Elderly Moms And Sleep: Understanding The Connection

There are many reasons why an elderly person may want to sleep all day. As people age, they tend to sleep more lightly and wake up during the night due to achy joints or the need to use the bathroom. Many seniors compensate for this lost sleep by taking a nap during the day, which is normal. However, it becomes a problem when they spend most of their time dozing instead of engaging in daily activities. This could be a sign of boredom, depression, chronic pain, nutritional deficiencies, or medication side effects. It is important to consult a doctor to rule out any underlying health issues and ensure they are receiving proper care.

Depression and low energy

While it is normal for older people to sleep more lightly and take restorative naps during the day to compensate for lost sleep at night, excessive daytime sleepiness in the elderly can indicate an underlying health problem.

Depression is a common mental health issue among older adults and can be a cause of fatigue and low energy. Research estimates that major depressive disorder occurs in 5% of community-dwelling elders, while up to 16% of older adults exhibit clinically relevant depressive symptoms. Sleep issues and fatigue can be warning signs of depression in seniors. If you notice these symptoms, it is important to talk to your loved one about how they are feeling and seek professional help if needed.

Additionally, side effects from medication and medical treatments can contribute to low energy levels in older adults. Polypharmacy, or the use of multiple drugs, can lead to interactions that magnify side effects such as drowsiness and dizziness. Certain medications, including antidepressants, antihistamines, and painkillers, are known to cause excessive sleepiness.

Emotional stress, such as grief from the loss of loved ones, stress from personal problems, or a sense of losing control over one's life, can also contribute to fatigue. Lifestyle factors, such as a lack of physical activity, irregular sleep patterns, excessive caffeine or alcohol consumption, and poor nutrition, can further exacerbate low energy levels.

If your elderly mother is experiencing low energy and excessive sleepiness, it is important to consult a healthcare professional to identify and address any underlying health issues. Treating the underlying cause can help reduce fatigue and improve overall well-being.

Medication side effects

Prescription drugs and over-the-counter medications for conditions like anxiety, depression, high blood pressure, insomnia, chronic pain, Parkinson’s disease, nausea, and allergies can all cause excessive sleepiness. Atypical antipsychotics are particularly hard on elderly patients, especially those living with dementia. If your loved one is using one or more of these drugs, discuss the side effects and alternative treatment options with their physician. It may be possible to reduce some medications in their regimen to smaller dosages or discontinue them completely. Sometimes altering the timing of a senior’s doses can improve their alertness during the day.

Benzodiazepines are the most commonly prescribed agents for sleep but carry a risk of adverse effects, including next-day sedation, impaired recall, cognitive impairment, and risk for abuse and dependence. They are also associated with an increased risk of falling. Nonbenzodiazepine hypnotics like zolpidem, zaleplon, and eszopiclone are effective agents for improving sleep onset but not sleep maintenance. They have a lower risk of drug-drug interactions and adverse effects similar to benzodiazepines (delirium, falls, and fractures). These hypnotics should be used with caution in older adults and for no longer than 90 days.

Antihistamines, particularly diphenhydramine, are frequently used among elderly patients, especially in nursing home settings. They are associated with next-day sedation and impaired psychomotor and cognitive function. Other side effects include urinary retention, blurred vision, orthostatic hypotension, dizziness, and palpitations.

Dementia

People with dementia, especially those in the later stages, often spend a lot of time sleeping during the day and night. This can be distressing for family and friends, who may worry that something is wrong. As the disease progresses, the person with dementia may find even simple tasks exhausting, which can lead to increased daytime sleep as their symptoms worsen.

The quality of sleep tends to deteriorate as people with dementia get older, and they may not get enough deep or 'slow-wave' sleep, which is important for keeping the brain healthy. Additionally, their internal 'biological clock' may become damaged, causing them to feel sleepy at the wrong times of day.

Sleeping disorders unrelated to dementia, such as sleep apnoea, can also contribute to longer sleep duration. Medications, including antipsychotics, antidepressants, antihistamines, and sleeping pills, may also play a role in increased sleepiness.

While it is generally not a cause for concern if a person with dementia is sleeping more during the day and does not appear uncomfortable or distressed, it is important to ensure they are still receiving proper nutrition, personal care, and medications. If the excessive sleeping is sudden or accompanied by other changes, it is important to consult a doctor to rule out any underlying conditions or infections.

To support a person with dementia in sleeping better at night, a healthy sleep routine, brief naps during the day, and a consistent daily schedule can be beneficial. Social interaction, mental stimulation, and physical activity can also improve their quality of life and potentially enhance their sleep.

It is important to note that neither over-the-counter nor prescription sleeping pills are typically recommended for people with dementia. Instead, engaging activities during the day, brief naps, and a set sleep schedule are suggested as non-pharmaceutical methods to encourage better sleep habits.

Boredom and lack of engagement

The result is a slide into a habit of napping throughout the day, not because they are tired but because they are bored. They may not be clinically depressed, but with no schedule to keep and little to look forward to, they fill their time with sleep.

To combat this, it is important to find ways to stimulate your mother's interest in life. This could include socialisation through visitors, attending events at a senior centre, or even adult day care. Having a schedule to adhere to, such as being ready for an adult day care bus, can be very helpful. After a few hours of engaging in activities and socialising with professionals and peers, your mother may be more tired in the evening and sleep better at night.

If adult day care is not an option, consider hiring someone to come in during the day to provide companionship and take your mother on day trips. This can help her maintain an interest in life and improve her quality of life.

Age-related changes

As we age, our bodies change and our sleep patterns are no exception. Older people tend to sleep more lightly than when they were younger, often waking up during the night due to achy joints or the need to use the bathroom. This can result in them feeling the need to compensate for lost sleep by taking a nap during the day. While this is normal, it becomes a problem when an elderly person spends the majority of the day sleeping instead of engaging in their daily activities.

There are several age-related changes that can cause excessive daytime sleeping in the elderly. Here are some potential reasons:

• Dementia: People with dementia, especially in the later stages, often spend a lot of time sleeping during the day and night. This is because the damage to their brain makes it exhausting for them to do simple tasks like communicating or eating.
• Medication: Elderly individuals often manage multiple health conditions with various medications, which may have side effects such as drowsiness and dizziness. Certain medications, such as antipsychotics, antidepressants, antihistamines, and sleeping pills, are known to contribute to sleepiness.
• Depression: Depression can cause anyone to lose interest in activities and experience excessive fatigue. It is not a normal part of aging and should be addressed by a qualified doctor.
• Boredom: As people age, they may struggle with activities they once enjoyed due to physical limitations or declining eyesight. This can lead to boredom and a lack of stimulation, resulting in excessive napping.
• Chronic Pain and Nutritional Deficiencies: Age-related conditions and a decline in physical activity can lead to chronic pain, which may disrupt sleep at night and cause daytime sleepiness. Nutritional deficiencies can also contribute to fatigue and sleep disturbances.
• Changes in Sleep Patterns: The quality of sleep tends to deteriorate as people get older, with a decrease in deep or 'slow-wave' sleep, which is important for brain health and refreshment.
• Terminal Illness: In some cases, excessive sleeping in individuals with serious medical conditions may indicate that their health has taken a turn. However, it does not necessarily mean that death is near.

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