Sleep problems

Sleep disorders associated with poor job performance, discord in relationships, mood swings, reduced memory and learning, impaired concentration, fatigue, irritability and decreased general well-being.

Estimated that 50% of American adults experience 1 or more symptoms of insomnia, at least, at least a few nights each week.

Approximately 29% of adults report sleeping less than seven hours per night and 50 to 70,000,000 have chronic sleep and wakefulness disorders (Schoenborn CA).

Approximately 10% of Americans have persistent sleep complaints.

Often underdiagnosed.

Obstructive sleep apnea, insomnia, restless leg syndrome, and excessive daytime sleepiness are commonly encountered sleep problems.

Limited or restless sleep may increase risk of a variety of poor health outcomes: hypertension, diabetes, stroke, depression, cognitive decline, and Alzheimer’s disease.

Reduced sleep catalyzes inflammation. which may lead to illnesses such as obesity, diabetes, heart disease, and some forms of cancer.

Poor sleep quality, sleep problems and daytime sleepiness were associated with increased spinal fluid indicators of Alzheimer’s disease.

Abnormal motor behaviors during sleep include sleepwalking, nocturnal seizures, and confusional arousals.

Rapid eye movement sleep behavior disorder is under diagnosed and is a potentially injurious parasomnia and should be considered in an older patient is complaining of abnormal activity during sleep.

Rapid eye movement sleep behavior disorder is characterized by dream enactment behavior that results from the loss of REM sleep without atonia.

Rapid eye movement sleep behavior disorder has potential for injuries and cause injuries in their bed partners and is concerning for its connection to Parkinson’s neurodegenerative disease

Rapid eye movement sleep behavior disorder occurs primarily in older adults, with a male predominance of 80%.

The onset of rapid eye movement sleep behavior disorder most commonly occurs in the 5th and 6th decades.

Rapid eye-movement sleep behavior disorder is idiopathic when not associated with neurological disorders or symptomatic when underlying causes such as inflammatory or autoimmne disorders, brain lesions, or provoked antidepressant medications are present.

Rapid eye-movement sleep behavior disorder, in the idiopathic or symptomatic category are associated with neurodegenerative diseases especially Parkinson’s disease,dementia with Lewy bodies, multiple system atrophy, and pure autonomic failure.

Rapid eye-movement sleep behavior disorder may manifest initially as a idiopathic prodromal state occurring years-decades before the evolution to overt motor, cognitive, or autonomic impairments presenting as the neurodegenerative disease.

One of every five serious injuries from driving accidents can be attributed to driver sleepiness.

A persistent lack of sleep may lead to hyperalgesia in which the patient perceives a heightened pain and may further lead to poorer sleep.

Among men younger than 65 years, sleeping only 3-5 hours per night significantly increases the risk of dying for prostate cancer.

Information from the Behavioral Risk Factor Surveillance System dad among 403,981 respondents, 30.7% reported no days of insufficient rest or sleep at 11.1% reported insufficient rest or sleep every day during the preceding 30 days (CDC).

Females are more likely than males, 12.4 vs. 9.9% and blacks at 13.3% were more likely to report insufficient rest or sleep.

3 groups of disorders: primary, secondary to a mental disorder and others, related to substance abuse or general medical problems.

Primary sleep disorders presumed to result from endogenous disturbance in sleep–wake mechanisms which are frequently complicated by behavioral conditioning.

Changes in the ability to sleep are common in the elderly.

Sleep patterns evolve with age and may be associated with a reduction in total sleep time and the amount of time spent in deep or slow wave sleep.

With age there is weakening of the suprachiasmatic nuclei circadian rhythm.

Subdivided into parasomnias and dyssomnias.

Parasomnias associated with abnormal behavior or physical changes associated with sleep, sleep stages or sleep transitions.

Parasomnias include nightmares, sleep t2242or and sleepwalking.

Dyssomnias refer to alteration in the amount, quality or timing of sleep and include primary hypersomnia, narcolepsy, sleep apnea and circadian rhythm sleep disturbance.

Primary insomnia refers to process of difficulty in the initiation or maintaining sleep.

Old-age is associated with increased prevalence of insomnia, but this is not the case for healthy older adults who slept well when they were younger.

Changes in sleep include an increasing number of nighttime awakenings and lower sleep efficiency ref2242ed to as the ratio of time in bed asleep to the time in bed.

Sleep changes likely due to changes in health and well-being and affected by age, medical associated processes, and cognitive status.

Sleep increasingly disruptive with worsening of health, as well as with symptoms of anxiety and depression.

Approximately 6% of long-term care elderly residents have insomnia, compared to 4% of community-based older adults.

Sleep disturbances are common in menopause.

Insomnia associated with increased depression, impaired daytime function, reduced libido and increased use of healthcare in women.

Women with combined vasomotor and insomnia symptoms have more ED department visits and lower physical and mental quality of life in women without sleep disturbances.

Sleep disturbance contribute to weight gain in midlife women.

Chronic sleep deprivation can lead to daytime fatigue and decreased physical activity.

Women who sleep 5 hours or less gain more weight than those sleeping more than 7 hours every night.

Sleep disturbance in midlife women may be related to nocturnal vasomotor symptoms, night sweats, mood problems, obstructive sleep apnea and low estrogen levels.

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