you wake up many times during the night, staying awake for 15 seconds each time you wake up.

Such awakenings create the illusion of a sleepless night. At the same time, you shouldn’t grab sleeping pills, but it’s better to calm down about poor sleep. When there is concern about the quality and quantity of sleep, it is better to seek help from a psychologist.

Caring for the elderly will restore their health and sound sleep

Who should I turn to for help?

The Ultramed Gerontology Clinic treats elderly people with various diseases. A psychotherapist treats insomnia in a medical setting. However, depending on the causes of the disease, intervention by other experts is possible.

In many cases, patients undergo an initial examination, which is carried out by a general practitioner, who then refers the client to the right specialist. The help of a psychologist is often effective.

If you need surgical treatment for insomnia, then we are ready to provide you with all the necessary help from highly qualified specialists with more than 20 years of experience.

Recommendations from experts

There are many other ways to regain healthy sleep:

• 1.5 hours before bedtime, turn off the overhead lights, leaving only the floor lamp or sconce. In the dark, melatonin production will begin.
• The hormone is activated in dark blue and violet light. You can hang curtains in these shades; they can be drawn 2-3 hours before going to bed.
• It is also better to choose pillowcases in blue tones.
• Among the foods that stimulate the production of melatonin are rice and barley porridge, potatoes baked in their skins, corn, and tomatoes. Dinner should be light and eaten 2 hours before going to bed.

People over 60 often experience sleep disturbances. How to correct the situation and return to the normal duration of night rest must be discussed together with your doctor. Sleeping pills are taken last, focusing on the mild and safe ones.

Cost of services

This list does not contain all prices for services provided by our clinic. The full price list can be found on the “Prices” , or by calling: 8(969)060-93-93. Initial consultation is FREE!

Sedatives

Many patients, despairing of coping with the problem of how to fall asleep and fully relax, begin to take these drugs on their own, without first consulting a doctor. Indeed, the main advantage of herbal medicines is their safety, the absence of the risk of overdose and daytime drowsiness.

But at the same time, they can hardly be called the best drugs for the treatment of insomnia. They are only effective for minor sleep problems. They are prescribed for increased anxiety and restlessness, irritability and emotional lability.

This is not a complete list of medications used for insomnia. According to indications, nootropics (for example, Phenibut), anxiolytics, and multivitamin complexes are prescribed. At the same time, it is impossible to say what is better or worse: a treatment regimen that helped in one case may not work in another. Therefore, only a doctor should determine what to drink for insomnia. Still have questions? Would you like to make an appointment? Call our operator by phone.