As a sleep researcher and professor at the University of Alabama’s Capstone College of Nursing, I often give lectures on sleep disorders to students and in the community. Every time I lecture, someone raises their hand and says, “I have witnessed those symptoms many times. My father (or mother or spouse or child) has that very problem.” Its true, sleep disorders are more common that most people appreciate. Sleep science is still emerging and most nurses have had no formal education about the science of sleep. New textbooks include sleep disorders today, but earlier editions had very little accurate information on the subject.
In our 24/7 culture, sleep is something that we don’t take as seriously as we should. That is to say, just like eating the right foods — you can’t cheat on sleep all week long and then catch up on the weekends. Sleep is just as important to health as nutrition. In order to promote and maintain our health, it requires healthy food choices everyday at every meal along with adequate servings of sleep every night. Similarly, sleep hygiene are those methods that we use to promote good quality sleep on a daily basis. Sleep hygiene includes those simple things like a quiet and dark environment, a comfortable and safe place to sleep and a bedtime routine that helps us fall asleep easily. If this sounds like teaching toddlers about bedtime, remember that we all benefit from those same good bedtime habits.
On the other hand, there are sleep problems that are actual medical disorders. Many people do understand which sleep habits are actually symptoms of these disorders. In some cases they will think these sleep problems are part of other medical conditions. One instance that comes to my mind is a nurse friend whose husband was always exhausted after work. This poor man could hardly eat his dinner he was so tired. However, he was often exhausted at work too and needed a dozen cups of coffee a day just to function. My friend and her husband thought his fatigue was due to his job and his increasing age. The notion of a serious but treatable sleep disorder never came to mind. Hearing these symptoms along with a history of loud and irregular snoring, I reviewed the symptoms of sleep apnea for my friend. Sure enough, after an overnight sleep study, that turned out to be the case. Once he was properly diagnosed and properly treated, this fellow became a new man who played tennis after work and mowed the lawn before dark on weeknights!
When it comes to older adults and home care, it’s particularly important for clinicians to have a working knowledge of sleep hygiene. Having a regular sleep schedule offset by daily exercise and exposure to bright morning light will promote healthy sleep. Likewise, we all need to remember that sleep disorders produce excessive daytime sleepiness. Sleep disorders come in many forms that commonly include: snoring combined with breathing holding (sleep apnea), leg discomfort and compulsive leg movements at night (restless leg syndrome) and problems falling asleep or staying asleep or waking too early (insomnia). Also, sleep loss and poor quality sleep can have a negative impact on cognitive functioning and behavior for all members of the household, patient and caregiver alike.
Remarkably, most of sleep disorders are treatable – but only if they are identified! Good sleep hygiene practices combined with appropriate treatment for sleep disorders can improve the day-to-day function and well being of older adults. Likewise, the entire household benefits from improved sleeping conditions when the problem sleeper gets the help that they need.
The first step in improving sleep quality for older adults and families is to change the way we all think about sleep. To help you get started in your quest to learn more about sleep and how to help your patients, visit CHAMP’s tools page and select the “Sleep” topic!
So the next time you’re at an older patient’s home, ask them how they’ve been sleeping and listen carefully!
