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Overview of Age-Related Sleep Disorders

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Sleep disorders are commonly associated with the effects of aging. Aging affects the levels of melatonin and growth hormones, which help regulate arousal and sleep cycles. Medications taken for chronic conditions can also affect sleep cycles. Individuals who have difficulty falling asleep or staying asleep for adequate periods may use excessive chemical substances to help produce sleep and then use other substances to enhance their arousal and attention during the day.1 Individuals who work rotating shift hours or travel across time zones may find adapting to changes in their sleep cycle more difficult as they age. Sleep disorders affect mood, attention levels, and concentration during waking hours. Clients with sleep disorders may not feel they have enough energy or stamina to participate in regular exercise programs.2

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Comorbidities to Consider

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  • Client may have mood disorders and cardiovascular diseases that are also associated with aging.

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Client Examination

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Keys to Examination of Clients

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  • A sleep polysomnographic test is used to assess the stages of sleep that these clients attain and the number of awakenings during the night.

  • Perform baseline assessments of posture, balance, and flexibility before developing an exercise program for a client.

  • Employ a questionnaire, such as the Epworth Sleepiness Scale, to assess sleep quality and daytime sleepiness.3

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Recommended Baseline Testing of Fitness Levels

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  • Aerobic capacity can be assessed with submaximal tests using walking and cycle ergometry.

  • Screen for cardiopulmonary risk factors and risks for falling before starting a new exercise program.

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Exercise Prescription

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Type: Walking, bicycling, aquatherapy, and tai chi4,5,6

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Intensity: Moderate intensities of 60%–85% of peak heart rate

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Duration: Start at 30 minutes

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Frequency: 5 days per week

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Getting Started

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Exercises to improve sleep quality are generally recommended to be done in the morning and outdoors, as evening exercise may interfere with the circadian rhythms and body temperatures to promote sleep.2 Aerobic exercise increasing to 45 minutes for 5 days per week have been shown to have the best treatment response for improving sleep quality.5,7 The combination of aerobic exercise with stretching, resistive exercise and coordination activities for improving balance are also recommended for these individuals. Clients should be encouraged to increase the duration and frequency of their exercise programs gradually to maintain 5 days per week for 45 minutes.5

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References

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Misra  S, Malow  BA. Evaluation of sleep disturbances in older adults. Clin Geriatr Med 24(1):15–26, 2008.  [PubMed: 18035228]
2. +
Youngstedt  SD. Effects of exercise on sleep. Clin Sports Med 24:355–365, 2005.  [PubMed: 15892929]
3. +
Johns  MW. Sleepiness in different situations ...

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