Sleep disturbance in older ICU patients

Sterniczuk, Roxanne; Rusak, Benjamin; Rockwood, Kenneth

doi:10.2147/cia.s59927

Cited by 44 publications

(35 citation statements)

References 116 publications

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“…Physical disability is yet another issue in the elderly that marks the loss of independence, as difficulty in performing activities necessary for independent living increases . This affects sleep regardless of whether a person has assistance at home or is in a hospital intensive care unit . For those who have assistance at home, there are genuine concerns that their caregiver's sleep is also affected …”

Section: Sleep and Physical Disabilitymentioning

confidence: 99%

Sleep disorders in the elderly: a growing challenge

2018

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In contrast to newborns, who spend 16-20 h in sleep each day, adults need only about sleep daily. However, many elderly may struggle to obtain those 8 h in one block. In addition to changes in sleep duration, sleep patterns change as age progresses. Like the physical changes that occur during old age, an alteration in sleep pattern is also a part of the normal ageing process. As people age, they tend to have a harder time falling asleep and more trouble staying asleep. Older people spend more time in the lighter stages of sleep than in deep sleep. As the circadian mechanism in older people becomes less efficient, their sleep schedule is shifted forward. Even when they manage to obtain 7 or 8 h sleep, they wake up early, as they have gone to sleep quite early. The prevalence of sleep disorders is higher among older adults. Loud snoring, which is more common in the elderly, can be a symptom of obstructive sleep apnoea, which puts a person at risk for cardiovascular diseases, headaches, memory loss, and depression. Restless legs syndrome and periodic limb movement disorder that disrupt sleep are more prevalent in older persons. Other common medical problems of old age such as hypertension diabetes mellitus, renal failure, respiratory diseases such as asthma, immune disorders, gastroesophageal reflux disease, physical disability, dementia, pain, depression, and anxiety are all associated with sleep disturbances.

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Section: Sleep and Physical Disabilitymentioning

confidence: 99%

Sleep disorders in the elderly: a growing challenge

2018

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“…3b). Disruptions can also be caused by social or environmental factors, such as shift work or jet lag, or by disease states that involve circadian disruption including Parkinson's and Alzheimer's disease (Karatsoreos 2014;Lim et al 2014;Ondo 2014;Sterniczuk et al 2014). As such, circadian problems are often a marker of a number of diseases.…”

Section: Amplitude Of Scn Oscillationmentioning

confidence: 99%

Circadian Insights into Motivated Behavior

Antle

Silver

2015

Current Topics in Behavioral Neurosciences

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For an organism to be successful in an evolutionary sense, it and its offspring must survive. Such survival depends on satisfying a number of needs that are driven by motivated behaviors, such as eating, sleeping, and mating. An individual can usually only pursue one motivated behavior at a time. The circadian system provides temporal structure to the organism's 24 hour day, partitioning specific behaviors to particular times of the day. The circadian system also allows anticipation of opportunities to engage in motivated behaviors that occur at predictable times of the day. Such anticipation enhances fitness by ensuring that the organism is physiologically ready to make use of a time-limited resource as soon as it becomes available. This could include activation of the sympathetic nervous system to transition from sleep to wake, or to engage in mating, or to activate of the parasympathetic nervous system to facilitate transitions to sleep, or to prepare the body to digest a meal. In addition to enabling temporal partitioning of motivated behaviors, the circadian system may also regulate the amplitude of the drive state motivating the behavior. For example, the circadian clock modulates not only when it is time to eat, but also how hungry we are. In this chapter we explore the physiology of our circadian clock and its involvement in a number of motivated behaviors such as sleeping, eating, exercise, sexual behavior, and maternal behavior. We also examine ways in which dysfunction of circadian timing can contribute to disease states, particularly in psychiatric conditions that include adherent motivational states.

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“…For example, opioids and benzodiazepines result in interrupted REM sleep [3,17]. Other classes of medications that reportedly cause sleep disturbances are those used for cardiovascular conditions, asthma, infections, depression and seizures [1].…”

Section: Medicationsmentioning

confidence: 99%

“…For example, sepsis causes alterations in melatonin secretion, increase in NREM sleep and decrease in REM sleep. All of these can contribute to poor sleep quality [3,9]. Patients with heart failure or who have experienced a stroke have altered breathing patterns, which are associated with disruptions in sleep [9].…”

Section: Patient Conditionsmentioning

confidence: 99%

“…Altered sleep architecture, quantity and quality increase the risk for delirium and other complications, ICU length of stay and mortality [2]. Sleep disturbances can also significantly affect patients' recovery from critical illness [3]. A multitude of factors contribute to sleep disturbances in the ICU, many of which are difficult to avoid.As far back as the early 2000s, patients have been reporting that inadequate sleep was among the most stressful aspects of their ICU admission [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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