By Jack Huber
A recent study found that the risk of dementia was higher and associated with adults in their 50s and 60s with a sleep duration of less than six hours. This emphasizes the importance for older adults to not only be screened for sleep disorders, but also to maintain and improve their sleep quality.
Between 40 percent and 70 percent of older adults have chronic sleep issues, but up to half go undiagnosed. Sleep disordered breathing, a potentially serious sleep disorder in which breathing repeatedly stops and starts, affects 22 million Americans; and 80 percent of the cases of moderate and severe obstructive sleep apnea, the repeated collapse or partial collapse of the upper airway, go undiagnosed.
Airway stents may be the answer for healthcare providers seeking to not only help optimize sleep for older patients, but also shift away from treating sleep issues with sedatives due to their addictive nature and side-effects, such as impaired memory and focus.
Aging increases body fat and reduces total body water and plasma proteins, resulting in increased drug elimination half-life and the potential risk of adverse effects. For this reason, older adults should be treated first with non-pharmacological options before using pharmacological options.
Non-pharmacological approaches include relaxation techniques, improving sleep hygiene and cognitive behavioral therapy. These options can be effective even for older adults with cognitive impairment. For proper sleep hygiene, individuals should avoid daytime naps, maintain a regular sleep schedule, limit substances such as caffeinated beverages, nicotine and alcohol, and exercise at least six hours before bedtime.
Common among older people, sleep disorder breathing (SDB) can lead to cognitive impairment, mood changes, compromised quality of life (often attributed to reduced social functioning and vitality), higher risk of stroke and comorbidities, with up to 50 percent of patients with mild symptomatic chronic heart failure having SDB.
One study found that older adults with untreated severe SDB had increased all-cause mortality. Additional outcomes of particular interest in older people may include glaucoma, falls with fractures, impaired quality of life, decreased pain tolerance, frailty, and mortality.
Untreated obstructive sleep apnea (OSA) can lead to high blood pressure, congestive heart failure, atrial fibrillation, stroke, and other cardiovascular problems. This disorder is also associated with Type 2 diabetes and depression, and is a factor in a large number of traffic accidents due to persistent drowsiness.
Treatments
Treatments for breathing issues include weight loss, smoking cessation and increased cardiovascular exercise, enhanced sleep opportunity and environment, optimized medical management of comorbidities, and reduction in caffeine, alcohol and sedatives.
Continuous positive airway pressure (CPAP) therapy is a common treatment for OSA. CPAP pushes air into the airways to keep them open with a pump that controls airflow, a tube carrying air from the machine to the user, and a mask that goes over the mouth, nose or both. Typical problems with CPAP, however, include discomfort, leaky mask, trouble falling asleep, stuffy nose, and a dry mouth. Other treatments include oral appliances, surgery and sleep aid devices.
The most effective sleep-aid devices support natural nasal breathing, which is essential for optimal health because they filter, warm and humidify inhaled air. This protects the lungs, leads to better oxygen supply to the body, stimulates the calming nervous system, and reduces snoring and SDB. All of these factors contribute to a stronger immune system and improve quality of life.
Among the most promising sleep-aid devices, innovative stent-based therapies not only support healthy, natural nasal breathing, but also enhance physical performance, mitigate symptoms of chronic sinusitis and other quality-of-life conditions such as allergies, rhinitis, chronic rhinitis, sinusitis, allergic rhinitis, and many autoimmune diseases.
Stents can be worn comfortably for up to 18 hours at a time for optimal breathing, transform unhealthy sleep patterns, improve nasal breathing to increase oxygen supply, and result in more relaxing sleep.
Healthcare providers should look for airway stents that have been clinically tested for treatment of patients struggling with OSA and snoring and designed to support healthy, natural nasal breathing at night and during the day.
Jack Huber is president of Alaxo Airway Stents.