Day-Long Sleep For Elderly: Good Or Bad?

It is common for older people to experience changes in the quality and duration of their sleep. Older adults may sleep more lightly and wake up during the night due to achy joints or the need to use the bathroom. Many compensate for this lost sleep by taking restorative naps during the day, which is normal. However, it is not normal for seniors to spend all day in bed or doze off in front of the TV instead of engaging in daily activities. If your elderly mother is sleeping a lot more than usual during the day, it is important to identify the underlying causes, which may include depression, medication issues, boredom, chronic pain, nutritional deficiencies, or other health concerns. A visit to the doctor is recommended to rule out any underlying health problems and ensure your mother receives the care she needs.

Depression and low energy

While occasional tiredness is normal, a persistent lack of energy could be a sign of depression or another health condition. If your mother is experiencing low energy and depression, it's important to seek medical advice and explore treatment options.

Depression is a serious mood disorder that can affect how a person feels, acts, and thinks. It is a common problem among older adults, but it is not a normal part of aging. If your mother has experienced depression earlier in life, she may be more likely to experience it again in her later years.

There are several types of depression that older adults may experience:

• Major Depressive Disorder: This includes symptoms lasting at least two weeks that interfere with a person's ability to perform daily tasks.
• Persistent Depressive Disorder (Dysthymia): This involves a depressed mood that lasts more than two years, but the person may still be able to perform their daily tasks, unlike someone with Major Depressive Disorder.
• Substance/Medication-Induced Depressive Disorder: This type of depression is related to the use of substances, such as alcohol or pain medication.
• Depressive Disorder Due to a Medical Condition: Depression can also be related to a separate illness, such as heart disease or multiple sclerosis.

Other forms of depression include psychotic depression, postmenopausal depression, and seasonal affective disorder.

Signs and symptoms of depression in older adults may include:

• A persistent sad, anxious, or "empty" mood
• Feelings of hopelessness, guilt, worthlessness, or helplessness
• Irritability, restlessness, or difficulty sitting still
• Loss of interest in once pleasurable activities, including sex
• Decreased energy or fatigue
• Moving or talking more slowly
• Difficulty concentrating, remembering, or making decisions
• Changes in sleep patterns, such as difficulty sleeping, waking up too early, or oversleeping
• Changes in appetite, such as eating more or less than usual, which may result in unplanned weight gain or loss
• Thoughts of death or suicide, or suicide attempts

If your mother exhibits several of these signs and symptoms, and they last for more than two weeks, it is important to encourage her to talk with her doctor. Depression is a treatable condition, and counselling, medication, or other forms of therapy can help.

In addition to seeking professional help, there are some steps you can take to support your mother:

• Encourage her to seek medical treatment and stick to the treatment plan prescribed by her doctor.
• Help her set up medical appointments or accompany her to the doctor's office or a support group.
• Engage her in activities she used to enjoy, or find new activities that she might like.
• Invite her to go for walks or bike rides, as physical activity can boost her mood.

It is important to address depression and low energy in older adults. By taking these steps, you can help your mother improve her quality of life and overall well-being.

Medication issues

The average senior takes between four and five separate medications. It is important to be aware of the side effects of these medications and to consult a doctor if you notice any changes in your elderly relative's behavior or physical health.

Dementia and sleep disorders

Sleep disturbances are common in older people with dementia. The condition can cause significant problems with sleep-wake cycles, leading to excessive daytime sleepiness and fragmented sleep at night. This can result in older people with dementia taking frequent, short-duration naps throughout the day to compensate for their lack of sleep.

Additionally, other medically diagnosed sleep disorders often co-occur with dementia. For example, the prevalence of obstructive sleep apnea in people with dementia residing in long-term care facilities is estimated to be as high as 70-80%. Sleep apnea is when the muscles in the throat relax during sleep, causing irregular breathing and apneas (cessation of breathing). This can lead to hypoxia, where the brain is deprived of sufficient oxygen.

Other sleep disorders associated with dementia include:

• Insomnia
• Circadian rhythm problems (shift in the sleep-wake cycle)
• REM sleep behaviour disorder (RBD)

It is important to note that the relationship between dementia and sleep disturbances is complex. Sleep disturbances may be an early sign of dementia, but they can also be a consequence of the condition. Experts believe that the two likely influence each other.

If you are concerned about your elderly mother sleeping all day, it is recommended to consult a doctor to rule out any underlying health problems.

Boredom and lack of engagement

With limited options for entertainment and social interaction, older people can experience a decline in their quality of life. They may no longer have a schedule to keep or much to look forward to in their daily lives, leading to boredom and fatigue. This can result in the habit of napping throughout most of the day.

Additionally, older adults may face challenges with their sleep due to changes in their body's internal clock, known as the suprachiasmatic nucleus (SCN). The SCN controls 24-hour daily cycles or circadian rhythms, which influence when a person feels sleepy or alert. As the SCN deteriorates with age, it can disrupt these rhythms, leading to more tiredness during the day.

It is important to note that daytime sleepiness becomes a concern when it interferes with an elderly person's daily activities and engagement with life. If you notice that your mother is sleeping excessively during the day and it is impacting her overall well-being, it may be time to consult a doctor to identify any underlying health issues.

• Encourage Social Interaction: Arrange for regular social interactions, such as visits from family and friends, or consider in-home care or adult day care services that can provide companionship and a broader social circle.
• Provide Mental Stimulation: Offer engaging activities that stimulate their minds, such as puzzles, games, or hobbies that they can enjoy.
• Facilitate Physical Activity: Encourage physical activity appropriate for their age and health condition. This can include walks, light exercises, or activities that promote movement.
• Create a Routine: Establish a daily routine to provide structure and a sense of purpose. This can include scheduled activities, mealtimes, and a consistent sleep schedule.
• Address Medication Side Effects: If your mother is taking multiple medications, discuss the side effects and alternatives with her doctor. Sometimes adjusting dosages or timing can improve alertness during the day.
• Seek Professional Help: Consult a doctor or elder care expert to rule out any underlying health conditions and to receive guidance on improving your mother's sleep and engagement.

Remember, it is important to respect your mother's choices and preferences while also ensuring her health and well-being. By addressing boredom and lack of engagement, you can help improve her quality of life and overall sleep patterns.

Other health concerns

If your elderly mother is sleeping all day, it is important to ensure she is still receiving adequate nutrition, personal hygiene, and medication. Without proper care, complications such as dehydration, malnutrition, and pressure ulcers can arise. If she is bedridden, she may also be at risk of developing bedsores and other health issues.

Excessive daytime sleepiness could be a sign of other underlying health issues. For example, it may be a symptom of advancing dementia, particularly in its later stages. It could also be a sign of depression, which is not a normal part of aging and should be addressed with medical attention, therapy, and support from loved ones.

Other possible causes of excessive daytime sleepiness include medication side effects, boredom, vitamin deficiencies, and chronic pain. If your mother is taking multiple medications, these could be interacting in ways that make her excessively sleepy. It is important to consult a doctor to review her medications and rule out any other potential causes.

If your mother is nearing the end of her life, her sleep patterns may change, and she may experience decreased activity and marked changes in consciousness. In such cases, hospice care can provide guidance and ensure she remains calm and comfortable.

Frequently asked questions