26
the guardians
Insomnia
as you age
COMPLAINTS of poor sleep or
excessive daytime sleepiness are more
common in older persons. The elderly
endure significant changes to their
established sleep/ wake patterns such
as retirement, reductions in physical
and social activity and in some cases
institutionalisation. Surveys have shown
26 to 45 per cent of older people complain
of insomnia.
Changes in sleep as
a result of ageing
The most striking age related change in
sleep physiology is a reduction in the
amount and amplitude of delta sleep.
Compared with younger persons, elderly
persons spend more time in bed relative
to the amount of time they are actually
asleep.
“Although the elderly do not require
more time to fall asleep (sleep latency),
they awaken more frequently during the
night and stay awake longer. They may
nap more during the day and are more
sensitive to changes in time zones and
other environmental cues,” says Pantai
Hospital Kuala Lumpur Consultant Physi-
cian and Geriatrician Dato Dr Rajbans
Singh.
CARP.CA
The HEALTH | NOVEMBER, 2018
Metabolic
syndrome
in persons
60 years
and above
Abdominal obesity and high
blood pressure among the
common symptoms
D
O you feel tired? Do
you feel fatigued and
lethargic? Do you
have a fuzzy mind?
Are you reaching
middle-age? These
are a few of the
symptoms of a new disorder – meta-
bolic syndrome.
Pantai Hospital Kuala Lumpur Con-
sultant Physician and Geriatrician Dato
Dr Rajbans Singh revealed that this
syndrome goes by many other names –
Syndrome X, Dysmetabolic syndrome,
insulin resistance syndrome, obesity
syndrome and Reaven’s syndrome.
What is metabolic syndrome?
Because sleep disturbances are often
transient responses to situational stresses
or new surroundings, only disturbances
persisting more than one month are
considered clinically significant.
Factors which disturb sleep patterns
include anxiety, depression, pain, dis-
comfort due to constipation, urgency,
frequency, nocturia, restless legs,
cramps, daytime napping, nocturnal
cough or breathlessness and unrealistic
expectations.
Treatment of insomnias
The most important principle in manag-
ing insomnia is to consider sleeping pills
as last resort.
Rajbans explained that the aim of non-
pharmacologic measures is to strengthen
the association of time spent in bed with
sleeping and to weaken its association
with activities incompatible with sleep
(worrying, lying awake). These goals can
be met with careful attention to sleep
hygiene - regular schedule of going to
sleep and arising, even on weekends and
holidays.
“The sleeping area should be kept at
a comfortable temperature and as noise
free as possible. It is just as important that
the bed not be associated with the frustra-
tion of trying to get to sleep. This means
not using the bed for non-sleep activities
such as reading or watching television.”
“Good sleep hygiene also includes
avoiding nocturia by limiting the inges-
tion of fluids such as caffeine and tobacco
which can interfere with sleep when
taken to late in the evening.
SCIENCE NEWS FOR STUDENTS
It is a cluster of related syndromes
which can cause an individual to be
susceptible to a series of medical night-
mares such as heart disease, stroke,
diabetes, kidney diseases, clogged
arteries and premature death.
The symptoms of a metabolic syn-
dromes are:
1. Central / abdominal obesity as mea-
sured by weight circumference. Men
greater then 40 inches (120cm) and
women greater than 35 inches (88cm).
2. Fasting triglycerides (bad choles-
terol) greater than or equal to 150mg
/ dL.
five symptoms. If left untreated, the
medical complications can develop
in as few as 15 years. It can affect any
age but most frequently those who are
significantly overweight with most of
the excess fat in the abdominal area
and are inactive.”
Rajbans emphasised that for per-
sons 60 years and above, it’s going to
be harder to lose weight because your
hormone drops, and the inability to
exercise due to other medical problems
would compound the problem.”
Who is at risk?
Dr Rajbans emphasised that for
persons 60 years and above, it’s going
to be harder to lose weight because
your hormone drops.
3. HDL cholesterol (good cholesterol)
– men less than 40mg/dL while women
less than 50mg/dL.
4. Blood pressure greater than or equal
to 130/85mm Hg.
5. Fasting glucose greater than or equal
to 110mg /dL.
“A diagnosis of metabolic syndrome
is made if one fulfils three out of the
“The prevalence increases with age
affecting less than 10 per cent of people
in their 20s and 40 per cent in their 60s.
Body mass index (BMI) is a measure
of your percentage of body fat based
on height and weight. If the BMI is
greater than 25 it increases the risk of
metabolic syndrome. In addition to
these, those with gestational diabetes
(diabetes during pregnancy) and
family history of type 2 diabetes are
likely to develop metabolic syndrome.”
Hypertension, cardio vascular dis-
ease and polycystic ovarian syndrome
– a hormonal disorder in which the
ovaries produce an excess of male hor-
mones increases the risk of metabolic
syndrome.
Walking and aerobics helps
prevent metabolic syndrome
M
ETABOLIC Syndrome is a
slow progressive syndrome
that may take as long as
15 years before it appears in a full
spectrum.
“Therefore in alignment with
all medical diseases, prevention is
better than cure. You can curb your
insulin resistance by just taking
control and making lifestyle changes
such as walking just 30 minutes
everyday or engaging in any aerobic
activity,” explained Pantai Hospital
Kuala Lumpur Consultant Physician
and Geriatrician Dato Dr Rajbans
Singh.
“By just loosing as little as five
per cent to 10 per cent of your body
weight one can reduce insulin levels,
high blood pressure and decrease
the risk of diabetes. Smoking ciga-
rettes creates an increase in insulin
resistance and hence worsens the
health consequences of metabolic
WHEREYOULIVEMATTERS.ORG
syndrome. In addition, thinking
and eating sensibly is a good tip for
a healthy lifestyle. Ensure that your
grocery cart includes whole grains,
beans, fruits and vegetables. These
items are rich with dietary fiber
which helps in lowering the insulin
levels.