OT 504 Wk 12 OT 504 LG1 Aging and Sleep

many older adults need 5 or less hours of sleep per night true or false

false. older adults should get between 7 to 8 hours of sleep per night

Why is sleep important for mental health?

Sleep helps improve mood, reduces stress, and supports emotional well-being.

How does sleep benefit brain health?

Sleep helps the brain learn, form memories, solve problems, and stay focused.

How does sleep reduce disease risk?

Getting enough sleep supports the immune system and lowers the risk of chronic diseases such as heart disease and diabetes.

Name three benefits of getting enough sleep.

• Helps mental health

• Helps brain health

• Reduces disease risk

True or False: Getting enough sleep can improve both mental and physical health.

True.

What are the two main types of sleep?

REM (Rapid Eye Movement) sleep and Non-REM sleep

What is REM sleep?

active sleep, when dreaming commonly occurs and the brain is highly active.

Approximately what percentage of the night is REM sleep?

About 25% of the night.

How often does REM sleep occur during the night?

About every 90 minutes in repeating sleep cycles.

What happens to the body during REM sleep?

• The body is mostly immobile (muscles are temporarily relaxed).

• Breathing and heart rate become irregular.

What is Non-REM sleep?

Non-REM is quiet sleep and includes Stages 1–3.

Approximately what percentage of the night is spent in Non-REM sleep?

About 75% of the night.

What important processes occur during Non-REM sleep?

Tissue growth and repair occur during Non-REM sleep

Which type of sleep is considered active sleep?

REM sleep.

Which type of sleep is considered quiet sleep?

Non-REM sleep.

How much sleep should older adults get per night?

About 7–9 hours per night; many recommendations specify 7–8 hours for adults 65+.

Why is sleep important?

Sleep helps mental health, brain health, and reduces disease risk.

What are the two major types of sleep?

REM sleep and Non-REM sleep (NREM).

What are the characteristics of REM sleep?

• Active sleep

• About 25% of the night

• Occurs in approximately 90-minute cycles

• Body is immobile

• Breathing and heart rate are irregular

What are the characteristics of Non-REM sleep?

• Quiet sleep

• Stages 1–3

• About 75% of the night

• Tissue growth and repair occur during NREM sleep.

What are the two processes that regulate sleep?

C Process = Circadian rhythm; S Process = Homeostatic sleep pressure.

What is the C Process?

The circadian rhythm, or sleep-wake cycle, that helps us fall asleep at night and wake in the morning.

What factors can affect the circadian rhythm?

Age, genetics, and lifestyle factors.

What is the Homeostatic S Process?

Sleep pressure, or our body's need for sleep, which builds the longer we are awake.

What happens to sleep pressure the longer someone stays awake?

Sleep pressure increases.

How do naps affect sleep pressure?

Naps can set back/reduce accumulated sleep pressure.

What can increase sleep pressure?

Cognitively and/or physically demanding activities.

What additional factors influence the interaction between the C and S processes?

Light exposure, body temperature, regular sleep/wake times, and physical activity.

What is a chronotype?

A person's tendency toward morningness or eveningness.

What is social jet lag?

The difference in sleep between weekdays and weekends/free days.

What is catch-up sleep?

Sleeping more to compensate for previously lost sleep.

What happens to slow-wave/deep sleep with aging?

It decreases, resulting in lighter and less restorative sleep.

What are common age-related changes in sleep?

• Decreased slow-wave/deep sleep

• Decreased total sleep time

• Decreased sleep efficiency

• Increased frequent awakenings

• Increased prolonged periods of wakefulness

• Decreased REM sleep

Does experiencing sleep difficulties in older adulthood automatically mean they are normal?

No. Sleep disturbances are common with age, but common does not mean normal.

What is the relationship between sleep and cognition in older adults?

Changes in sleep structure and quality may generate or accelerate cognitive decline.

What is cognitive frailty?

Physical frailty + cognitive impairment.

What happens to the pineal gland with aging?

The pineal gland calcifies with age, reducing melatonin production.

Approximately what percentage of older adults have difficulty sleeping?

About 40–70%.

Approximately what percentage of older adults report insomnia symptoms?

About 50%.

What percentage of people with cognitive impairments experience sleep disturbances?

Approximately 60–70%.

What factors are correlated with poorer sleep or insomnia in older adults?

ADL dependence and depression.

What are possible consequences of sleep deprivation in older adults?

High blood pressure, diabetes, heart attack, heart failure/stroke, increased fall risk, impaired cognitive functioning.

What six categories can sleep complaints fall into?

• Sleep fragmentation

• Abnormal sleep duration

• Trouble falling or remaining asleep

• Difficulty staying awake during the day

• Sleep-wake cycle imbalances

• Unusual behaviors during sleep.

What is insomnia?

Difficulty falling asleep and/or staying asleep; the most common sleep problem in adults age 60+.

What is nocturia?

Waking during the night to urinate, defined as waking more than once per night to use the bathroom.

What may contribute to daytime drowsiness in older adults?

Medications, lack of stimulating activity, and certain diagnoses, such as dementia.

What does a "flipped" sleep-wake cycle mean?

Sleeping during the day and being awake/active at night.

How can pain affect sleep?

Pain can cause disrupted sleep.

What is sleep apnea?

A condition where breathing repeatedly stops and starts during sleep.

What are the three main types of sleep apnea?

Obstructive sleep apnea (OSA), central sleep apnea (CSA), and treatment-emergent sleep apnea.

What is Restless Leg Syndrome (RLS)?

A condition involving an irresistible urge to move the legs.

What are parasomnias?

Abnormal experiences or behaviors during sleep.

What are examples of Non-REM parasomnias?

Sleep terrors, sleepwalking, and confusional arousals.

What are examples of REM parasomnias?

Nightmare disorders, REM sleep behavior disorder (RBD), and sleep paralysis.

What factors can contribute to sleep difficulties in older adults?

Social/behavioral changes, stimulants, misuse of medications, age-related cell death, and changes in body systems.

What three areas should an OT consider when determining why an older adult has sleep difficulty?

Sleep need, sleep opportunity, and sleep ability.

Why is identifying the cause of sleep difficulty important for OT?

Understanding the 'why' helps determine the appropriate intervention and treatment plan.

What are DIMS?

Disorders of Initiating and Maintaining Sleep.

What are DOES?

Disorders of Excessive Somnolence.

During sleep screening, what important distinction should an OT make between fatigue and sleepiness?

Fatigue relates to DIMS, while sleepiness relates to DOES.

What is sleep preparation?

Establishing activity patterns that promote sleep and health.

What is sleep participation?

Sustaining a sleep state without disruption.

What should an OT determine when screening a client's sleep?

Whether the problem primarily involves sleep preparation or sleep participation.

What are potential benefits of naps?

Reduce fatigue, increase alertness, promote relaxation, and improve mood.

What are potential drawbacks of naps?

Sleep inertia and interference with nighttime sleep.

What are general recommendations for naps?

Keep them around 20 minutes, nap before 3 PM, and recognize that naps affect individuals differently.

What might an OT sleep goal target?

Participation in sleep preparation routines, sleep hygiene strategies, sleep duration, nighttime awakenings, and physical activity to increase sleep drive.

Why might an OT address physical activity as part of a sleep goal?

Physical activity can increase sleep drive, support cardiovascular function, and reduce fall risk.

What is the overall focus of OT intervention for sleep?

Promoting optimal sleep performance.

How can occupational therapists address sleep?

Educate clients/caregivers about sleep expectations, modify the sleep environment, and encourage health-management behaviors.

What can an OT generalist do for sleep concerns?

Screen for sleep concerns, provide basic sleep education, and address sleep hygiene.

What are non-pharmacologic treatment options for sleep?

CBT-I, mindfulness-based stress reduction, physical activity, daylight exposure, acupuncture, and sleep hygiene.

What is CBT-I used to treat?

Insomnia.

What type of exercise was identified as optimal for improving sleep in older adults?

A combination of aerobic and resistance training.

How should pharmacologic treatments generally be used for insomnia?

For short-term management of insomnia.

What strategies are suggested for nocturia?

Stop drinking fluids 2–3 hours before sleep and talk with the physician/provider.

What sleep-safety interventions should be considered for older adults?

Keep a phone by the bed, use a light within reach or automatic light, and reduce hazards in the bedroom.

What is sleep hygiene?

The healthy habits, behaviors, and environmental factors that contribute to sleeping well on a regular basis.

What is the lecture's recommended bedtime-preparation timeline?

• Stick to a sleep schedule

• Avoid caffeine 4–6 hours before bed

• Avoid vigorous exercise 90 minutes before bed

• Discontinue electronics 30 minutes before bed

• Begin sleep ritual 15 minutes before bed.

How can someone create a healthier sleep environment?

Turn lights off/down, reduce sound, reduce temperature, choose a supportive bed and pillow, wash bedding regularly, and maintain a clean, clutter-free space.