The Mutualistic Relationship between Sleep Disorder and Stress among the Elderly
Abstract
This secondary mixed study aims to trace the mutual relationship between geriatric sleep disorder and stress levels. The mutualistic relationship between geriatric sleep disorder and stress shall be assessed by referring to the proximity of a linear relationship having a linear interaction with each other. This deterioration can be traced to variations in the individuals’ internal clock, the suprachiasmatic nucleus (SCN), composed of over twenty thousand cells.
This master clock tends to control the individual’s twenty-four-hour cycles, namely the circadian rhythms. This research paper attempts to trace the mutualistic relationship between stress and geriatric sleep disorder more prevalent among the elderly. In this case, the elderly are very vulnerable to sleep disorders due to the physiological changes caused by old age. The specific objectives of this research study include: What is the relationship between sleep disorder and the individual’s stress levels.
Does the prevalence of geriatric sleep disorders increase with age? Which comes first with age, stress, or geriatric sleep disorder? Understanding how the lack of proper sleep on the individual’s quality of life. According to the literature studied in this research, there is a significant and mutual relationship between stress levels and sleep disorders, which tend to exacerbate with age. It was found that physiological changes due to age can lead to the development of geriatric sleep disorders. This study shall use a mixed research method of secondary data on sleep, sleep disorders, stress levels and age.
The appropriate method shall be selected based on the nature of the research question. Therefore the research shall analyse the data on each of the research objectives one at a time. This study has confirmed a mutual relationship between geriatric sleep disorders and high-stress orders. Sleep disorders are more prevalent among older adults, which tends to increase their mortality and morbidity.
Chapter 1: Introduction
This secondary mixed study aims to trace the mutual relationship between geriatric sleep disorder and stress levels among the elderly. The mutualistic relationship between geriatric sleep disorders and stress shall be assessed by referring to the proximity of a linear relationship having a linear interaction with each other.
In this case, a mutualistic relationship means that geriatric sleep disorders tend to cause elevated stress levels, which reduces the number of hours the individual can sleep in a day. This eventually leads to a rapid deterioration of the individual’s mental health and well-being in general if the necessary interventions are not made on time.
1.1 General Statement
A geriatric sleep disorder is a condition that affects the individual’s ability to sleep regularly and has a significant relationship with stress. The sleep disorder tends to impair sleep, preventing them from sleeping restfully, thus affecting their overall quality of life. The failure to get enough sleep affects individual health and safety, interpersonal relationships, and work performance. Even though geriatric sleep disorders are prevalent at old age, anyone can experience a sleep disorder from time to time.
More than seventy million Americans suffer eighty different geriatric sleep disorders, with the common ones being narcolepsy, restless legs syndrome, sleep apnea, and insomnia. The individual suffering from a sleep disorder may have difficulty falling asleep, lacking energy during the day, thus performing everyday activities (Song et al., 2021). Therefore, it is vital for researchers and healthcare providers, in the case of both physical and mental health, to understand the most prevalent sleep disorder, their causes, effects, and their relationships with stress levels and age.
1.2 Problem Statement
Gulia & Kumar (2018) confirms that there is a relationship between geriatric sleep disorders and age. This is a critical issue because the population of the elderly, people age sixty five years and older in the United States is expected to increase to more than a fifth of the people by the year 2040. According to Buchanan & Rotkirch (2018), the same trend was found in the case of the United Nations, whereby the population of the elderly is expected to triple by the end of the twenty-first century.
Ageing comes with various problems affecting the individual’s well-being, with geriatric sleep disorders being traced across the board. Buchanan & Rotkirch (2018) notes that the quality and duration of sleep tend to deteriorate with old age. This deterioration can be traced to variations in the individuals’ internal clock, the suprachiasmatic nucleus (SCN), composed of over twenty thousand cells. This master clock tends to control the individual’s twenty-four-hour cycles, namely the circadian rhythms.
According to Gulia & Kumar (2018), individual tends to face various mental stress in different stages of their lives. Even though mental stress is inevitable throughout an individual’s lifetime, excess and chronic stress tend to harm their physical and psychological health and well-being in general. The anxiety of institutionalisation causes the elder’s pressure, dependence on other people, deteriorated physical activities, death of loved ones, deterioration of lifestyle, and care for grandchildren.
Kalmbach et al. (2018) noted that one of the major physiological consequences of elevated stress levels is geriatric sleep disorder like insomnia. Understanding the relationship between old age, high-stress levels, and sleep disorders is critical in enhancing the individual’s overall well-being. There has been a small proportion of the research connecting mental health, age, and geriatric sleep disorder. Further research needs to determine the mutualistic interaction between sleep and stress levels among the elderly.
The specific objectives of this research study include:
- What is the relationship between sleep disorder and the individual’s stress levels?
- Does the prevalence of geriatric sleep disorders increase with age?
- Which comes first with age, stress, or geriatric sleep disorders?
- Understanding how the lack of proper sleep on the individual’s quality of life.
1.3 Theoretical Framework
This research paper attempts to trace the mutualistic relationship between stress and geriatric sleep disorders. In this case, the elderly are very vulnerable to sleep disorders due to the physiological changes caused by old age. The lack of physiological recovery causes the individual to experience elevated stress levels, exacerbating sleep disorders.
To answer the above-stated research questions, the researcher shall study recent literature on the increased prevalence of geriatric sleep disorders and stress levels. The researcher is more interested in determining which of the two comes first. This means whether sleep disorders precede elevated stress levels or goes the latter precedes the former.
Anxiety and stress are significant factors for geriatric sleep disorders, which exacerbate poor mental health, leading to an anxiety disorder. The predominant trait of geriatric sleep disorders is abnormal sleep patterns interfering with emotional, mental, and physical functions. Additionally, anxiety and stress tend to increase with the lack of sleep at night. Insomnia is the most common sleep disorder which involves trouble falling asleep and waking up unrefreshed.
It is often a challenge for mental health providers to identify which comes first between sleep and anxiety disorders. When a sleep disorder is predominantly caused by an anxiety disorder, treating the anxiety disorder can be an effective remedy for the sleep disorder (Papi et al., 2019). Effective treatment methods may include exercise, meditation, resting regularly during the day, and talking to a close friend or relative of professional mental health providers like physiatrists and psychologists.
Relative to the younger people, the elderly achieve less sleep at night even though they need more sleep to achieve physiological recovery. The elderly get more awakenings and arousals during the night, something that increases daytime sleepiness. This means that the overall sleep-wake cycle for the adult tends to be fragmented between day and night times, making it hard for them to achieve rapid eye movement (REM) sleep that tends to begin about one and a half hours after the individual fall asleep. This naturally facilitates the increase in brain activities, blood pressure, breathing. The individual is likely to dream during this stage, but their memory and learning are generally improved by reaching this stage.
The predominant sleep disorders among the elders is insomnia during the night, in addition to daytime sleepiness. In addition to this, the elderly are more likely to suffer from stress due to their financial status after they retire from formal employment, care from children and grandchildren, care from the sick, and fear institutionalisation. They, therefore, need more sleep to recover mentally and emotionally. The stress causes nightmares, insomnia, frequent bathroom visits during the night, and tiredness (CAI et al., 2019). Psychologically and emotionally, they experience forgetfulness, poor concentration, restlessness, depression, frustrations, anxiety, and fear.
According to the literature studied in this research, there is a significant and mutual relationship between stress levels and geriatric sleep disorders, which tend to exacerbate with age. It was found that physiological changes due to age can lead to the development of geriatric sleep disorders. They are also vulnerable to elevated stress levels due to the aggregated changes in their lives often related to reducing the overall quality of living.
Therefore, the prevalence of geriatric sleep disorders and high-stress levels increase across the individual’s lifetime. In this case, the common sleep disorders include insomnia, sleep apnea, parasomnias, narcolepsy, and restless leg syndrome (Liu et al., 2017). It was found that the elders have problems falling and staying asleep, have a strong urge to take naps during the day, suffer daytime fatigue, are often anxious and irritable, lack concentration, and gain weight.
These are the various symptoms that usually indicate different geriatric sleep disorders. The researcher also found that the multiple causes of elevated stress levels can occur independently as an individual grows in age. Combining the various symptoms of elevated stress levels leads to the diagnosis of a given sleep disorder.
Chapter 2: Literature Review
According to the recent research, this literature review aims to trace the relationship between sleep disorders, stress levels, and mental health. Wahbeh et al. (2018) defines sleep as a recurring state of relaxation that includes a reduced interaction between other human beings and outside entities, muscular inhibitions, inhibited sensory activities, and an altered state of consciousness. This tends to have both rapid eye movement, whereby they experience dreams, with the body being in a state of paralysis and non-rapid eye movement sleeping.
Hershner & Auckley (2021) pointed out that frequent geriatric sleep disorders like sleep apnea, narcolepsy, restless legs syndrome and insomnia can affect other aspects of an individual’s life. These include their performance at work, mental health, body weight, physical health, and interactions with other people. There are about eighty different geriatric sleep disorders, with the common ones being narcolepsy, restless legs syndrome, and insomnia. Caffein consumption and having devices like television screens and mobile phones lead to losing up to five hours for both children and adults.
A geriatric sleep disorder is defined as a condition that impairs an individual’s sleep preventing them from getting restful and eventually falling asleep. This disorder can affect an individual of any age but is more prevalent among the elderly. Yin et al. (2017) report that about a third of the American population report not having a night of adequate sleep at least seven hours a day.
About seventy million Americans tend to suffer from geriatric sleep disorders. They often have a problem falling asleep regularly; they are often tired during the day, affecting their ability to attend to everyday activities. An indivdual must get seven to nine hours of sleep every night. Despite these needs, Al-Abri, M. A. (2020) found that individuals aged eighteen and fifty-four years get an average of six hours a weekday and eight hours of sleep during the weekends.
It was also found that sleep time has been on a downward trend over the past decade. The researchers also looked into the sleep hours of the elderly; that is, people aged fifty-five to eighty fours years get seven hours both during the weekdays and weekends.
The researcher attributed this to the fact that they have less daily activities based on the fact that most of them are retired. They also develop geriatric sleep disorders, something that contributes to them getting less sleep regularly. Al-Abri (2020) reported that the downward trend in sleep is across time and with age. Additionally, Hershner & Auckley (2021) research found that the optimal number of sleep hours tends to vary with age.
2.1 The Cybernetic Theory of Stress, Coping and Well-being
According to the cybernetic theory of stress, coping, and well-being, self-regulation minimises the variability between internal standards and environmental inputs, which are the basis of reference. The approach, therefore, tries to explain human behaviour, something that needs to be both behavioural and psychological phenomena. The interruption of both environmental and internal leads to negative feedback loops that tend to elevate stress levels. Elevated stress levels are caused by the descripancy between what individuals perceive about their functioning and the levels they desire.
2.2 The Relationship between Old Age and Stress Levels
Hershner & Auckley (2021) note that life expectancy has been on the rise over the past two centuries, which has led to a phenomenon known as global ageing. The older an individual gets, the more the sources of their stress levels. This can be attributed to functional abilities, cognitive abilities, independence, physical health, financial and psychosocial well-being. Adversity tends to increase throughout the lives of the elderly, which tends to impair their physical health and quality of life in general.
According to Wahbeh et al. (2018), common stressors that increase with age include cognitive impairment, chronic illness, psychosocial stress, financial well-being and independence. Additionally, as individual ages physiologically, they tend to be more vulnerable to stressors due to a reduction in their levels of resilience. This can be conceptualised as the accumulation of wear and tear caused by subjective experiences and predisposition to life experiences.
Chronic stress tends to affect the hypothalamic-pituitary-adrenal axis, thus affecting the neuroendocrine system and functionality. This leads to a negative feedback loop, thus leading to the release of cortisol, which increases the individual’s alertness and other stress glucocorticoids. Another stress factor that increases with age for adult human beings is inflammation, linked to geriatric sleep disorders like insomnia and other illnesses like Alzheimer’s disease.
Ageing is often accompanied by a four-fold elevation in serum levels of inflammatory mediators like acute phase cytokines proteins. It is also important to note that there are sex differences between the stress levels, with females being twice as affected by stress as their male counterparts. This can be attributed to the hormone estrogen, which is more in women than men. Cortisol levels also increase with psychosocial and psychological stress and tend to increase with age.
2.3 Geriatric Sleep Disorders
According to Wahbeh et al. (2018), half of the elderly population experience geriatric sleep disorders. These geriatric sleep disorders tend to increase the risk of mortality and morbidity, which can be attributed to the fact that they cannot get the quality and quantity of sleep needed. Hershner & Auckley (2021) noted that there is no direct relationship between sleep and age. However, geriatric sleep disorders are a function of psychiatric illness and medical illness, increased medication, and the circadian cycle disruption.
Relative to the young, the elderly experience changes in sleep characterised by reduced slow-wave sleep advanced sleep phase, which results in early awakening and fragmented sleep. Psychologists often have to suggest the treatment of medical conditions that cause geriatric sleep disorders rather than directly treating the sleep disorder based on the fact that it is a symptom rather than the core problem.
2.4 The Relationship between Geriatric Sleep Disorders and Stress Levels
Liu et al. (2017) emphasise that sleep is essential for optimal and normal human function. It tends to allow the human brain to recharge and the rest of the body to get to a place of rest. Stress levels often affect the individual’s quality and quantity of sleep. Elevated stress levels and geriatric sleep disorders tend to impact mental and physical health. The lack of adequate sleep affects the individual’s concentration, general ability, energy levels and mood regulation. According to Hershner & Auckley (2021), geriatric sleep disorders are a function of physical health.
The lack of adequate sleep leads to physical health problems like kidney disease, arthritis, depression, stroke, diabetes, heart disease, and obesity. Elevated stress levels cause autonomic nervous systems (ANS) to release hormones like cortisol and adrenaline. This is due to family, finances, health, school, and work, which often keep the individuals alert at night that impair their sleep health.
2.6 Discussion
A thorough review of the literature on age, geriatric sleep disorder and stress levels reveal that the three variables are correlated. Additionally, the research has indicated that geriatric sleep disorder are more prevalent in the future based on the fact that the population of the elderly is expected to increase. According to the literature, evidence-based stress levels are a significant factor for sleeping disorders. Therefore, it is necessary to understand the mutual relationship between geriatric sleep disorders and elevated stress levels among seniour members of society.
This would involve showing the high-stress levels increase the prevalence of geriatric sleep disorder. Additionally, geriatric sleep disorder reduce the duration and quality of sleep an individual regularly gets, which further elevation of stress levels. In this interrogation, the researcher shall look into the relationship between sleep disorders and the individual’s stress levels. Additionally, the study shall assess the prevalence of geriatric sleep disorders and the influence of age. The researcher shall also determine the order of the variables, age, elevated stress levels, and sleep quality. The research also seeks to understand the impact of lack of proper sleep on the individual’s quality of life.
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Chapter 3 Methodology
3.1 Introduction
This study shall use a mixed research method of secondary data on sleep, geriatric sleep disorder, stress levels and age. The appropriate method shall be selected based on the nature of the research question. Therefore the research shall analyse the data on each of the research objectives one at a time.
3.2 Data Collection
The data to be analysed shall be collected from various recent research studies on the case of sleep. This shall help answer all the questions to understand the mutual relationship between geriatric sleep disorder and elevated stress levels among the elderly in society. It is important to note that different data sets, qualitative and quantitatives, shall be refered to to answer the research as mentioned above questions.
Each of these datasets has different sample sizes, thus providing a universal perspective on the relationship between geriatric sleep disorder, age, and stress levels. In this analysis, the research sall include the impact of genders, stress levels, and age to understand the relationship between stress levels and sleep fully.
3.3 Quality Control
The research shall institute three levels and quality control, which will facilitate identifying the relevant datasets and recent research studies on geriatric sleep disorder and stress levels. The researcher shall then select the relevant method of analysis depending on the research question of focus.
3.4 Data Analysis
The researcher shall explore the references in various ways. This shall involve using the term Medical Subject Heading of the National Library of Medicine (MeSH). The main source of secondary data, in this case, is PubMed on information concerning stress and its impact on the quality of sleep an individual gets and how this changes as the individual grows in age.
The MeSH terms of use, in this case, are “sleep” and “stress”, in the attempt to fully refine the process, the research shall use terms like “geriatric sleep disorder”, “elderly”, “age”, and “elevated stress levels.” The researcher shall consult the textbook Principles and Practice of Sleep Medicine (Kryger et al., 2016) to understand the concept of sleep disorder as used in the journal “sleep”. An analytical research design shall be applied in the assessment of secondary data.
The researcher shall consult both the relationship between the two variables, namely geriatric sleep disorder and stress levels. The researcher shall look into the relationship between sleep time and geriatric sleep disorder. Here the researchers shall determine what sleep duration range is considered as a sleep disorder. The data on sleep shall be presented in tables and other data visualisation methods and charts.
The population of focus in this study is American adults aged sixty-five years and above. Data visualisation shall show the differences in sleep hours between male and female humans of various age groups. The relationship between stress levels and geriatric sleep disorder and how this relationship changes in age.
3.5 Study Limitations
The main potential limitation of this study is its relevance to the data collected by other researchers involved in a sleep study. The researcher shall have to rely on the accuracy of some of the decisions made by the researchers. Most research studies interrogate the relationship between geriatric sleep disorder and age and sleep disorders and stress levels separately, with very few focusing on the geriatric sleep disorder and their causes.
Chapter 4 Findings and Discussion
After using the MeSH terms like “geriatric sleep disorders” and “stress”, two dozen research articles examine the relationship between stress levels and sleep disorders. The researchers found a dozen articles with the use of “psychological”, “stress levels”, “mental health”, something that led to the finding of one hundred research articles.
The researcher found that the overarching sleep disorder is insomnia, with sleep apnea being another common sleep disorder. In the study of the sleeping trends in the United States, the researchers found that there has been an upward trend in sleeping hours for both male and female human beings of all ages. Additionally, Americans have different sleeping schedules for weekdays and weekends.
Figure 1: Sleeplessness in America
Source: The American Time Survey
The Relationship between Geriatric Sleep Disorder and Elevated Stress Levels
According to the research consulted, the researcher found that their sleep and stress levels affect each other. It was found that sleep deprivation tends to elevate stress levels, causing sleep disturbances. The researcher found that the elderly often experience geriatric sleep disorders that can be attrributed to age-related health problems like heart disase, with others being related to age. This study confirmed that the majority of the older adults in the United States experience poor qualities of sleep. It was found that elevated stress levels are a major contributor to sleep disorders for individuals of all ages.
Figure 2: A conceptual diagram on the relationship between geriatric sleep disorders and elevated stress levels.
The researcher found that sleep disorders like infectious diseases, cardiovascular disease, schizophrenia, post-traumatic stress disorder, and depression cause insomnia among elderly adults. The researcher found that a relationship between sleep disorders and stress levels. The more sleep deprivation, the higher the stress levels, which reduces the inididual ability to regulate both their sleep habits and stress disorders.
4.1 The Prevalence of Geriatric Sleep Disorders Increase with Age
It was found that geriatric sleep disorders tend to exacerbate with age, with prevalence levels of up to fifty per cent for individuals aged sixty-five years and above. It was found that sleep disorders are something that has increased over the past five years. This study confirmed that the older an individual gets, the more prone to sleep disorders, with most individuals aged sixty-five years and older getting only five hours of sleep.
Insomnia is one of the geriatric sleep disorders that tend to increase with age. This study confirmed that older adults tend to experience sleep disorders, which impairs their bodies’ resilience. The older the individual gets, the more prevalent the sleep disturbances. Additionally, older adults also experience daytime sleepiness due to the lack of adequate sleep at night. The lack of sufficient sleep affects their mental health in general, which is indicated by inadequate sleep.
4.2 Age, stress, or geriatric sleep disorders
The researcher was interested in determining what comes first between sleep disorders, age, and the elevation of stress levels. According to the secondary data used, it was found that ageing is inevitable. The human body tends to deteriorate with age, thus losing the resilience and the normal functioning of the human body. This deterioration of the human body comes with increased inflammation. Therefore, ageing takes place independent of stress levels and geriatric sleep disorders.
With the increased inflammation resulting from age and age-related diseases, the individual tends to experience elevated stress levels. However, the stress levels also tend to increase due to other factors such as retirement, family ties, and institutionalisation. geriatric sleep disorders are experienced by individual’s of all ages, but the prevalence tends to increase with age. Other factors that link sleep disorders, stress levels, and age include medication, medical conditions and mental health disorders. It was found that period comes first of the three variables.
4.3 Sleep Deprivation and the Quality of Life
It was found that the lack of adequate sleep tends to impair the individual’s quality of life. According to the secondary research data analysed, sleep is critical to the health and overall well-being of the individual. The lack of adequate sleep tends to impair the safety, quality of life, physical health, and mental health of the individual, all of which are critical aspects of the quality of life. It was found that adequate sleep for older adults is at least seven hours a day. It was found that getting adequate sleep is critical to a healthy quality of life, essential to the individual’s overall well-being.
Chapter 5: Conclusion
This study has confirmed a mutual relationship between geriatric sleep disorders and elevated stress orders not only to the older adults but also individuals of other ages. However, sleep disorders are more prevalent among older adults, which tends to increase both their mortality and morbidity. It was found that thethe most prevalent sleep disorders are fragmented sleep at night and sleepiness during the day. In this case, stress is a factor that causes sleep disorders, and in return, the lack of adequate sleep tends to elevate the individual’s stress levels.
It was found that the recommended number of sleep hours for older adults is seven hours per day. The impact of geriatric sleep disorders and the quality of life makes them a public health burden, especially in the case of elderly adults. Even though older adults are in retirement, they tend to pay less than younger individuals. Therefore sleep disorders and retirement do not occur in a social vacuum, something that tends to affect the elderly at an individual level. It was found that insomnia is one of the most prevalent something that affects the individual’s depression.
The lack of adequate sleep tends to cause depressive symptoms affecting the individuals metally and impairing their neuroendocrine stress system, mood, psychomotor performance, alertness, memory, and attention. Geriatric sleep disorders not only interact with stress levels but mental health in general.
Sleep disturbances harm mental health. Older adults tend to experience sleep deficiencies, something that affects them physically and mentally. Poor sleep quality tends to impary the individual’s physical recovery, which leads to inflammation and tiredness. The lack of adequate recovery of the brain tends to impair the individual’s mental resilience. Future research studies need to use primary data to interrogate the correlation between geriatric sleep disorders and changes in stress levels.
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