Our ageing population brings a growing crisis: people over 65 are at greater risk of dual sensory impairment (also known as “deafblindness” or combined vision and hearing loss).

Some 66% of people over 60 have hearing loss and 33% of older Australians have low vision. Estimates suggest more than a quarter of Australians over 80 are living with dual sensory impairment.

Combined vision and hearing loss describes any degree of sight and hearing loss, so neither sense can compensate for the other. Dual sensory impairment can occur at any point in life but is increasingly common as people get older.

The experience can make older people feel isolated and unable to participate in important conversations, including about their health.

Causes and conditions

Conditions related to hearing and vision impairment often increase as we age – but many of these changes are subtle.

Hearing loss can start as early as our 50s and often accompany other age-related visual changes, such as age-related macular degeneration.

Other age-related conditions are frequently prioritised by patients, doctors or carers, such as diabetes or heart disease. Vision and hearing changes can be easy to overlook or accept as a normal aspect of ageing. As an older person we interviewed for our research told us

I don’t see too good or hear too well. It’s just part of old age.

An invisible disability

Dual sensory impairment has a significant and negative impact in all aspects of a person’s life. It reduces access to information, mobility and orientation, impacts social activities and communication, making it difficult for older adults to manage.

It is underdiagnosed, underrecognised and sometimes misattributed (for example, to cognitive impairment or decline). However, there is also growing evidence of links between dementia and dual sensory loss. If left untreated or without appropriate support, dual sensory impairment diminishes the capacity of older people to live independently, feel happy and be safe.

A dearth of specific resources to educate and support older Australians with their dual sensory impairment means when older people do raise the issue, their GP or health professional may not understand its significance or where to refer them. One older person told us:

There’s another thing too about the GP, the sort of mentality ‘well what do you expect? You’re 95.’ Hearing and vision loss in old age is not seen as a disability, it’s seen as something else.

Isolated yet more dependent on others

Global trends show a worrying conundrum. Older people with dual sensory impairment become more socially isolated, which impacts their mental health and wellbeing. At the same time they can become increasingly dependent on other people to help them navigate and manage day-to-day activities with limited sight and hearing.

One aspect of this is how effectively they can comprehend and communicate in a health-care setting. Recent research shows doctors and nurses in hospitals aren’t making themselves understood to most of their patients with dual sensory impairment. Good communication in the health context is about more than just “knowing what is going on”, researchers note. It facilitates:

• shorter hospital stays
• fewer re-admissions
• reduced emergency room visits
• better treatment adherence and medical follow up
• less unnecessary diagnostic testing
• improved health-care outcomes.

‘Too hard’

Globally, there is a better understanding of how important it is to maintain active social lives as people age. But this is difficult for older adults with dual sensory loss. One person told us

I don’t particularly want to mix with people. Too hard, because they can’t understand. I can no longer now walk into that room, see nothing, find my seat and not recognise [or hear] people.

Again, these experiences increase reliance on family. But caring in this context is tough and largely hidden. Family members describe being the “eyes and ears” for their loved one. It’s a 24/7 role which can bring frustration, social isolation and depression for carers too. One spouse told us:

He doesn’t talk anymore much, because he doesn’t know whether [people are] talking to him, unless they use his name, he’s unaware they’re speaking to him, so he might ignore people and so on. And in the end, I noticed people weren’t even bothering him to talk, so now I refuse to go. Because I don’t think it’s fair.

So, what can we do?

Dual sensory impairment is a growing problem with potentially devastating impacts.

It should be considered a unique and distinct disability in all relevant protections and policies. This includes the right to dedicated diagnosis and support, accessibility provisions and specialised skill development for health and social professionals and carers.

We need to develop resources to help people with dual sensory impairment and their families and carers understand the condition, what it means and how everyone can be supported. This could include communication adaptation, such as social haptics (communicating using touch) and specialised support for older adults to navigate health care.

Increasing awareness and understanding of dual sensory impairment will also help those impacted with everyday engagement with the world around them – rather than the isolation many feel now.

Moira Dunsmore, Senior Lecturer, Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, University of Sydney; Annmaree Watharow, Lived Experience Research Fellow, Centre for Disability Research and Policy, University of Sydney, and Emily Kecman, Postdoctoral research fellow, Department of Linguistics, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Have you heard people say eating cheese before bed will cause you to have vivid dreams or nightmares?

It’s a relatively common idea. And this week, a new study has landed this suggestion back in the spotlight.

But is it true? Let’s unpack the evidence.

A gouda night’s sleep?

Canadian researchers recently investigated this idea in a sample of 1,082 undergraduate psychology students. The students completed a survey, which included questions about how they perceived their diet influenced their sleep and dreams.

Some 40% of participants reported certain foods impacted their sleep, with 25% of the whole sample claiming certain foods worsened their sleep, and 20% reporting certain foods improved their sleep.

Only 5.5% of respondents believed what they ate affected the nature of their dreams. But many of these people thought sweets or dairy products (such as cheese) made their dreams more strange or disturbing and worsened their sleep.

In contrast, participants reported fruits, vegetables and herbal teas led to better sleep.

This study used self-reporting, meaning the results rely on the participants recalling and reporting information about their sleep and dreams accurately. This could have affected the results.

It’s also possible participants were already familiar with the notion that cheese causes nightmares, especially given they were psychology students, many of whom may have studied sleep and dreaming.

This awareness could have made them more likely to notice or perceive their sleep was disrupted after eating dairy. In other words, the idea cheese leads to nightmares may have acted like a self-fulfilling prophecy and results may overestimate the actual likelihood of strange dreams.

Nonetheless, these findings show some people perceive a connection between what they eat and how they dream.

While there’s no evidence to prove cheese causes nightmares, there is evidence that does explain a link.

The science behind cheese and nightmares

Humans are diurnal creatures, meaning our body is primed to be asleep at night and awake during the day. Eating cheese before bed means we’re challenging the body with food at a time when it really doesn’t want to be eating.

At night, our physiological systems are not primed to digest food. For example, it takes longer for food to move through our digestive tract at night compared with during the day.

If we eat close to going to sleep, our body has to process and digest the food while we’re sleeping. This is a bit like running through mud – we can do it, but it’s slow and inefficient.

Cheese can be particularly challenging to digest at night because of high concentrations of fat and protein, which slows down our digestion.

If your body is processing and digesting food instead of focusing all its resources on sleep, this can affect your shut-eye. Research has shown eating close to bedtime reduces our sleep quality, particularly our time spent in rapid eye movement (REM) sleep, which is the stage of sleep associated with vivid dreams.

People will have an even harder time digesting cheese at night if they’re lactose intolerant, which might mean they experience even greater impacts on their sleep. This follows what the Canadian researchers found in their study, with lactose intolerant participants reporting poorer sleep quality and more nightmares.

It’s important to note we might actually have vivid dreams or nightmares every night – what could change is whether we’re aware of the dreams and can remember them when we wake up.

Poor sleep quality often means we wake up more during the night. If we wake up during REM sleep, research shows we’re more likely to report vivid dreams or nightmares that we mightn’t even remember if we hadn’t woken up during them.

This is very relevant for the cheese and nightmares question. Put simply, eating before bed impacts our sleep quality, so we’re more likely to wake up during our nightmares and remember them.

Can I still have brie before bedtime?

Don’t panic – I’m not here to tell you to give up your cheesy evenings. But what we eat before bed can make a real difference to how well we sleep, so timing matters.

General sleep hygiene guidelines suggest avoiding meals at least two hours before bed. So even if you’re eating a very cheese-heavy meal, you have a window of time before bed to digest the meal and drift off to a nice peaceful sleep.

How about other dairy products?

Cheese isn’t the only dairy product which may influence our sleep. Most of us have heard about the benefits of having a warm glass of milk before bed.

Milk can be easier to digest than cheese. In fact, milk is a good choice in the evening, as it contains tryptophan, an amino acid that helps promote sleep.

Nonetheless, we still don’t want to be challenging our body with too much dairy before bed. Participants in the Canadian study did report nightmares after dairy, and milk close to bed might have contributed to this.

While it’s wise to steer clear of food (especially cheese) in the two hours before lights out, there’s no need to avoid cheese altogether. Enjoy that cheesy pasta or cheese board, just give your body time to digest before heading off to sleep. If you’re having a late night cheese craving, opt for something small. Your sleep (and your dreams) will thank you.

Charlotte Gupta, Senior Postdoctoral Research Fellow, Appleton Institute, HealthWise Research Group, CQUniversity Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.