Late-life insomnia: A review
Article first published online: 31 MAY 2009
© 2009 Japan Geriatrics Society
Geriatrics & Gerontology International
Volume 9, Issue 3, pages 220–234, September 2009
How to Cite
Fetveit, A. (2009), Late-life insomnia: A review. Geriatrics & Gerontology International, 9: 220–234. doi: 10.1111/j.1447-0594.2009.00537.x
- Issue published online: 17 AUG 2009
- Article first published online: 31 MAY 2009
- Accepted for publication 1 April 2009.
- obstructive sleep apnea;
- restless legs syndrome;
- sleep disorders
Aging is associated with substantial changes in sleep patterns, which are almost always negative in nature. Typical findings in the elderly include a reduction in the deeper stages of sleep and a profound increase in the fragmentation of nighttime sleep by periods of wakefulness. The prevalence of specific sleep disorders increases with age, such as a phase advance in the normal circadian sleep cycle, restless legs syndrome, and obstructive sleep apnea, which is increasingly seen among older individuals and is significantly associated with cardio- and cerebrovascular disease as well as cognitive impairment. Elderly patients with sleep disturbances are often considered difficult to treat; yet, they are among the groups with the greatest need of treatment. Management of sleep disturbances begins with recognition and adequate assessment. Hypnotic drugs have clearly been shown to improve subjective and objective sleep measures in short-term situations, but their role in chronic insomnia still remains to be further defined by research evidence. Non-pharmacological treatments, particularly stimulus control and sleep restriction, are effective for conditioned aspects of insomnia and are associated with a stable, long-term improvement in sleep. This review delineates the common causes of disordered sleep in older individuals, and effective diagnostic approaches and treatments for these conditions.