seniors are at higher risk of medical and psychiatric conditions that can lead to insomnia symptoms, as well as other sleep disorders such as sleep-disordered breathing or restless legs syndrome. these decreases in sleep quality and duration are tied to the body’s internal timekeeping systems. determining the root causes of insomnia in older adults is key to a successful diagnosis. for the management of chronic insomnia in seniors, the first step often focuses on sleep education and improved sleep hygiene. in addition to insomnia, studies have shown seniors are at higher risk of other sleep disorders.
timed light exposures in the evening can be used to treat these disorders for some elderly patients. periodic limb movements are involuntary, repetitive movements of the arms and legs during sleep that occur more than 15 times per hour of sleep. both of these conditions can cause nighttime arousals that lead to waking episodes and tiredness the following day. if you experience sleep difficulties, try one of the following to ensure you get enough rest and feel refreshed in the morning: if you still experience problems with sleep onset or duration despite taking these measures, then you may have a sleep disorder. our editors and medical experts rigorously evaluate every article and guide to ensure the information is factual, up-to-date, and free of bias.
the aim is to summarize recent diagnostic guidelines and both nonpharmacological and pharmacological strategies for the management of insomnia in the older population. insomnia in the icsd-3 is defined as a complaint of trouble initiating or maintaining sleep that is associated with daytime consequences and is not attributable to environmental circumstances or inadequate opportunity to sleep. rapid eye movement (rem) sleep occurs in the fourth stage, stage r sleep.29 stage n1 sleep is the lightest stage and it accounts for 18% of older adults’ sleep time.30 in stage n2 sleep, brain waves slow, body temperature begins to drop, and heart rate slows as sleep deepens, accounting for 48% of sleep time.
older adults should therefore be treated with nonpharmacological options prior to pharmacological options.16,70 there are several nonpharmacological options for the treatment of insomnia, including relaxation techniques, improving sleep hygiene, and cognitive behavioral therapy. it has been found to be effective in the geriatric population, with benefits persisting for 6 months and beyond.79 internet-based behavioral therapies have also been found to be effective in older populations.80 multicomponent cognitive behavioral therapy that involves sleep hygiene measures, relaxation techniques, sleep restriction, and stimulus control is also as effective in older adults as a stand-alone treatment.81,82 there are several pharmacological options available for use in older patients with insomnia. in a study of adults age 18 to 75 years old with mean age of 40.9 years, the mirtazapine group had significant improvement in sleep latency, sleep efficiency, and awakenings after sleep onset after only 2 weeks of treatment.97 it may be preferred over other drugs as it produces sedative effects solely through histamine receptor antagonism.97 because of conflicting evidence and habituation to its sedative effects, it should not be used to treat insomnia in the absence of depression.
the overall prevalence of insomnia symptoms ranges from 30% to 48% in the elderly,,, whereas the prevalence of insomnia disorder ranges from 12% insomnia, the most common sleep disorder, is a subjective report of insufficient or nonrestorative sleep despite adequate opportunity to sleep. despite the fact insomnia is one of the most common sleep disorders in seniors. up to 48% of older adults experience symptoms of insomnia., .
more than 50% of noninstitutionalized adults over age 65 have reported some chronic sleep disorder, such as difficulty falling asleep, early morning awakening, 5 common causes of sleep problems in older adults 1. sleep problems due to an underlying medical problem. 2. snoring, sleep apnea, and other forms of sleep- what are treatment options for insomnia in elderly patients? the satisfaction of sleep declines with age. this probably is related to changes in sleep, .
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