Hypersomnia In Old Age: Causes, Symptoms And Treatment
It is not surprising that many older people mention that they spend much of the day sleeping. This is a very common reality in this population group, and it is a phenomenon that does not have to be linked to any pathology but rather to normative variations in sleep rhythms as the years go by.
In this article We collect and briefly explain the phenomenon of hypersomnia in old age.
Hypersomnia is considered the presence of excessive sleepiness for at least one month. This drowsiness can be seen both in extended periods of sleep (as occurs in Kleine-Levin syndrome) and in the form of daytime sleep that causes a functional limitation of the individual in their activity in various areas. It is also common for people with hypersomnia to have lower intellectual performance and problems with concentration, memory and irritability.
This definition largely coincides with what happens in elderly subjects, who fall asleep frequently during the day. It could be said, therefore, that many elderly people present hypersomnia in old age. However, it must be taken into account that in most cases this fact is explained by the change in sleep cycles that occur throughout life.
Sleep cycles
Falling asleep is not like turning off a switch. The transition from sleep to wakefulness does not occur abruptly in which our brain activity suddenly changes to repair itself and process information. In fact, as many readers will already know, there are a total of five phases that we go through continuously throughout the entire 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 being in which we fall asleep and disconnect from the environment and the second two (which are often grouped together in a single phase called the Delta phase) slow and restorative sleep. . The last phase corresponds to paradoxical sleep or REM phase, in which the information obtained while awake is processed and phenomena such as dreams occur.
These cycles vary in quantity and quality throughout life, both in total time spent sleeping and in the number of hours per day in which each phase occurs. For example, babies spend a large part of the day sleeping, and during that time the high presence of hours dedicated to REM sleep stands out.
Aging and sleep
As we grow, sleep patterns change. Although REM sleep remains more or less constant (with slight decreases) from the age of twenty, the rest of the sleep phases vary throughout life.
It has been observed that upon reaching old age there is a marked tendency towards sleep fragmentation, it is common for there to be multiple nocturnal awakenings. Likewise, slow wave sleep, the sleep that is most restorative for the body, is greatly reduced. The sleep phase that occupies the most time is phase two, a light and not completely restorative sleep from which the subject can wake up easily.
As time goes by, circadian rhythms naturally shorten, causing the subject to wake up earlier and earlier (although they also tend to go to bed early).
In conclusion, l The quantity and quality of sleep of the elderly is less than what they had at other stages of life. This is why during the normative periods of sleep they do not rest adequately, which causes an increase in fatigue and daytime sleepiness. In this way, hypersomnia in old age arises as a normative process and without having to refer to the presence of other alterations.
Problems linked to the appearance 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 indicative of the existence of a physical or mental disorder, so it is necessary to take into account the existence or not of other symptoms beyond drowsiness.
1. Depression
For example, it is common for people with depression to suffer from either insomnia or hypersomnia. And it is common for people with depression to manifest in the long run the loss of positive reinforcement, anhedonia, disconnection from the environment, passivity and low level of energy and motivation. It is a condition that can be had at any age, but is especially common among the elderly population due to the high number of losses and declines typical of age.
The loss of physical and mental capacity, of roles (such as work), the emergence of dependence on aid in some cases, the death of part of the social environment, or the increasing loneliness that older people manifest turn out to be reasons It is common that those who reach old age suffer from some type of depressive syndrome.
It is common that with age it is common to require different medications to treat different health problems. And this consumption is another of the main causes of hypersomnia in old age. Antihistamines, tranquilizers, analgesics, antiemetics and antidepressants are some of the drugs which can cause increased drowsiness.
3. Dementia
Patients with different types of dementia and neurodegenerative diseases also often see their sleep patterns altered such as in Alzheimer’s disease.
4. Brain tumors or cancer treatment
Another cause that can cause an increase in fatigue and hypersomnia in old age is suffering from some type of tumor that affects or compresses the brain areas linked to sleep management. In addition, Cancer treatment itself through chemotherapy can cause daytime hypersomnia.
5. Anemia
Lack of essential nutrients can cause anemia, in which the body is limited by not having enough elements to function effectively. This can cause increased weakness and drowsiness in the elderly, causing hypersomnia.
