Sleep disorder diagnosis

| Some elderly people or their relatives mistakenly think that daytime sleepiness is normal in old age, as well as believe that older people need less sleep, which can influence them not to report their problems to their doctor.

This makes, together with the fact that the elderly tend to overestimate or underestimate the duration and quality of their sleep, it is sometimes difficult to detect them and therefore establish their treatment. At other times, caregivers believe that the older person should going to bed early and waking up late, with disproportionate expectations regarding the dream of the elderly. For all this in the elderly, it must be confirmed that insomnia really exists and with the collaboration of the patient, their relatives and caregivers (especially if they live with the elderly) and their partner, the following must be found out:

• Check the number of hours who sleeps throughout the day and add them up. Assess whether the demand comes from the patient, family or caregivers; if what is intended is that he sleeps an excessive number of hours.
• Find out what time you go to bed, because if it is early it is logical that you wake up at 4 or 5 in the morning. For an elderly person to sleep an average of six hours a day is sufficient, with all possible individual differences. Sometimes you may believe that you are not sleeping, as well as family and caregivers, because you go to bed early and sleep during the day. In institutions they are sometimes pretended to sleep too much.
• It must be identified if there are physical or mental illnesses that provoke or favor the painting. Investigate all medications that the patient is taking, including herbal, natural or parapharmacy products, which may be affecting sleep. It is convenient to check if you suffer from a prostate disorder, there are painful conditions or you take diuretics, suffer from cardiorespiratory failure, take bronchodilators, etc.
• The couple should be questioned if they observe snoring, nightmares, bruxism (grinding of teeth), pulling on the legs or sudden movements in bed.
• Ask the patient if he has Difficulty falling asleep, if you suffer from early awakenings in the morning or if the awakenings are multiple throughout the night. Ask yourself how you feel in the morning and throughout the day and if you need naps. Likewise, it is necessary to find out if he is self-medicating and the routines that he follows when going to bed and getting up. It is useful to carry out a "sleep diary" where these aspects are reflected 24 hours a day in a period of 2 to 3 weeks.
• Polysomnographic studies in the elderly are recommended in special situations, such as when in doubt, during the study of sleep apneas or restless legs syndrome.

Conclusions.

The diagnosis of insomnia is not based exclusively on the number of hours slept, but in the existence of signs arising from sleep deprivation during the day. Thus, if the patient feels tired, falls asleep easily, has a lack of concentration, or psychological disorders or related physical illnesses appear, it may be thought that the patient really suffers from a.

On the contrary, even if the patient reports subjective sleep disturbances, if during the day he is active, collaborative and without the need to sleep, the patient will be considered to have had a "restful sleep", sufficient to maintain homeostasis of his organic and psychological functions, regardless of subjective complaints of "few hours of sleep."