The Impact of Sleep Deficiency on Dementia and Mortality in Older Adults

In general, sleep is a crucial human function that is vital in sustaining their overall health for every age group of people, but more notable in the elderly group. Stress response and rest also vary with one’s age and body condition; therefore, as people advance in age, they are likely to have sleep disorders such as insomnia, short sleep duration, or poor quality sleep. These disturbances are not merely annoying; the rising trends in literature indicate that sleep deficiency in the elderly is section connected with adverse health outcomes comprising dementia and all-cause mortality. The effects of getting inadequate amounts of sleep during the day continue beyond basic tiredness and can actually cause a quickening of cognitive decay and a decrease in total lifespan. In this article, we discuss how sleep deficiency in older people harms the development of dementia and raises the mortality rate according to the recent data of the very field of sleep research.

Sleep Deficiency: A Growing Concern for Older Adults

Sleep deficiency thus encompasses both sleep duration and sleep quality. Non-muscle-specific age-related alterations in sleep parameters include delay in onset of sleep and difficulty in maintaining sleep, an increase in the number of awakenings at night, and a reduction in the quantities and quality of stages three and four. Such problems can be riding with diseases, life conditions, and even medication that a patient uses. If people only have a few interrupted nights’ sleep, it may not be a big problem; however, long-term sleep loss or poor sleep quality certainly can cause a lot of permanent harm in the long run. For elderly people, the risk is even higher because they are more vulnerable in relation to age-related factors, including cardiovascular diseases, diabetes, and neurodegenerative diseases.

The Link Between Sleep Deficiency and Dementia

Another of the most disturbing links between sleep and health in elderly people is the relationship that has been established between sleep loss and the development of dementia. Dementia, especially Alzheimer’s disease, is a clinical condition that is marked by slow loss of mental faculties, memory, and the ability to perform daily tasks. As the mediators between sleep and dementia are still under study, there are several potential mechanisms that can be described.

Sleep can also be said to be immensely essential for the brain since it helps in memory and also removes metabolic waste products from the brain. The human brain clears out its beta-amyloid proteins during the night, especially during the period of sleep and in particular, slow-wave sleep. Amyloid plaques are among the most known signs of Alzheimer’s disease. Hence, due to sleep deprivation, the brains cannot effect the removal of these toxic substances out of the brain parenchyma, thus allowing them to catalyze neurodegenerative processes.

Several studies have also explained that patients who have disruption of sleep, for instance, by having frequent awakenings or short durations of sleep, would develop dementia at an older age. Sleeping less than 6 hours per night increases the dementia risk by twofold. Sleep fragmentation, which includes difficulty in either falling or staying asleep, is also a risk factor for developing poor cognition. Consequently, such findings point to sleep management in the elderly as one of the potential interventions in the prevention or, at least, the delay of dementia.

Yearwise Publication Trend on sleep deficiency

Find publication trends on relevant topics

Sleep Deficiency and Cognitive Decline

Apart from the development of dementia, sleep deficiency results in other mild cognitive impairments. Those elderly people who are suffering from poor sleep, even if they have not been diagnosed with dementia, have a tendency to manifest reduced mental speed, a short span of attention, and memory disturbances. These are all things that can cause a lot of interference with daily activities and decrease the ability to manage money, medications, or other pertinent issues.

Surprisingly, the literature on this topic highlights findings supporting sleep disruption as an outcome as well as a cause of neurodegeneration. For instance, early dementia patients have disturbed sleep, and this can further be observed to reach its peak as the disease progresses to the next level. This leads to a vicious cycle, whereby lack of sleep fuels more deterioration of the brain, hence leading to sleeplessness.

The Impact of Sleep Deficiency on Mortality

Sleep deficiency is not only a problem from the cognitive standpoint but also was associated with higher mortality rates in elderly people. Rest is a restorative process that plays a significant role in the immune response of the heart and metabolism. Adequate sleep is when the human body’s organelles undergo several processes that make it less vulnerable to diseases and have a longer lifespan. When sleep is poor consistently, the systems deteriorate, and high risks of diseases and early death are experienced.

Several research works have demonstrated that both shortened sleep duration, which can be defined as a sleep duration of fewer than 5 hours per night, and long sleep duration, which can be described as more than 9 hours of sleep per night, are related to higher mortality rates. Cardiovascular diseases remain the leading cause of sleep-related mortality in older adults, but other causes include stroke, diabetes, and respiratory disease, among others. The reasons as to why this is the case are therefore diverse in nature. For example, prior work has found that sleep deprivation raises blood pressure and creates inflammation, both of which are predictors of cardiovascular events.

Besides, chronic sleep deficiency can lead to health risks and other issues, such as the possibility of falls and accidents, in the senior population. Slowed reaction time, poor coordination, memory, and impaired balance that are caused by sleep deprivation increase the risk of developing severe physical injuries. Falls are one of the major causes of injury and fatality among the elderly, and this, in combination with the fact that sleep plays a critical role in the health of the elderly, makes insufficient sleep a major concern.

Recent Publications on sleep deficiency

Find publications on relevant topics

Sleep and Immunity in Older Adults

Yet another relationship between sleep and death is immunity. In this connection, it is agreed that sleep depletion weakens immunity significantly. It is also understood that sleep is beneficial for both natural and acquired immunity, with the lack of sleep reducing the strength of immune processes in the body. Other times it is due to infection, which is even more vulnerable for older adults because their immune system weakens with age, and this is worsened by sleep deficiency. Similar studies indicated that people who sleep less than 6 hours every night are likely to fall sick easily or develop severe diseases or infections such as pneumonia that can be fatal among the elderly.

Also, previous studies have demonstrated that sleep disorders are associated with lower efficacy of vaccination in the elderly population. For instance, those older citizens who have developed chronic sleep disorders are likely to show low antibody levels after vaccination, thus being prone to ailments such as flu or pneumonia. Since vaccines are critically useful for averting fatal diseases in the elderly, it is critical to remember the part sleep has in shielding the immunity of the body.

Addressing Sleep Deficiency in Older Adults

Since sleep deficiency has been shown to influence dementia risk and mortality in older adults, approaches to treat these sleep-related problems in older adults should be regarded as critical public health concerns. Here we are discussing some of the measures that would ensure better sleep quality as well as quantity for this category of patients.

Cognitive Behavioral Therapy for Insomnia (CBT-I): CBT-I a/s is proven to be a highly effective mode of treatment and free from the side effects of substances. It involves strategies to alter behaviors and cognitive techniques on the subject of sleep. CBT-I has been reported to increase sleep efficiency, decrease sleep onset in FSAD, and increase total sleep time in older adults.

Sleep hygiene: That is why the promotion of good sleep hygiene practices can also be helpful. Among these are going to bed at the same time every night, ensuring that the bedroom is conducive to sleep, avoiding the use of caffeine products and alcohol, and participating in activities that put you to sleep before retiring to bed.

Physical Activity: Evidence also demonstrates that exercising in particular affects the quality of sleep as well as the duration that it takes to sleep. The physical activities, which include merely walking, have been proven to improve sleep quality in the elderly.

Addressing Underlying Medical Conditions: It is similarly well established that acute and chronic health conditions affect sleep by approximately 50% of older adults: sleep apnea, restless leg syndrome, chronic pain. Healing most of these ailments has the added advantage of enhancing the quality of sleep, hence reducing the effects of the risks associated with them.

Medications: At times, pharmacological management may be required to manage sleep disorders accompanied by aging. However, care should be taken, especially with the use of sleeping pills, as these can cause some side effects, especially to the elderly. Every time we should begin with non-pharmacological therapies.

Melatonin and Light Therapy: If an older adult patient has a sleeping disorder of the circadian rhythm, then melatonin may be useful, or light therapy. These interventions can be immensely beneficial to those who experience a problem with their sleep, may it be insomnia or sleep disorders with sleep-wake cycles.

Conclusion

The prospective cohort study shows that sleep deficiency increases the risk of dementia and all-cause mortality in elderly people. So the question arises: how are we going to address sleep disturbances as the life expectancy of our population is likely to grow further with the current rates of aging? Habits of sleep are essential not only for mental and immune systems but also for the whole body and organism’s wellness. So, by paying much attention and giving focused effort into increasing the duration and quality of sleep among senior citizens, we may be able to solve another major problem—that of dementia—and also increase lifespan. For community health promotion and promotion of sleep health, physicians and caregivers have the responsibility of ensuring that the elderly sleep well.

References

  1. Robbins, R., Quan, S.F., Weaver, M.D., Bormes, G., Barger, L.K. and Czeisler, C.A., 2021. Examining sleep deficiency and disturbance and their risk for incident dementia and all-cause mortality in older adults across 5 years in the United States. Aging (Albany NY)13(3), p.3254.
  2. St-Onge, M.P., Grandner, M.A., Brown, D., Conroy, M.B., Jean-Louis, G., Coons, M. and Bhatt, D.L., 2016. Sleep duration and quality: impact on lifestyle behaviors and cardiometabolic health: a scientific statement from the American Heart Association. Circulation134(18), pp.e367-e386.
  3. Bhaskar, S., Hemavathy, D. and Prasad, S., 2016. Prevalence of chronic insomnia in adult patients and its correlation with medical comorbidities. Journal of family medicine and primary care5(4), pp.780-784.
  4. Grandner, M.A., Sands-Lincoln, M.R., Pak, V.M. and Garland, S.N., 2013. Sleep duration, cardiovascular disease, and proinflammatory biomarkers. Nature and science of sleep, pp.93-107.
  5. Grummon, A.H., Sokol, R.L. and Lytle, L.A., 2021. Is late bedtime an overlooked sleep behaviour? Investigating associations between sleep timing, sleep duration and eating behaviours in adolescence and adulthood. Public health nutrition24(7), pp.1671-1677.
  6. Besedovsky, L., Lange, T. and Haack, M., 2019. The sleep-immune crosstalk in health and disease. Physiological reviews.
  7. Plog, B.A. and Nedergaard, M., 2018. The glymphatic system in central nervous system health and disease: past, present, and future. Annual Review of Pathology: Mechanisms of Disease13(1), pp.379-394.

Top Experts on “sleep deficiency