Abstract
Older adults represent a rapidly growing proportion of the population of industrialized nations, with a corresponding increase in the number of patients with significant sleep disturbances that adversely impact both health and quality of life. There is increasing focus on the importance of sleep’s interactions with health in the context of aging and over the last decade there have been significant and rapid advances in our ability to diagnose and treat sleep disorders in older adults. Thorough assessment of sleep problems is often iterative, time consuming, and may require serial evaluations and information from multiple sources. Accurate assessment and effective management of disturbed sleep in older adults, while often complex, is ultimately rewarding. This chapter provides an overview of the effective assessment and management of sleep disorders in older adults, both in community and long-term care settings.
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References
Alessi CA, Martin JL, Webber AP et al (2005) Randomized, controlled trial of a nonpharmacological intervention to improve abnormal sleep/wake patterns in nursing home residents. J Am Geriatr Soc 53(5):803–810
Allen RP, Walters AS, Montplaisir J et al (2005) Restless legs syndrome prevalence and impact: REST general population study. Arch Intern Med 165:1286–1292
Ancoli-Israel S, Kripke DF, Klauber MR (1991) Sleep disordered breathing in community dwelling elderly. Sleep 14:486–495
Ayalon L, Ancoli-Israel S, Stepnowsky C et al (2006) Adherence to continuous positive airway pressure treatment in patients with Alzheimer’s disease and obstructive sleep apnea. Am J Geriatr Psychiatry 14:176–180
Banno K, Kryger MH (2007) Sleep apnea: clinical investigations in humans. Sleep Med 8:400–426
Bjorvatn B, Pallesen S (2009) A practical approach to circadian rhythm sleep disorders. Sleep Med Rev 13(1):47–60
Bloom HG, Ahmed I, Alessi CA et al (2009) Evidence-based recommendations for the assessment and management of sleep disorders in older persons. J Am Geriatr Soc 57(5):761–789
Bootzin RR, Nicassio PM (1978) Behavioral treatments for insomnia. In: Hersen M, Eisler RM, Miller PM (eds) Progress in behavior modification, vol 6. Academic, New York, pp 1–45
Chong MS, Ayalon L, Marler M et al (2006) Continuous positive airway pressure reduces subjective daytime sleepiness in patients with mild to moderate Alzheimer’s disease with sleep disordered breathing. J Am Geriatr Soc 54(5):777–781
Cooke JR, Ayalon L, Palmer BW et al (2009) Sustained use of CPAP slows deterioration of cognition, sleep, and mood in patients with Alzheimer’s disease and obstructive sleep apnea: a preliminary study. J Clin Sleep Med 5(4):305–309
Fetveit A, Bjorvatn B (2004) The effects of bright-light therapy on actigraphical measured sleep last for several weeks post-treatment. A study in a nursing home population. J Sleep Res 13:153–158
Foley D, Ancoli-Israel S, Britz P et al (2004) Sleep disturbances and chronic disease in older adults: results of the 2003 National Sleep Foundation Sleep in America Survey. J Psychosom Res 56:497–502
Foley DJ, Monjan AA, Brown SL et al (1995) Sleep complaints among older persons: an epidemiological study of three communities. Sleep 18:425–432
Foley DJ, Monjan A, Simonsick EM et al (1999) Incidence and remission of insomnia among elderly adults: an epidemiologic study of 6,800 persons over three years. Sleep 22(Suppl 2):S366–S372
Hening WA, Allen PR, Tenzer P et al (2007) Restless legs syndrome: demographics, presentations and differential diagnosis. Geriatrics 62:26–29
Joshi S (2008) Non-pharmacological therapy for insomnia in the elderly. Clin Geriatr Med 24:107–119
Littner MR, Kushida C, Anderson WM et al (2004) Practice parameters for the dopaminergic treatment of restless legs syndrome and periodic limb movement disorder. Sleep 27:557–559
Martin JL, Webber AP, Alam T et al (2006) Daytime sleeping, sleep disturbance and circadian rhythms in the nursing home. Am J Geriatr Psychiatry 14:121–129
McCurry SM, Gibbons LE, Logsdon RG et al (2005) Nighttime insomnia treatment and education for Alzheimer’s disease (NITE-AD): a randomized controlled trial. J Am Geriatr Soc 53(5):793–802
McCurry SM, Logsdon RG, Terri L et al (2007) Evidence-based psychological treatments for insomnia in older adults. Psychol Aging 22:18–27
McCurry SM, Logsdon RG, Vitiello MV et al (2004) Treatment of sleep and nighttime disturbances in Alzheimer’s disease: a behavior management approach. Sleep Med 5(4):373–377
Morgenthaler TI, Lee-Chiong T, Alessi C et al (2007) Practice parameters for the clinical evaluation and treatment of circadian rhythm sleep disorders. An American Academy of Sleep Medicine report. Sleep 30(11):1445–1459
Morin CM, Colecchi C, Stone J et al (1999) Behavioral and pharmacological therapies for late life insomnia. JAMA 281:991–999
Morin CM, Hauri PJ, Espie CA et al (1999) Nonpharmacologic treatment of chronic insomnia. An American Academy of Sleep Medicine review. Sleep 22:1134–1156
Morin CM, Vallières A, Guay B et al (2009) Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia: a randomized controlled trial. JAMA 301(19):2005–2015
National Institutes of Health State (2005) National Institutes of Health State of the Science Conference Statement Manifestations and Management of Chronic Insomnia in Adults June 13–15. Sleep 28(9):1049–1057
Naylor E, Penev PD, Orbeta L et al (2000) Daily social and physical activity increases slow-wave sleep and daytime neuropsychological performance in the elderly. Sleep 23(1):87–95
Ohayon MM (2002) Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev 6:97–111
Phillips BA, Young T, Finn L et al (2000) Epidemiology of restless legs syndrome in adults. Arch Intern Med 160:2137–2141
Reid KJ, Martinovich Z, Finkel S et al (2006) Sleep: a marker of physical and mental health in the elderly. Am J Geriatr Psychiatry 14:860–866
Richards KC, Beck C, O'Sullivan PS et al (2005) Effect of individualized social activity on sleep in nursing home residents with dementia. J Am Geriatr Soc 53(9):1510–1517
Sack RL, Auckley D, Auger RR et al (2007) Circadian rhythm sleep disorders: part I, Basic principles, shift work and jet lag disorders; An American Academy of Sleep Medicine Review. Sleep 30(11):1460–1483
Sack RL, Auckley D, Auger RR et al (2007) Circadian rhythm sleep disorders: part II, Advanced sleep phase syndrome, delayed sleep phase syndrome, free-running type, and irregular sleep wake rhythm; An American Academy of Sleep Medicine Review. Sleep 30(11):1484–1501
Schenck CH, Bundlie SR, Patterson AL et al (1987) Rapid eye movement sleep behavior disorder: a treatable parasomnia affecting older adults. JAMA 257:1786–1789
Schenck CH, Mahowald MW (1996) REM sleep parasomnias. Neurol Clin 14:697–720
Schnelle JF, Ouslander JG, Simmons SF et al (1993) The nighttime environment, incontinence care, and sleep disruption in nursing homes. J Am Geriatr Soc 1:910–914
Sloane PD, Williams CS, Mitchell CM et al (2007) High-intensity environmental light in dementia: effect on sleep and activity. J Am Geriatr Soc 55:1524–1533
Spielman AJ, Saskin P, Thorpy MJ (1987) Treatment of chronic insomnia by restriction of time in bed. Sleep 10:45–56
Stepanski EJ, Wyatt JK (2003) Use of sleep hygiene in the treatment of insomnia. Sleep Med Rev 7:215–225
Taylor DJ, Mallory LJ, Lichstein KL et al (2007) Co-morbidity of chronic insomnia with medical problems. Sleep 30:213–218
Vaz Fragoso CA, Gill TM (2007) Sleep complaints in community-living older persons: a multi-factorial geriatric syndrome. J Am Geriatr Soc 55:1853–1866
Vitiello MV (2006) Sleep in normal aging. Sleep Med Clin 1(2):171–176
Vitiello MV (2007) Growing old should not mean sleeping poorly: recognizing and properly treating sleep disorders in older adults. J Am Geriatr Soc 55(11):1882–1883, Guest Editorial
Vitiello MV, Borson S (2001) Sleep disturbances in patients with Alzheimer’s disease: epidemiology, pathophysiology and management. CNS Drugs 15(10):777–796
Vitiello MV, Rybarczyk BD, Von Korff M et al (2009) Cognitive behavioral therapy for insomnia improves sleep and decreases pain in older adults with co-morbid insomnia and osteoarthritis. J Clin Sleep Med 5(4):355–362
Young T, Shahar E, Nieto FJ et al (2002) Predictors of sleep-disordered breathing in community-dwelling adults: The Sleep Heart Health Study. Arch Intern Med 22:893–900
Zee PC, Bloom HG (2006) Understanding and resolving insomnia in the elderly. Geriatrics 61:1–12
Zee PC, Vitiello MV (2009) Circadian rhythm sleep disorder: irregular sleep wake rhythm type. Sleep Med Clin 4(2):213–218
Acknowledgements
Dr. Vitiello is supported by Public Health Service grants: AG025515, AG031126, AG030484, CA116400, HP08846, MH072736 and NR011400.
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Vitiello, M.V. (2012). The Effective Assessment and Management of Sleep Disturbances in Community-Dwelling and Institutionalized Older Adults. In: Chiang, RY., Kang, SC. (eds) Introduction to Modern Sleep Technology. Intelligent Systems, Control and Automation: Science and Engineering, vol 64. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-5470-6_13
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DOI: https://doi.org/10.1007/978-94-007-5470-6_13
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