Ageing and sleep

Guilleminault C, Silvestri R, Mondini S, et al. Aging and sleep apnea action of benzodiazepines, acetazolamide, alcohol and sleep deprivation in a healthy elderly group. J Gerontol 1984 39 655-661. 

Webb WB. A further analysis of age and sleep deprivation effects. Psychophysiology 1985 22 156-161. 

Nicolas A, Michaud M, Lavigne G, Montplaisir J (1999). The influence of sex, age and sleep/wake state on characteristics of periodic leg movements in restless legs syndrome patients. Clin Neurophysiol 110 1168-1174... 

Insomnia complaints are common in the general population and can be dichotomized into problems of delayed sleep onset and those related to sleep maintenance. Increasing attention is being focused on the adverse daytime effects of insomnia. Sleep disturbances become more common with increased age and are more prevalent in women. Sleep complaints arise from very diverse etiologies which prominently include concomitant primary... 

Pathological conditions in which the VLPO system is weakened (i.e. less drive for sleep) could, therefore, result in more frequent changes between wakefulness and sleep, as has been demonstrated in animal models. Interestingly, elderly individuals have significantly reduced numbers - often by as much as 50% - of sleep-promoting VLPO neurones, an age-related loss of VLPO cells that may explain, at least partially, this population s characteristic difficulty in falling and staying asleep. 

Sleep disorders are common. Approximately 50% of adults will report a sleep complaint over the course of their lives.2 In general, sleep disturbances increase with age, and each disorder may have gender differences. The full extent and impact of disordered sleep on our society are not known because many patients sleep disorders remain undiagnosed. Normal sleep, by definition, is a reversible behavioral state of perceptual disengagement from... 

Restless-legs syndrome occurs in 5% to 15% of the population, making it a common sleep disorder.11,12 The prevalence of RLS increases with age and in various medical conditions such as end-stage renal disease (ESRD), pregnancy, and iron deficiency.13 RLS appears to be more common in women than in men and has a genetic link. The majority of RLS patients (63% to 92%) report a positive family history.14... 

Non-REM parasomnias have variable prevalence rates depending on patient age and different diagnoses. Sleep talking, brux-ism, sleepwalking, sleep terrors, and enuresis occur more frequently in childhood than in adulthood. Nightmares appear to occur with similar frequency in adults and children. REM behavior disorder (RBD), an REM-sleep parasomnia, has a reported prevalence of 0.5% and frequently is associated with concomitant neurologic conditions.16 Chronic RBD is more common in elderly men and may have a familial disposition. 

Bitwise D. L. (2005). Sleep in normal aging and dementia. Sleep 16, 40-81. 

Joffe RT, Swinson RP Total sleep deprivation in patients with obsessive-compulsive disorder. Acta Psychiatr Scand 77 483-487, 1988 Joffe RT, Swinson RP, Levitt AJ Acute psychostimulant challenge in primary obsessive-compulsive disorder. J Chn Psychopharmacol 11 237-241, 1991 Johns CA, Greenwald BS, Mohs RC, et al The chohnergic treatment strategy in aging and senile dementia. Pharmacological Bulletin 19 185-197, 1983 Johnson BB, Naylor GJ, Dick EG, et al Prediction of chnical course of bipolar manic depressive illness treated with hthium. Psychol Med 10 329-334, 1980... 

Methylcobalamin is the coenzyme form of vitamin It is neurologically active, most bioavailable and best utilized. Unlike cyanocobalamin, it does not require any conversion after absorption by the body and is better retained by the liver and other tissues. It has exhibited beneficial effects against brain aging, irregular sleep patterns. It supports immune function and promote normal cell growth. It represents one of the best values in nutritional products, given its comparably low cost and its wide range of potential benefits. 

Hughes RJ, Sack RL, Lewy AJ. The role of melatonin and circadian phase in age-related sleep-maintenance insomnia assessment in a clinical trial of melatonin replacement. Sleep 1998 21 52-68. 

Patients with Breathing Disorders. Some evidence indicates that BZDs may exacerbate breathing difficulties in patients with chronic lung disorders ( 339, 340). Because flurazepam has been reported to exacerbate sleep apneas in middle-aged and elderly normal volunteers, the possibility of undiagnosed sleep apnea should always be considered before a BZD is prescribed ( 341). 

As Mark Solms points out in his recent book, the dreams of patients with temporal lobe epilepsy are more intense than those of normals. They are more frequently intensely unpleasant or nightmarish, and this is presumably a function of higher levels of anxiety mediated by the hyperexcit-able amygdala of the epileptic patients. These hypotheses are testable in two ways. One is to confirm the anecdotal reports of patients by studying the subjects in sleep labs, as Jose Calvo and his group have done in Mexico City. Compared to age- and sex-matched controls, the epileptic subjects had measurably higher levels of anxiety in their dream reports. 

To answer this question we need to look more closely at the sleep side of depression. There are three parts to the main story. The first is that many depressives have a markedly reduced time to onset of the first REM period after falling asleep. This tendency to enter REM rapidly is measured as REM latency. The second part is that depressives may also have a marked reduction in time spent in stages III and IV, the deepest and most restful phase of NREM sleep. That could be one reason that their sleep is so unrefreshing. The third reason is that the first REM period is often longer—and stronger—than is seen in age and sex matched normal controls. These processes are represented in terms of the AIM state space model as figure 11.1. 

Fibromyalgia A disease characteristically affecting depressed, middle-aged women complaining of diffuse, symmetrical and persistent musculoskeletal pain/tenderness and sleep disturbance with no organic basis, or a real pathological entity. It requires more than a psychological/psychatric approach to treat effectively. 

Parts of the continental rail network had been resurrected centuries ago, but this area was older than that. Age and decay had crawled in under a blanket of snow and there they had remained, for who knew how many centuries, sleeping permanently now in the cracked and rusted rails wherever they showed through, in the crumbling snow-capped loading plat-... 

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