Sleep In Older Adults: Normative Changes, Sleep Disorders, and Treatment Options
Identifieur interne : 001712 ( Main/Exploration ); précédent : 001711; suivant : 001713Sleep In Older Adults: Normative Changes, Sleep Disorders, and Treatment Options
Auteurs : Nalaka S. Gooneratne [États-Unis] ; Michael V. Vitiello [États-Unis]Source :
- Clinics in geriatric medicine [ 0749-0690 ] ; 2014.
Abstract
Sleep disorders are common in older adults: Approximately 5% of older adults meet criteria for clinically significant insomnia disorders and 20% for sleep apnea syndromes. When considering insomnia symptoms, it is important to distinguish age-appropriate changes in sleep from clinically significant insomnia, with the latter distinguished by the presence of significant daytime symptoms such as fatigue. Evaluation with a sleep diary and screening for comorbid conditions, especially mood disorders, is essential. Non-pharmacologic therapies, such as cognitive-behavioral therapy for insomnia, can be highly effective and have sustained benefit. A broad range of pharmacologic therapies are also available but can have unwanted psychomotor effects. If left untreated, insomnia can be associated with increased risk of depression and significant impairments in quality of life. In regards to sleep apnea, a high index of suspicion is crucial for effective diagnosis because symptoms commonly noted in younger patients, such as obesity or loud snoring, may not be present in older patients. Diagnosis and management is fairly similar across age groups, except that a more nuanced approach to weight loss is warranted in older adults. The increasing use of home-based portable polysomnography and auto-titrating positive-airway pressure therapy can reduce barriers to treatment.
Url:
DOI: 10.1016/j.cger.2014.04.007
PubMed: 25037297
PubMed Central: 4656195
Affiliations:
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Gooneratne</name><affiliation wicri:level="2"><nlm:aff id="A1">Division of Geriatric Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Division of Geriatric Medicine, Department of Medicine, University of Pennsylvania, Philadelphia</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A2">Center for Sleep and Circadian Neurobiology and Division of Sleep Medicine, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Center for Sleep and Circadian Neurobiology and Division of Sleep Medicine, School of Medicine, University of Pennsylvania, Philadelphia</wicri:cityArea></affiliation></author><author><name sortKey="Vitiello, Michael V" sort="Vitiello, Michael V" uniqKey="Vitiello M" first="Michael V." last="Vitiello">Michael V. Vitiello</name><affiliation wicri:level="2"><nlm:aff id="A3">Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, Washington</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Washington (État)</region></placeName><wicri:cityArea>Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle</wicri:cityArea></affiliation></author></analytic><series><title level="j">Clinics in geriatric medicine</title><idno type="ISSN">0749-0690</idno><idno type="eISSN">1879-8853</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>1 Synopsis</title><p id="P1">Sleep disorders are common in older adults: Approximately 5% of older adults meet criteria for clinically significant insomnia disorders and 20% for sleep apnea syndromes. When considering insomnia symptoms, it is important to distinguish age-appropriate changes in sleep from clinically significant insomnia, with the latter distinguished by the presence of significant daytime symptoms such as fatigue. Evaluation with a sleep diary and screening for comorbid conditions, especially mood disorders, is essential. Non-pharmacologic therapies, such as cognitive-behavioral therapy for insomnia, can be highly effective and have sustained benefit. A broad range of pharmacologic therapies are also available but can have unwanted psychomotor effects. If left untreated, insomnia can be associated with increased risk of depression and significant impairments in quality of life. In regards to sleep apnea, a high index of suspicion is crucial for effective diagnosis because symptoms commonly noted in younger patients, such as obesity or loud snoring, may not be present in older patients. Diagnosis and management is fairly similar across age groups, except that a more nuanced approach to weight loss is warranted in older adults. The increasing use of home-based portable polysomnography and auto-titrating positive-airway pressure therapy can reduce barriers to treatment.</p></div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Pennsylvanie</li><li>Washington (État)</li></region></list><tree><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Gooneratne, Nalaka S" sort="Gooneratne, Nalaka S" uniqKey="Gooneratne N" first="Nalaka S." last="Gooneratne">Nalaka S. Gooneratne</name></region><name sortKey="Gooneratne, Nalaka S" sort="Gooneratne, Nalaka S" uniqKey="Gooneratne N" first="Nalaka S." last="Gooneratne">Nalaka S. Gooneratne</name><name sortKey="Vitiello, Michael V" sort="Vitiello, Michael V" uniqKey="Vitiello M" first="Michael V." last="Vitiello">Michael V. Vitiello</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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