The benefit of nonpharmacological interventions for insomnia in old age is investigated. A total of 13 single-outcome studies involving 388 patients (mean age exceeding 60 years, minimum age in sample, 50 years) were included in a meta-analysis of treatment efficacy. This analysis demonstrated that behavioral interventions produce improvements in sleep parameters of older insomniacs, measured in terms of sleep-onset latency, number of nocturnal awakenings, time awake after sleep onset, and total sleep time. Clinical improvements seen at posttreatment were maintained at followups (averaging 6 months). It is concluded that behavioral treatments produce significant and long-lasting improvements in the sleep pattern of older insomniacs. Suggestions for future research are outlined.Insomnia is a disorder characterized by difficulty falling asleep, difficulty maintaining sleep or inability to return to sleep after waking up very early in the morning (Lacks & Morin, 1992), and it is by far the most common sleep disorder
Antipsychotic drug withdrawal affected activity and sleep efficiency over the short term. Increases in total activity and impaired sleep quality after drug discontinuation should be monitored, because the long-term effect of these changes is not known. The NPI-Q and actigraphy are feasible tools that disclose relevant changes occurring during antipsychotic withdrawal in NH patients with dementia. Their use in clinical practice should be substantiated by larger studies.
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