Hypersomnia in old age: causes, symptoms and treatment

It is not surprising that many older people mention that they spend a large part of the day sleeping. This is a very frequent reality in this population group, and it is a phenomenon that does not have to be linked to any pathology but to normative variations in sleep rhythms as the days go by. years.

In this article we collect and briefly explain the phenomenon of hypersomnia in old age.

The concept of hypersomnia

Is considered hypersomnia the presence of excessive drowsiness for at least a month. This sleepiness can be seen both in extended periods of sleep (as occurs in the Kleine-Levin syndrome) and in the form of daytime sleep that cause a functional limitation of the individual in his activity in various fields. It is also common for people with hypersomnia to have lower intellectual performance and problems with concentration, memory, and irritability.

This definition largely coincides with what occurs in elderly subjects, who fall asleep frequently during the day.. Thus, it could be said that many elderly people present hypersomnia in old age. However, it must be taken into account that in most cases this fact can be explained by changes in sleep cycles that occur throughout life.

sleep cycles

Falling asleep is not like turning off a switch. The transition from sleep to wakefulness does not occur in a sudden way in which our brain activity suddenly changes to repair itself and process information. In fact, as many readers will already know, there are a total of five phases that we go through on an ongoing basis. throughout the entire sleep period, repeating itself cyclically in a pattern that lasts for about 110 minutes.

Four of these phases correspond to slow or non-REM sleep., being the first two phases in which we fall asleep and disconnect from the environment and the second two (which often come together in a single phase called the Delta phase) slow and restful sleep. The last phase corresponds to paradoxical sleep or REM phase, in which the information obtained during wakefulness is processed and phenomena such as dreams occur.

These cycles vary in quantity and quality throughout life., both in total time spent sleeping and in the number of daily hours in which each phase occurs. For example, babies spend a large part of the day sleeping, and during that time the high presence of hours dedicated to REM sleep stands out.

aging and sleep

As we grow older, sleep patterns change. Although REM sleep remains more or less constant (with slight decreases) after the age of twenty, the rest of the sleep phases vary throughout life.

It has been observed that upon reaching old age there is a marked tendency to fragment sleep, being common that there are multiple nocturnal awakenings. Likewise, slow wave sleep, the sleep that is most restful for the body, is greatly reduced. The sleep phase that occupies the longest time is phase two, a light and not fully restorative sleep from which the subject can be easily awakened.

With the passage of time the Cardiac rhtyms they shorten naturally, causing the subject to wake up earlier each time (although they also tend to go to bed early).

In conclusion, heThe quantity and quality of sleep in the elderly is less than what they had in other stages of life. That is why during the normative periods of sleep they do not finish resting adequately, which causes increased fatigue and daytime sleepiness. In this way, hypersomnia arises in old age as a normative process and without having to refer to the presence of other alterations.

Problems linked to the appearance of daytime sleep

Increased fatigue and the presence of a slight increase in daytime sleep may be part of normative aging. But it can also be indicative of the existence of a physical or mental disorder, so it is necessary to take into account the existence or not of other symptoms beyond drowsiness.

1. Depression

For example, it is common for people with depression to suffer from either insomnia or hypersomnia.. And it is that it is frequent that people with depression manifest in the long run the loss of positive reinforcement, anhedonia, disconnection from the environment, passivity and low level of energy and motivation. It is a condition that can be had at any age, but is especially frequent among the elderly population due to the high number of losses and decreases typical of age.

The loss of physical and mental capacity, of roles (such as work), the emergence of dependency on aid in some cases, the death of part of the environment or the increasing loneliness that older people show are frequent reasons why those who reach old age suffer from some type of syndrome depressant.

2. Consumption of medicines

It is common that with age it is common to need different medications to treat different health problems. And this consumption is another of the main causes of hypersomnia in old age. Antihistamines, tranquilizers, analgesics, antiemetics and antidepressants are some of the drugs which can cause increased sleepiness.

3. dementias

Patients with different types of dementia and neurodegenerative diseases also tend to see their sleep patterns altered, as for example in the Alzheimer disease.

4. Brain tumors or cancer treatment

Another cause that can lead to increased fatigue and hypersomnia in old age is Suffering from some type of tumor that affects or compresses the brain areas related to the sleep management. In addition, cancer treatment itself with chemotherapy can cause daytime hypersomnia.

5. Anemia

Lack of essential nutrients can cause anemia, in which the body is limited by not having enough elements to function effectively. This can cause an increase in the weakness and drowsiness of the elderly, causing hypersomnia.

Bibliographic references:

• Echavarri, C.; Erro, M.E. (2007). Sleep disorders in the elderly and dementia. Annals of the Navarro Health System, 30, supl.1. Pamplona.
• Phillip, b. & Ancoli, S. (2000) Sleep disorders in the elderly. Sleep Med.; 2: 99-114.
• Resendiz, M.; Valencia, M.; Santiago, M.V.; Castaño, V.A.; Montes, J.; Hernandez, J. & Garcia, G. (2004). Excessive daytime sleepiness: causes and measurement. Rev. Mex. neuroci.; 5 (2). Mexico.