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Sleep in Geriatric Psychiatry Inpatients

  • Kim A. Hardin
  • Zachary C. Ryder
Chapter

Abstract

A majority of the geriatric population experiences some type of chronic sleep problem, which can lead to persistent sleep loss and negatively impact cognitive and physiological functioning. Recognition of factors that both promote and impair sleep is particularly important in hospitalized geriatric patients with psychiatric illnesses. This chapter reviews the changes that occur in sleep with aging and the environmental and intrinsic factors that can affect sleep. This chapter also addresses sleep disorders which impact psychiatric functioning and offers suggestions for therapeutic interventions.

Keywords

Sleep deprivation Delirium Primary sleep disorders Hospitalization 

References

  1. 1.
    Foley D, Ancoli-Israel S, Britz P, et al. Sleep disturbances and chronic disease in older adults: results of the 2003 National Sleep Foundation Sleep in America Survey. J Psychosom Res. 2004;56(5):497–502.CrossRefPubMedCentralGoogle Scholar
  2. 2.
    Bixler E. Sleep and society: an epidemiological perspective. Sleep Med. 2010;10(Supp 1):S3–6.Google Scholar
  3. 3.
    Pilkington S. Causes and consequences of sleep deprivation in hospitalized patients. Nurs Stand. 2013;27(49):35–42.CrossRefPubMedCentralGoogle Scholar
  4. 4.
    Krumholz HM. Post-hospital syndrome-an acquired, transient condition of generalized risk. NEJM. 2013;368(2):100–2.CrossRefPubMedCentralGoogle Scholar
  5. 5.
    Gooneratne NS, Vitiello MV. Sleep in older adults: normative changes, sleep disorders, and treatment options. Clin Geriatr Med. 2014;30:591–627.CrossRefPubMedCentralGoogle Scholar
  6. 6.
    Hirshkowitz M, Whiton K, Albert SM, et al. National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health. 2015;1(1):40–3.CrossRefPubMedCentralGoogle Scholar
  7. 7.
    Guadiola-Lemaitre B, Quera-Salva MA. Melatonin and the regulation of sleep and circadian rhythms. In: Kryger MH, Roth T, Dement WC, editors. Principles and practice of sleep medicine. 5th ed. St. Louis: Saunders; 2011. p. 420–30.CrossRefGoogle Scholar
  8. 8.
    Benarroch EE. Suprachiasmatic nucleus and melatonin: reciprocal interactions and clinical correlations. Neurology. 2008;71:594–8.CrossRefPubMedCentralGoogle Scholar
  9. 9.
    Beersma DG, Gordijn MC. Circadian control of the sleep-wake cycle. Physiol Behav. 2007;90:190–5.CrossRefPubMedCentralGoogle Scholar
  10. 10.
    Kim SJ, Benloucif S, Reid KJ, et al. Phase-shifting response to light in older adults. J Physiol. 2014;592:189–202.CrossRefPubMedCentralGoogle Scholar
  11. 11.
    Duffy JF, Zeitzer JM, Rimmer DW, et al. Peak of circadian melatonin rhythm occurs later within the sleep of older subjects. Am J Phys. 2002;282:E297–303.Google Scholar
  12. 12.
    Kessel L, Siganos G, Jorgensen T, et al. Sleep disturbances are related to decreased transmission of blue light to the retina caused by lens yellowing. Sleep. 2011;34:1215–9.CrossRefPubMedCentralGoogle Scholar
  13. 13.
    Farajnia S, Michel S, Deboer T, et al. Evidence for neuronal desynchrony in the aged suprachiasmatic nucleus clock. J Neurosci. 2012;32:5891–9.CrossRefPubMedCentralGoogle Scholar
  14. 14.
    Buysse DJ, Monk TH, Carrier J, et al. Circadian patterns of sleep, sleepiness, and performance in older and younger adults. Sleep. 2005;28:1365–76.CrossRefPubMedCentralGoogle Scholar
  15. 15.
    Landolt HP, Borbely AA. Age-dependent changes in sleep EEG topography. Clin Neurophysiol. 2001;112:369–77.CrossRefPubMedCentralGoogle Scholar
  16. 16.
    Dijk DJ, Duffy JF, Czeisler CA. Age related increase in awakenings: impaired consolidation of nonREM sleep at all circadian phases. Sleep. 2001;24:565–77.CrossRefPubMedCentralGoogle Scholar
  17. 17.
    Darchia N, Campbell IG, Feinberg I. Rapid eye movement density is reduced in the normal elderly. Sleep. 2003;26:973–7.CrossRefPubMedCentralGoogle Scholar
  18. 18.
    Ohayon M, Carskadon MA, Guilleminault C, et al. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep. 2004;27:1255–73.CrossRefPubMedCentralGoogle Scholar
  19. 19.
    Moraes W, Piovezan R, Poyares D, Bittencourt LR, Santos-Silva R, Tufic S. Effects of aging on sleep structure throughout adulthood: a population-based study. Sleep Med. 2014;15:401–9.CrossRefGoogle Scholar
  20. 20.
    Dew MA, Hoch CC, Buysse DJ, et al. Healthy older adults’ sleep predicts all-cause mortality at 4 to 19 years of follow-up. Psychosom Med. 2003;65:63–73.CrossRefPubMedCentralGoogle Scholar
  21. 21.
    Ohayon M, Wickire E, Hirshkowitz M, et al. National sleep foundation’s sleep quality recommendations: first report. Sleep Health. 2017;3:6–19.CrossRefPubMedCentralGoogle Scholar
  22. 22.
    Bartick MC, Thai X, Schmidt T, et al. Decrease in as-needed sedative use by limiting nighttime sleep disruptions from hospital staff. J Hosp Med. 2010;5(3):20–4.Google Scholar
  23. 23.
    Duong T, Hardin K, Mohammed J. Approach to disorders of sleep in hospitalized patients. Hosp Med Clin. 2017;6:543–61.CrossRefGoogle Scholar
  24. 24.
    Savva GM, Wharton SB, Ince PG, et al. Age, neuropathology, and dementia. NEJM. 2009;360(22):2302–9.CrossRefPubMedCentralGoogle Scholar
  25. 25.
    Ferrie J, Shipley M, Akbaraly T, et al. Change in sleep duration and cognitive function: findings from the Whitehall II study. Sleep. 2011;34(5):565–73.CrossRefPubMedCentralGoogle Scholar
  26. 26.
    Keage AD, Banks S, Yang KL, Morgan K, Brayne C, Matthew FE. What sleep characteristics predict cognitive decline in the elderly? Sleep Med. 2012;13:886–92.CrossRefPubMedCentralGoogle Scholar
  27. 27.
    Avidan A. Sleep in dementia and other neurodegenerative disorders. In: Culebras A, editor. Sleep disorders and neurologic diseases. 2nd ed. New York: Taylor & Francis Group; 2007.Google Scholar
  28. 28.
    Martin J, Marler MR, Shochat T, et al. Circadian rhythms of agitation in institutionalized patients with Alzheimer’s disease. Chronobiol Int. 2000;17:405–18.CrossRefPubMedCentralGoogle Scholar
  29. 29.
    Zhdanova IV, Tucci V. Melatonin, circadian rhythms, and sleep. Curr Treat Options Neurol. 2003;5(3):225–9.CrossRefPubMedCentralGoogle Scholar
  30. 30.
    Foley DJ, Monjan AA, Brown SL, et al. Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep. 1995;18(6):425–32.CrossRefPubMedCentralGoogle Scholar
  31. 31.
    ICSD 3, American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed. Darien: American Academy of Sleep Medicine; 2014.Google Scholar
  32. 32.
    American Psychiatric Association (APA). Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: APA Publishing; 2013.CrossRefGoogle Scholar
  33. 33.
    Gooneratne NS, Gehrman PR, Nkwuo JE, et al. Consequences of co-morbid insomnia symptoms and sleep-related breathing disorder in elderly subjects. Arch Intern Med. 2006;166:1732–8.CrossRefPubMedCentralGoogle Scholar
  34. 34.
    Stone KL, Ancoli-Israel S, Blackwell T, et al. Actigraphy-measured sleep characteristics and risk of falls in older women. Arch Intern Med. 2008;168:1768–75.CrossRefPubMedCentralGoogle Scholar
  35. 35.
    Jaussent I, Bouyer J, Ancelin M-L, et al. Insomnia and daytime sleepiness are risk factors for depressive symptoms in the elderly. Sleep. 2011;34(8):1103–10.  https://doi.org/10.5665/SLEEP.1170.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Pigeon WR, Hegel M, Unützer J, et al. Is insomnia a perpetuating factor for late-life depression in the IMPACT cohort? Sleep. 2008;31(4):481–8.CrossRefPubMedCentralGoogle Scholar
  37. 37.
    Ohayon MM, Roth T. Place of chronic insomnia in the course of depressive and anxiety disorders. J Psychiatr Res. 2003;37:9–15.CrossRefPubMedCentralGoogle Scholar
  38. 38.
    Jacobs GD, Pace-Schott EF, Stickgold R, Otto MW. Cognitive behavior therapy and pharmacotherapy for insomnia: a randomized controlled trial and direct comparison. Arch Intern Med. 2004;164:1888–96.CrossRefPubMedCentralGoogle Scholar
  39. 39.
    Videnovic A, Klerman EB, Wang W, Marconi A, Kuhta T, Zee PC. Timed light therapy for sleep and daytime sleepiness associated with Parkinson disease: a randomized clinical trial. JAMA Neurol. 2017;74(4):411–8.CrossRefPubMedCentralGoogle Scholar
  40. 40.
    Billioti de Gage S, Begaud B, Bazin F, et al. Benzodiazepine use and risk of dementia: prospective population based study. BMJ. 2012;345:623–6.CrossRefGoogle Scholar
  41. 41.
    Hatta K, Kishi Y, Wada K, et al. Preventive effects of ramelteon on delirium: a randomized placebo-controlled trial. JAMA Psychiat. 2014;71:397–403.CrossRefGoogle Scholar
  42. 42.
    Sun H, Palcza J, Rosenberg R, et al. Effects of suvorexant, an oxrein receptor antagonist, on breathing in patients with chronic obstructive pulmonary disease. Respir Med. 2015;109:416–26.CrossRefPubMedCentralGoogle Scholar
  43. 43.
    Lipford MC, Flemming KD, Calvin AD, et al. Associations between cardioembolic stroke and obstructive sleep apnea. Sleep. 2015;38(11):1699–705.  https://doi.org/10.5665/sleep.5146.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Young T, Shahar E, Nieto FJ, et al. Predictors of sleep-disordered breathing in community-dwelling adults: the sleep heart health study. Arch Intern Med. 2002;162:893–900.CrossRefPubMedCentralGoogle Scholar
  45. 45.
    Yaffe K, Laffan AM, Harrison SL, et al. Sleep disordered breathing, hypoxia, and risk of mild cognitive impairment and dementia in older women. JAMA. 2011;306(6):613–9.CrossRefPubMedCentralGoogle Scholar
  46. 46.
    Liu D, Myles H, Foley DL, et al. Risk factors for obstructive sleep apnea are prevalent in people with psychosis and correlate with impaired social functioning and poor physical health. Front Psych. 2016;7:139.  https://doi.org/10.3389/fpsyt.2016.00139.CrossRefGoogle Scholar
  47. 47.
    Koyanagi A, Stickley A. The association between sleep problems and psychotic symptoms in the general population: a global perspective. Sleep. 2015;38(12):1875–85.  https://doi.org/10.5665/sleep.5232.CrossRefPubMedPubMedCentralGoogle Scholar
  48. 48.
    Howell MJ, Schenck CH. Rapid eye movement sleep behavior disorder and neurodegenerative disease. JAMA Neurol. 2015;72:707–12.CrossRefPubMedCentralGoogle Scholar
  49. 49.
    Postuma RB, Gagnon JF, Tuineaig M, et al. Antidepressants and REM sleep behavior disorder: isolated side effect or neurodegenerative signal. Sleep. 2013;36(11):1579–85.CrossRefPubMedCentralGoogle Scholar
  50. 50.
    Aurora RN, Zak RS, Maganti RK, et al. Best practice guide for the treatment of REM sleep behavior disorder (RBD). J Clin Sleep Med. 2010;6:85–95.PubMedPubMedCentralGoogle Scholar
  51. 51.
    Jacobs T, Moss S, Jurd R. GABAA receptor tracking and its role in the dynamic modulation of neuronal inhibition. Nat Rev Neurosci. 2008;9:331–43.CrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Kim A. Hardin
    • 1
  • Zachary C. Ryder
    • 2
  1. 1.Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep MedicineUniversity of California, DavisSacramentoUSA
  2. 2.Texas A&M University Health Science Center, College of MedicineTempleUSA

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