Sleep In Older Adults: Normative Changes, Sleep Disorders, and Treatment Options
Identifieur interne : 005305 ( Ncbi/Merge ); précédent : 005304; suivant : 005306Sleep 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
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PMC:4656195Le document en format XML
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<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>
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<title-group><article-title>Sleep In Older Adults: Normative Changes, Sleep Disorders, and Treatment Options</article-title>
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Division of Geriatric Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania</aff>
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Center for Sleep and Circadian Neurobiology and Division of Sleep Medicine, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania</aff>
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Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, Washington</aff>
<author-notes><corresp id="cor1">Contact Author: Nalaka S. Gooneratne, MD, MSc, Associate Professor, Division of Geriatric Medicine, Center for Sleep and Circadian Neurobiology, University of Pennsylvania School of Medicine, 3615 Chestnut Street, Philadelphia, PA 19104, O: 215 573 2048, F: 215 573 8684, <email>ngoonera@mail.med.upenn.edu</email>
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<pmc-comment>elocation-id from pubmed: 10.1016/j.cger.2014.04.007</pmc-comment>
<abstract><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>
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<kwd-group><kwd>Sleep apnea</kwd>
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<kwd>sedative-hypnotic</kwd>
<kwd>polysomnography</kwd>
<kwd>depression</kwd>
<kwd>dementia</kwd>
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