Dear Dr. Archer,
My mother is 86 years old, and due to her sleep apnea, her short term memory and some long term memory has become affected. She only sleeps a couple of hours a night, and depression is setting in.
When I ask her what her doctors can do about her lack of sleep, she says they tell her that they cannot do anything! She's on oxygen at night while she sleeps, but she still wakes up. She says she can't be prescribed certain medications because they can't be combined with other medications she's currently taking. I asked her if she has explained to them that she only sleeps three to four hours a night or less, and she tells me that she has, but they can't do anything they're not already doing.
It seems to me that at 86 years old, sleeping only three or four hours a night, that I am going to wake up one day soon to find my mother dead in bed. She has become extremely depressed and even becomes very melancholy, reminiscing over memories of her childhood. Also, the content in R or PG movies that didn't offend her years ago now offends her as being immoral. I see depression on her face, as she sits on the sofa. She looks as if she's very deep in thought, perhaps thinking about the good old days, but I am not sure. I believe her depression is caused by her continuous lack of sleep.
Is it true that doctors might not be able to do anything for her? She has recently become inactive physically and has no motivation to go anywhere or do anything outside the house. This is very scary to me and she's probably scared, as well.
Dennis
Dear Dennis,
Changes in sleep are definitely a part of the normal aging process, so sleep difficulties are common among the elderly. In a report by the National Institute on Aging in a study of over 9,000 persons over the age of 65, over half of the individuals had chronic sleep complaints. Most have difficulty falling asleep and then maintaining sleep. Many complained of excessive daytime sleepiness.
There is a strong association between sleep apnea and hypertension. Regarding those patients with dementia, severe sleep disruption often leads to nursing home placement. Although a mild deterioration in sleep quality may be normal as we age, the complaint of significantly disrupted nighttime sleep must be evaluated and treated. There are a few things you can do so see if your mom can achieve adequate sleep on her own.
Caffeine intake can contribute to sleep loss, even if consumed in the afternoon. Any alcohol consumption in the evening, while initially sedating, will prevent the deeper sleep and actually increases arousals during the latter part of the night. If your mom goes to bed and remains awake for an excessive amount of time, this can cause her to develop increased awake time that, in turn, is reinforced nightly. I do not know if your mom is overweight, Dennis, but obesity can greatly increase the occurrences of sleep apnea.
If none of these symptoms concern your mom bring her to a Sleep Clinic, where professionals in this field can monitor her sleep habits overnight in a controlled setting, evaluate their findings and suggest a solution. In this specialty setting, it can be determined if she suffers from obstructive sleep apnea (OSA), which can have significant implications for your mom, especially if she is suffering from chronic illness.
If you haven't done so already, go with your mom to her next doctor's appointment and speak to him yourself. There are ways to obtain sleep without additional medications, and he can offer you input, as well as pros and cons regarding the suggestions I have listed above. He will also be able to recommend specialists in the sleep field in your area that will be able to provide your mom some relief and rest. As in many aspects of life, it can be a matter of trial and error. Good luck to both you and your mom.
Dr. Archer
