Underlying Sleep Disorders in Older Adults

Posted by Darian Dozier on Sep 21, 2022 5:23:00 PM

Add a heading-Mar-14-2022-01-19-59-88-AM

Older adults commonly have sleep troubles, mostly due to physiological changes that can interrupt normal sleep patterns, but sometimes due to underlying disorders that can manifest into insomnia. It's important to identify these underlying disorders for accurate treatment. Sleep aids can have detrimental effects in elderly adults, so if they can be avoided through accurate diagnoses, then that will be better for their health. 

Below are some common underlying disorders that can negatively affect health. If you think one of these impacts you or a loved one, then it's important to speak with your primary care physician immediately. 

Alzheimer Disease 

Alzheimer disease is a neurodegenerative disorder from a build up of irregularly folded proteins. These proteins have biochemical changes that stops them from being degraded. As they accumulate in the brain, they prevent the brain from being able to work at an optimal level, especially with memory. As time goes on, these proteins overwhelm the brain, and the brain loses its ability to control basic functions, such as feeding and breathing. This is an irreversible disease without a cure. 

Alcohol use 

Even though a glass of wine or a drunken evening may induce, what seems like a good night of deep sleep, alcohol actually inhibits your body's ability to get a good night's rest. Alcohol can mess up your sleep architecture, so you do not flow through the four stages of sleep (Non-Rapid Eye Movement 1-3 and Rapid Eye Movement). There is very little REM sleep which is essential for creating memories and building connections. Recovery that takes place during sleep also is impaired with alcohol use.

If alcohol abuse takes place for a prolonged period of time, sleep may be interrupted by an inability to breathe (from liver disease), thiamine deficiency which can create a dementia-like state, and other health problems that can impair one's ability to get a good night's rest. 

Chronic Disease 

Chronic conditions, like liver failure and heart failure, can cause sleep disturbances because of fluid imbalances. In a normal heart, blood is pumped throughout the heart and lungs and then returned to the body. If you increase fluids, then your brain signals to your body to urinate and turns off any desire to drink. If you decrease fluids, then you become thirsty so that way you can replenish the fluids. 

In an abnormal heart, your body isn't able to regulate fluids as it would like. The blood vessels in the lungs become backed up because the heart can't pump all of the blood out of its chambers. That extra fluid has nowhere to go but your lungs. So when you lay flat on your back, all of that fluid goes into your lungs and makes it hard to breathe. If this wakes you up at night, it is called paroxysmal nocturnal dyspnea. If it happens as soon as you lie down, then it is called orthopnea. The same can happen with liver failure, as damaged liver tissue cannot pump blood like it's supposed to, causing a back up that eventually floods your lungs. 

Signs of heart failure include trouble breathing while laying flat, and any puffiness or swelling that you may experience. If you are experiencing these symptoms, then it's important to get things checked out right away. 


Depression in older adults is very common. Life changes, thoughts about impending mortality, and loneliness are all factors that lead to depression in older individuals. Depression may be hard to diagnose because so many other health factors may be contributing, including thyroid disease, neurological diseases (Parkinson's) heart disease, and vascular diseases like anemia. 

Depression can interfere with sleep - either too much or too little - and a lack of sleep can lead to depression. They both influence each other to create a vicious cycle of sleep deprivation and negative feelings. 

If you or a loved one are experiencing depressive symptoms, it's important to talk with your doctor about it and rule out any other underlying causes first. 

Pain from chronic disease 

Arthritis, myalgias, rheumatoid arthritis, and musculoskeletal pain can all create so much discomfort that it can be hard to go to sleep. Pain management is also difficult to navigate because of the negative side effects of so many analgesics. It can be hard to get comfortable in the bed when parts of your body are so uncomfortable that they keep you up at night. 

If you are having sleep trouble, think about if there are any pains in your body that you didn't notice before, but seem to bother you at night. Getting help for those may help to improve your sleep. 

Frequent Urination 

Frequent urination is troublesome for a variety of reasons. One, it can interrupt sleep if you have to get up and use the bathroom throughout the entire evening. Two, it can increase risk of accidents if you are getting in and out of bed and going to the bathroom in the middle of the night. 

Frequent urination may be a sign of a variety of issues. Kidney disease is common, along with diabetes. If you are a man, then issues like benign prostatic hypertrophy may cause the sensation of urination without any urine being produced. Urinary tract infections, prostatitis, vulvovaginitis, and many other genitourinary disorders that become more common with age can lead to the need to urinate. 

Also, medications and supplements that include diuretics (alcohol, caffeine, antihypertensive medications) can also be a cause of frequent urination. 

If you are struggling with using the restroom many times throughout the night, then it may be time to talk with your doctor to find out what the underlying issue is and how to address it. 

Sleep disorders 

Your sleep troubles may be caused by sleep disorders such as insomnia, Restless Leg Syndrome (RLS), sleep apnea, to name a few. These disorders mostly need to be diagnosed via a sleep study, or a polysomnography, which takes place at a sleep lab (just like ours) and is interpreted by a sleep health professional. 

If you don't think your sleep troubles are caused by any of the above issues, or anything not mentioned, then it may be best to get in touch with one of our sleep health professionals to get help. Simply click the orange button below to get in contact with someone in our office. 

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