Sleep Disorders in Seniors: Nighttime Aggression and Solutions

Q: Sleep Disorders in Seniors: Nighttime Aggression and Solutions

Hello, Mao Mao： Please first ensure her and her family's safety, and then take her to Hualien Hospital to see Dr. <br>Jiang Si-yi in the Neurology Department for an examination. <br>Dr. <br>Jiang's clinic hours starting in February are every Monday and Wednesday morning, and Tues

Sleep disorders in the elderly - acting out in dreams?

Hello, doctor.
My mother is 65 years old.
This year during the Lunar New Year, I stayed with her and noticed that she often tries to hit people in her sleep, actually getting up and grabbing things around her, which resulted in bruises on her thigh.
She also talks loudly in her sleep.
From my previous observations, she used to talk in her sleep but did not exhibit any physical movements, and it was difficult to wake her up.
This time, during my six-day visit, she attempted to get up in her sleep at least three times.
I wonder if she is just too tired (since she mentioned feeling a bit tired during the New Year).
From my observations, these incidents typically occur about 2 to 3 hours after she goes to bed, and then they stop.
I would like to know if this situation requires medication for control.
Is it due to aging, or could there be other brain-related issues? Additionally, she does not take any long-term medications.
My mother lives in Hualien; are there any hospitals in Hualien or elsewhere that specialize in sleep disorders?

Mao Mao, 20~29 year old female. Ask Date: 2004/01/25

Dr. Wang Fangli reply Internal Medicine

Hello, Mao Mao: Please first ensure her and her family's safety, and then take her to Hualien Hospital to see Dr.
Jiang Si-yi in the Neurology Department for an examination.
Dr.
Jiang's clinic hours starting in February are every Monday and Wednesday morning, and Tuesday and Thursday afternoon.
Internal Medicine Dr.
Wang Fang-li.

Reply Date: 2004/01/25

More Info

Understanding sleep disorders in seniors, particularly those involving nighttime aggression and unusual behaviors, is crucial for ensuring their safety and well-being. Your mother's experience of exhibiting aggressive behavior during sleep, such as attempting to hit or grab objects, is concerning and may indicate a condition known as REM Sleep Behavior Disorder (RBD). This disorder is characterized by the loss of normal muscle atonia during REM sleep, which can lead to individuals acting out their dreams, sometimes violently.

Potential Causes
1. Aging: As people age, their sleep architecture changes. Seniors often experience lighter sleep and may have more fragmented sleep patterns. This can lead to increased occurrences of sleep disturbances.

2. Neurological Conditions: RBD can be associated with neurodegenerative diseases, such as Parkinson's disease or Lewy body dementia. If your mother has other symptoms, such as changes in movement, cognition, or mood, it may warrant further investigation.

3. Sleep Deprivation: If your mother was particularly tired during the holiday season, this could exacerbate sleep issues. Stress and fatigue can lead to more vivid dreams and increased likelihood of acting them out.

4. Medications: Although you mentioned she is not on long-term medications, any recent changes in medication or new prescriptions could also contribute to sleep disturbances.

Recommendations
1. Consult a Sleep Specialist: It is essential to have your mother evaluated by a healthcare professional who specializes in sleep disorders. In Hualien, you can check with local hospitals or clinics to see if they have a sleep medicine department. Many larger hospitals have sleep centers that can conduct sleep studies to better understand her condition.

2. Sleep Hygiene: Encourage good sleep hygiene practices. This includes maintaining a regular sleep schedule, creating a comfortable sleep environment, and avoiding stimulants like caffeine or heavy meals before bedtime.

3. Safety Precautions: Given her aggressive behaviors during sleep, it may be wise to ensure her sleeping environment is safe. Remove sharp objects or anything she could potentially harm herself with if she acts out during the night.

4. Medication: While it may not be necessary to start medication immediately, if her symptoms persist or worsen, a healthcare provider may consider prescribing medications to help manage her sleep behavior. This should be done under careful supervision, especially in older adults.

5. Monitor Symptoms: Keep a sleep diary for your mother, noting when these episodes occur, their duration, and any other relevant behaviors. This information can be invaluable for her healthcare provider in diagnosing and treating her condition.

Conclusion
Your mother's nighttime aggression and dream enactment are concerning and should not be overlooked. While aging can contribute to changes in sleep patterns, the presence of these specific behaviors suggests a need for further evaluation. By consulting with a sleep specialist and implementing safety measures, you can help ensure her well-being and address any underlying issues that may be contributing to her sleep disturbances.

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