Elderly need not endure sleepless nights long term

There's bad news and good news about how growing old affects your ability to sleep.

The bad news is that it becomes more difficult to enter that deep, restful slumber at night that so many people covet. That's a natural biological change that is compounded by other sleep disturbances such as pain, illness and the effects of medications intended to treat the symptoms of those other problems.

The good news, say researchers and those who treat sleep problems, is that most of the chronic insomnia affecting the elderly can be addressed through adjustments of sleep habits or by prescription drugs that assist sleep rather than hinder it. While sleepless nights become more common for people 65 and older, it's not something they need to quietly endure long term.

''An older person who's got a problem sleeping should not accept that as a problem of just being old - it is most likely due to something else that is treatable,'' said Dr. Andrew Monjan, chief of the neurobiology of aging branch of the National Institute on Aging.

Studies have suggested that 30 percent or more of the elderly population have persistent difficulty falling asleep or remaining asleep as long as they like, a rate of insomnia that Monjan said is about twice as high as the problem among young adults. Most of those with problems don't seek treatment, which doctors say is fine only so long as their lives aren't disrupted.

''My criteria is at the point it begins interfering with your daytime functions - that's the point you should seek help,'' said Sonia Ancoli-Israel, a University of California San Diego psychiatry professor who studies older adults' sleep habits. ''The best thing is, if you find yourself excessively sleepy during the day, you need to talk to a physician and figure out why.''

Many elderly end up out of sorts from falling asleep too soon in the evening, thereby waking up in the middle of the night unable to return to sleep. Dr. Timothy H. Monk at Western Psychiatric near Pittsburgh is getting a study under way to determine if afternoon naps will put such people on a more regular nighttime schedule.

''As human beings, we have a predisposition toward afternoon sleepiness,'' Monk said, noting how common midday siestas are elsewhere in the world. ''The aim is to push the night sleep back so it starts later, so we have later bedtimes and later wakeup times.''

Some of the sleep problems faced by the elderly, also, may have little to do with the amount of sleep they receive. Sleep apnea becomes more common with age, occuring in perhaps one of four older adults compared to fewer than one in 10 in middle age.

Apnea is a condition in which the sleeper's air passages are blocked and he repeatedly stops breathing for short periods, without realizing it. It results in a sleep of little rest, causing drowsiness the next day. It often takes a sleeper's partner to recognize the problem, and the individual can be helped at a sleep clinic by being fitted for a device known as a continous positive airway pressure machine, which is attached by a nosepiece at night.

Also more common among the elderly than the rest of the population is periodic limb movements disorder, in which legs jerk repeatedly at night and awaken the individual, whose alertness the next day is diminished. The same drugs used for Parkinson's disease can be used to control the problem and assist sleep.

(Distributed by Scripps Howard News Service, http://www.shns.com..)