Question

CLINICAL SCENARIO: Sleep Disorder

Mr. and Mrs. E, both 83 years of age, live alone in a busy, high-crime area of a large city. Mr. E has mild dementia but is able to function well with his wife’s assistance and supervision. Over the past year, however, he has had significant changes in his sleep pattern in which he awakens several times during the night to use the bathroom and sleeps most of the day. He has a tendency to drink caffeinated sodas when he awakens if his wife doesn’t stop him, so she often will get out of bed when he does to make sure he drinks caffeine-free liquids. Mrs. E’s frequent awakening with her husband compounds a long term she has had with getting out of bed when she hears any street sound to assure no one is breaking into their home. Mrs. E is not comfortable napping during the day and tends to feel tired most of the time.

1. What risks do their sleep patterns present for Mr. and Mrs. E?

2. What recommendations would you have for this couple?

3. What non-pharmacologic measures can be incorporated into an older adult lifestyle to facilitate sleep?

Answer 1

Adequate sleep is essential for maintaining good health and well functioning of our body. Sleep disorder are more common in older adult.

I) The risk associated with sleepdisorder are,

Inadequate sleep affect all function of our body mainly,

*Hypertension _hypertension in sleeplessness patient is higher compared to normal patient.

*Anxiety disorder _sleeplessness cause anxiety disorder .

*cardiovascular and cerebrovascular disorder such as stroke and myocardial infarction .

*Glucose intolerance _sleeplessness cause glucose intolerance leads to development of diabetes mellitus. .

*Obesity_decreased sleep cause low levels of leptin and high level of gherlin it leads to obesity .

*cognitive decline_decreased sleep affect mental functioning of person, it affect decision making and critical thinking ability of an individual .

II) recomendations for sleep disorder :

Good education is helpful to treat sleep disorder that include,

Educate to avoid day time nap.

Advice Mrs. E to avoid anxiety and anticipation ,it reduces sleep.

Advice the couples to avoid caffeinated drink, nicotine and alcohol, these all are stimulants.

Advise them to maintain sleep routine.

Educate them to go to bed only for sleep.

Educate them to relax mind before going to sleeping.

III) Non pharmacological measure to treat sleep disorder

There are many non pharmacological measure available to treat sleep disorder that include ,

1)sleep hygiene and sleep education:education about general health practice like diet, exercise and substance use and environmental factors like noise ,climate and light that improves or interfere with sleeping .

2)stimulus control therapy:it is a bunch of instructions provided for maintaining good sleep habit it include go to bed only when sleepy, use bedroom for sleep only, avoid watching TV and reading when sleepy.

3)sleep restriction therapy :set time for actual sleep. Go to the bed at the time of sleep only, it create mild sleep deprivation and leads to good sleep patterns.

4)relaxation training :it help to relax the mind, it include diaphragmatic breathing ,guided imagery and meditation.

5)cognitive behavioral therapy :in CBT, it include all type of therapies like guided imagery, relaxation techniques and stimulus control therapy .

6)chronotherapy:it is type behavioral therapy, in this therapy shifting of sleep time to our desired time of sleeping.