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ShareGrowing older does not mean irregular sleep patterns, constant fatigue, or dozing off at the most inappropriate times. Chances are you may be suffering from a sleep disorder, says Kareena N Gianani
Dr Atul Mehta, 70, had no idea of the disturbance his snoring caused until he went on a holiday to Malaysia, where an irate guest in the hotel he was staying at demanded he change his room.
"My snoring could be heard metres away," recalls an embarrassed Mehta, who till then had been ignoring his wife's pleas to treat his snoring and constant fatigue. He decided not to dismiss his situation as "normal sign of ageing", and consulted a fellow doctor.
Mehta was diagnosed with a severe case of sleep apnea, a sleep disorder where your breathing becomes shallow or even stops, causing the person to choke to death.
Sleep-related problems and disorders are common among senior citizens and only worsen if not treated. According to Dr Amita Nene, consultant chest physician and sleep medicine specialist at the Bombay Hospital, on an average, 48 per cent of seniors in the age group 55-84 are insomniacs, 30 per cent snore, eight per cent suffer from sleep apnoea and 18 suffer from restless leg syndrome (RLS).
For Khorshed Lakdawala, 65, it wasn't the snoring as much as the fact that she kept falling off to sleep on the train while commuting to work, often missing her destination. Like Mehta, she didn't think much of this, until one day, she dozed off during a telephone conversation with her employer.
"I was diagnosed with idiopathic hypersomnolence -- a sleep disorder where the patient feels an uncontrollable urge to sleep, in some cases for as long as 20 hours in a day," says Lakdawala.
"Sadly, most people are ill-informed and think that sleep-related problems are inevitable as they grow older, though this is not the case," says Dr Nene, who cites a lack of awareness as one the main reasons why such disorders go undiagnosed for long periods. Sleep patterns do change as we grow older, but if our sleep is not refreshing, it is not normal, she adds.
Older people sometimes become light sleepers or suffer from fragmented sleep. At times, it is common for the biological clock to shift, which is why a person's sleep timings may alter. Increased sensitivity to hormonal and physiological changes, as well as environmental conditions (light, noise, temperature) can result in shifting sleep patterns. While some seniors adapt to these changes, many are vulnerable to serious sleep disorders.
If left untreated, such disorders can cause other diseases. Sleep apnea, for instance, causes behavioural changes, heart failure and coronary heart disease. Also, many a time, a seemingly unrelated disease or illness --- both physical and psychological -- can cause sleep disorders.
Dr Zarir Udwadia, chest physician, PD Hinduja Hospital, says, "Any painful condition, such as arthritis or even a weak bladder may lead to insomnia or RLS in senior citizens. At times, the patient's sleep may continue to be affected even after the disease has been treated." In some cases, the medication used to treat the disease can upset a person's sleep pattern. According to doctors, diuretics used to treat high blood pressure, phenytoin (an anti-epileptic), thyroid hormone and SSRIs (selective serotonin reuptake inhibitors found in anti-depressants), increase the chances of sleep disorders in seniors.
Psychological problems are trickier to diagnose. Take the case of 67-year-old Kavita Mirani, who was initially diagnosed with primary insomnia. "When I failed to respond to the treatment, my doctor suspected that the problem was more psychological," says Mirani. In fact, Mirani's doctor suspected she was suffering from severe depression and diagnosed her with secondary insomnia, which is caused by a physical or psychological illness.
It's a never-ending cycle as sleep disorders and psychological trauma often go together and one cannot be treated without diagnosing the other. Dr Anupama Shah, a clinical psychologist at the Hinduja Hospital, says, "Death of a spouse, recent detection of an illness, physical abuse or neglect --- can have disastrous effects on the well-being of a senior."
In most cases, however, doctors say that sleep disorders can be cured with therapy and medication. Mehta had to use a nasal mask, which gave him, and his wife, immediate relief.
With inputs from Dignity Foundation.
