Recent Developments in the Management of Insomnia in Later Life
Purpose of review
Insomnia impacts a significant proportion of older adults yet is not an inevitable consequence of aging and is amenable to intervention. The aim of this narrative review is to provide an overview of recent recommendations and empirical findings regarding the management of insomnia in older adults.
The treatment of insomnia with cognitive behavioral therapy for insomnia (CBT-I) continues to be empirically supported and the recommended first-line intervention for adults. Accumulating evidence indicates that other non-pharmacological therapies for insomnia, such as mindfulness-based therapies, light therapy, and physical activity interventions, as well as treatment delivered by non-clinician “sleep coaches” also positively impact insomnia symptoms. Finally, recent systematic reviews offer guidelines and recommendations for pharmacological management of insomnia.
CBT-I remains the recommended first-line treatment for insomnia across adult ages. There is a continued need to increase the availability and optimize the delivery of CBT-I and other therapies for older adults with insomnia to maximize treatment benefits. There is also evidence for some benefit of pharmacological agents to treat insomnia; however, these are not without risks, particularly in the geriatric population.
KeywordsInsomnia Sleep Aging Older adults Therapy Treatment
American College of Physicians
American Academy of Sleep Medicine
Brief behavioral treatment for insomnia
Cognitive behavioral therapy for insomnia
Insomnia Severity Index 
Mindfulness-based stress reduction
Mindfulness-based therapy for insomnia
Pittsburgh Sleep Quality Index 
Randomized controlled trial
Sleep disordered breathing
Sleep onset latency
Total sleep time
Total wake time
Wake after sleep onset
Compliance with ethical standards
Conflict of interest
Adam D. Bramoweth reports grants from the US Department of Veterans Affairs, Health Services Research and Development Service, during the conduct of the study.
Caitlan A. Tighe declares that she has no conflict of interest.
Human and animal rights and informed consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
References and Recommended Reading
Recently published papers of particular interest have been highlighted as: •• Of major importance
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