Late‐life insomnia: A review

Abstract

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.

Evaluation of the PHQ-9 Item 3 as a Screen for Sleep Disturbance in Primary Care

“…3,37,38 (Categorical variables were dummy coded). Next, false negative (i.e., number of people who endorsed no sleep problems on the PHQ item-3 but who scored positive for insomnia symptoms on the ISI) and false positive (i.e., the number of people who endorsed sleeping problems on the PHQ item-3 but who did not screen positive for insomnia on the ISI) rates were calculated.…”

Insomnia among community dwelling elderly in Alexandria, Egypt

“…In addition, these complaints are present despite adequate circumstances and opportunities for sleep, and they result in impairment of daytime functions, such as attention, memory impairments, and fatigue [4].…”

A Review of Ecg-Based Diagnosis Support Systems for Obstructive Sleep Apnea

“…For example, the number of patients with phase advance in the normal circadian sleep cycle increases with age, so does the restless legs syndrome. Especially, OSA is increasingly seen among older individuals and it is significantly correlated with cardio-and cerebrovascular diseases as well as cognitive impairment [113]. OSA increases corrected QT dispersion, that is the difference between the maximum and minimum QT intervals and is a strong risk factor for cardiovascular mortality [114].…”