Hypersomnia in the elderly: causes, symptoms and treatment

It’s no surprise that many older people report spending a large portion of the day sleeping. This is a very common reality in this population group, and it is a phenomenon which should not be linked to any pathology but to normative variations in sleep patterns over the years.

In this article we collect and briefly explain the phenomenon of hypersomnia in the elderly.

The concept of hypersomnia

Hypersomnia is considered the presence of excessive drowsiness for at least a month. This drowsiness can be observed both in prolonged periods of sleep (as in Kleine-Levin syndrome) and in the form of daytime sleep which leads to functional limitation of the individual in his activity in various areas. decreased intellectual performance and problems with concentration, memory and irritability.

This definition largely coincides with what happens in the elderly, who frequently fall asleep during the day.. It could be said, then, that many elderly people experience hypersomnia in old age. However, it should be borne in mind that in most cases this is due to the change in sleep cycles that occur throughout life.

Sleep cycles

Falling asleep is not like turning off a light switch. The transition from sleep to wakefulness does not happen in a sudden way in which our brain activity suddenly changes to repair itself and process information. In fact, as many readers already know, there are a total of five phases that we go through continuously throughout the sleep period, cyclically repeating a pattern that lasts around 110 minutes.

Four of these phases correspond to slow or non-REM sleep, the first two phases during which we fall asleep and disconnect from the environment and the second two (which often clump into a single phase called the Delta phase) sleep slow and restorative. The last phase corresponds to the paradoxical phase of sleep or REM, in which the information obtained during the watch is processed and phenomena like dreams occur.

These cycles vary in quantity and quality throughout life., Both in total time spent asleep and in the number of daily hours each phase occurs. For example, babies spend much of the day asleep, and during that time the high presence of REM sleep hours stands out.

Aging and sleep

As we age, sleep patterns change. While REM sleep remains more or less constant (with slight drops) from the age of twenty, the other phases of sleep vary throughout life.

It has been observed that in reaching old age there is a marked tendency to fragment sleepIt is common to have several nocturnal awakenings. They also significantly reduce the sleep of slow waves, a more restful sleep for the body. The phase of sleep that takes the longest is phase two, a light and not completely restful sleep from which the subject can wake up easily.

Over time, circadian rhythms naturally shorten, causing the subject to wake up earlier and earlier (although they usually go to bed early).

In conclusion, lthe amount and quality of sleep in older people is lower than what they had at other stages of life. This is why they do not get enough rest during their normal sleep periods, causing them to increase their fatigue and daytime sleepiness. In this way, hypersomnia occurs in old age as a normative process and without having to refer to the presence of other alterations.

Problems related to the onset of daytime sleep

Increased fatigue and the presence of a slight increase in daytime sleep may be part of normative aging.. But it can also be a sign of the existence of a physical or mental disorder, so consider whether or not there are other symptoms beyond drowsiness.

1. Depression

For example, it is common for people with depression to experience insomnia or hypersomnia.. And it is common for people with depression to show long term loss of positive reinforcement, anhedonia, disconnection from the environment, passivity and low energy and motivation levels. . It is a condition that can be felt at any age, but is particularly common among the elderly population due to the high number of age-related losses and decreases.

The loss of physical and mental capacity, of roles (such as work), the emergence of dependence on help in some cases, the death of part of the social environment or the growing loneliness shown by Elderly people are common reasons why those who reach old age suffer from some type of depressive syndrome.

2. Drug consumption

It is common that with age it is common to need different medications to treat different health problems. And this consumption is another major cause of hypersomnia in the elderly. Antihistamines, tranquilizers, pain relievers, antiemetics, and antidepressants are among the medications which can cause increased drowsiness.

3. Dementias

Patients with different types of dementia and neurodegenerative diseases also often have their sleep altered., As in Alzheimer’s disease.

4. Brain tumors or cancer treatment

Another cause that can lead to increased fatigue and hypersomnia in older people is suffering from a type of tumor that affects or compresses areas of the brain related to sleep management. Likewise, treating the cancer itself with chemotherapy can cause daytime hypersomnia.

5. Anemia

Lack of essential nutrients can cause anemia, In which the body is limited by the lack of elements to function effectively. This can lead to increased weakness and drowsiness in the elderly, leading to hypersomnia.

Bibliographical references:

  • Echávarri, C .; Erro, ME (2007). Sleep disorders in the elderly and in dementias. Annals of the Navarro Health System, 30, supl 1 .. Pamplona.
  • Phillip, B. and Ancoli, S. (2000) Sleep disorders in the elderly. Sleep Med .; 2: 99-114.
  • Reséndiz, M .; Valence, M .; Santiago, MV; Castaño, VA; Montes, J .; Hernández, J. and García, G. (2004). Excessive daytime sleepiness: causes and extent. Tower. Mex. Neuroses .; 5 (2). Mexico.

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