Resources for the Comprehensive Geriatric Assessment based
Proactive and Personalised Primary Care of the Elderly
Sleep disorders are commonly underdiagnosed and are a significant source of concern in the geriatric population (Subramanian S, 2007), affecting 40-70% of older adults (Neikrug AB, 2010).
Sleep architecture changes as an intrinsic part of ageing (Dijk DJ, 1999).
While changes in sleep patterns may be part of the normal aging process, many of these disturbances may be related to pathological processes that are not considered a normal part of aging (Mahowald MW, 2007).
Several diverse factors may contribute to sleep disturbances in a large percentage of the elderly population, including retirement, health problems, death of spouse/family members, and changes in circadian rhythm (Avidan AY, 2005).
Excessive daytime sleepiness resulting from sleep disorders affects quality of life, as well as physical, psychological, and cognitive problems (Cole C, 2007),
Sleep disorders have been implicated with increased mortality. In addition, the number of medications used tends to increase with age, which in itself can lead to increased morbidity, mortality, and side effects such as falls (Latimer Hill E,2007), cognitive impairment, and further sleep disturbances (Barry PJ, 2008).
More than one half of people older than 64 years who live at home and two thirds of people older than 64 years who reside in a long-term care facility are estimated to have some form of sleep disturbance (Kamel NS, 2006).
Sleep disturbance or insomnia is the third most common patient complaint, ranking behind headaches and the common cold.
Older women are more likely to experience insomnia than older men (Byles JE, 2005).
In addition to affecting quality of life, sleep disorders have been associated with increased mortality.
Two primary sleep disorders that increase with age are sleep apnea (SA) and periodic limb movements in sleep (PLMS).
Sleep apnea can result in daytime hypersomnolence, systemic hypertension, cardiac arrhythmias, cor pulmonale, and sudden death (Yaffe K,2011).
Older women with sleep-disordered breathing (SDB), characterized by recurrent arousals from sleep and intermittent hypoxemia, have an increased risk of developing cognitive impairment Yaffe K,2011).
In older men, the likelihood of atrial fibrillation or complex ventricular ectopy (CVE) increased along with the severity of SDB (Mehra R,2009).
Sleep Diary - Grazioli v.1
One week long sleep diary
Epworth Sleepiness Scale
Measure average daytime sleepiness
Sleep Disorders is one of 4 conditions identified as
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STOP BANG Screening Questionnaire
A Screening Instrument for Sleep Apnea
SleepMed Insomnia Index and Sleep Matrix
Combination of Epworth Sleepiness Scale and SleepMed Index scores on a Sleep Matrix