Skip to main content

Advertisement

Log in

Treatment of sleep disorders in elderly patients

  • Published:
Current Treatment Options in Neurology Aims and scope Submit manuscript

Opinion statement

Sleep disorders are common among the elderly and are associated with diminished quality of life, increased risk for development of psychiatric disorders, inappropriate use of sleep aids, and decreased daytime functioning. The most common and important sleep disorders in the elderly include insomnia, obstructive sleep apnea syndrome, restless legs syndrome, rapid eye movement sleep behavior disorder, and the advanced sleep phase syndrome. In this article, we summarize the current treatment strategies for each of these sleep-related disorders. Before contemplating specific treatments, the authors recommend that more conservative and nonpharmacologic therapies be attempted first because the elderly are more likely to have medication side effects or complications related to surgery. Many sleep problems can be treated by simple sleep hygiene modifications that can be implemented and adopted easily. For others, therapies that specifically consider older adults may be required. For each of the sleep disorders we provide an updated discussion of therapies beginning with diet and lifestyle, pharmacologic treatment, interventional procedures, surgery, assistive devices, physical and speech therapy, exercise, and emerging therapies with specific considerations for older adults.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Wetter DW, Young TB: The relation between cigarette smoking and sleep disturbance. Prev Med 1994, 23:328–334.

    Article  PubMed  CAS  Google Scholar 

  2. Wetter DW, Fiore MC, Baker TB, Young TB: Tobacco withdrawal and nicotine replacement influence objective measures of sleep. J Consult Clin Psychol 1995, 63:658–667.

    Article  PubMed  CAS  Google Scholar 

  3. Riedel BW, Durrence HH, Lichstein KL, et al.: The relation between smoking and sleep: the influence of smoking level, health, and psychological variables. Behav Sleep Med 2004, 2:63–78.

    Article  PubMed  Google Scholar 

  4. Roehrs T, Roth T: Sleep, sleepiness, and alcohol use. Alcohol Res Health 2001, 25:101–109.

    PubMed  CAS  Google Scholar 

  5. Dufour MC, Archer L, Gordis E: Alcohol and the elderly. Clin Geriatr Med 1992, 8:127–141.

    PubMed  CAS  Google Scholar 

  6. Martin J, Shochat T, Ancoli-Israel S: Assessment and treatment of sleep disturbances in older adults. Clin Psychol Rev 2000, 20:783–805.

    Article  PubMed  CAS  Google Scholar 

  7. Espie CA: The Psychological Treatment of Insomnia. Chichester, United Kingdom: John Wiley; 1991.

    Google Scholar 

  8. Hays JC, Blazer DG, Foley DJ: Risk of napping: excessive daytime sleepiness and mortality in an older community population. J Am Geriatr Soc 1996, 44:693–698.

    PubMed  CAS  Google Scholar 

  9. Monk TH, Buysse DJ, Carrier J, et al.: Effects of afternoon “siesta” naps on sleep, alertness, performance, and circadian rhythms in the elderly. Sleep 2001, 24:680–687.

    PubMed  CAS  Google Scholar 

  10. Tamaki M, Shirota A, Hayashi M, Hori T: Restorative effects of a short afternoon nap (<30 min) in the elderly on subjective mood, performance and EEG activity. Sleep Res Online 2000, 3:131–139.

    PubMed  CAS  Google Scholar 

  11. Tamaki M, Shirota A, Tanaka H, et al.: Effects of a daytime nap in the aged. Psychiatry Clin Neurosci 1999, 53:273–275.

    Article  PubMed  CAS  Google Scholar 

  12. Campbell SS, Murphy PJ, Stauble TN: Effects of a nap on nighttime sleep and waking function in older subjects. J Am Geriatr Soc 2005, 53:48–53.

    Article  PubMed  Google Scholar 

  13. Barvaux VA, Aubert G, Rodenstein DO: Weight loss as a treatment for obstructive sleep apnea. Sleep Med Rev 2000, 4:435–452.

    Article  PubMed  CAS  Google Scholar 

  14. Avidan A: Sleep disordered breathing in the geriatric patient population in 2005. In Advances in Cell Biology and Gerontology. Philadelphia; Elsevier; 79–112.

  15. Kashyap R, Hock LM, Bowman TJ: Higher prevalence of smoking in patients diagnosed as having obstructive sleep apnea. Sleep Breath 2001, 5:167–172.

    Article  PubMed  CAS  Google Scholar 

  16. Casasola GG, Alvarez-Sala JL, Marques JA, et al.: Cigarette smoking behavior and respiratory alterations during sleep in a healthy population. Sleep Breath 2002, 6:19–24.

    Article  PubMed  Google Scholar 

  17. Robinson RW, White DP, Zwillich CW: Moderate alcohol ingestion increases upper airway resistance in normal subjects. Am Rev Respir Dis 1985, 132:1238–1241.

    PubMed  CAS  Google Scholar 

  18. Tanigawa T, Tachibana N, Yamagishi K, et al.: Usual alcohol consumption and arterial oxygen desaturation during sleep. JAMA 2004, 292:923–925.

    Article  PubMed  CAS  Google Scholar 

  19. Mahowald MW, Schenck CH: REM sleep behavior disorder. In Principles and Practice of Sleep Medicine, Second Edition. Edited by Kryger MH, Roth T, Dement WC, Philadelphia: WB Saunders; 1994:389.

    Google Scholar 

  20. Silber MH, Ehrenberg BL, Allen RP, et al.: An algorithm for the management of restless legs syndrome. Mayo Clin Proc 2004, 79:916–922.

    Article  PubMed  Google Scholar 

  21. Hornyak M, Trenkwalder C: Restless legs syndrome and periodic limb movement disorder in the elderly. J Psychosom Res 2004, 56:543–548.

    Article  PubMed  Google Scholar 

  22. Mitler MM: Nonselective and selective benzodiazepines receptor agonists: where are we today? Sleep 2000, 23(Suppl 1):S39–47.

    PubMed  Google Scholar 

  23. Tinetti ME, Speechley M, Ginter SF: Risk factors for falls among elderly persons living in the community. N Engl J Med 1988, 319:1701–1707.

    Article  PubMed  CAS  Google Scholar 

  24. Stenbacka M, Jansson B, Leifman A, Romelsjo A: Association between use of sedatives or hypnotics, alcohol consumption, or other risk factors and a single injurious fall or multiple injurious falls: a longitudinal general population study. Alcohol 2002, 28:9–16.

    Article  PubMed  Google Scholar 

  25. Avidan AY, Fries BE, James ML, et al.: Insomnia and hypnotic use, recorded in the Minimum Data Set, as predictors of falls and hip fractures in Michigan nursing homes. J Am Geriatr Soc 2005, 53. The results of this study examining data from more than 34,000 Michigan nursing home residents over the age of 65, taken over a six-month period raise support that appropriate treatment of insomnia reduces the fall risk associated with it by keeping patients asleep.

  26. Ancoli-lsrael S, Richardson GS, Mangano RM, et al.: Long-term use of sedative hypnotics in older patients with insomnia. Sleep Med 2005, 6:107–113. This new open-label trial of long-term hypnotic therapy suggests that they are safe and effective for the treatment of insomnia in older patients.

    Article  Google Scholar 

  27. Erman M, Rosenberg R, Caron J: Polysomnographic and patient-reported evaluation of the efficacy and safety of eszopiclone in elderly subjects with chronic insomnia. Sleep 2004, 27(Suppl):A257.

    Google Scholar 

  28. Scharf M, McCall WV, Erman M, Rubens R: A 2-week efficacy and safety study of esopiclone in elderly patients with primary insomnia. Sleep, In press.

  29. Roger M, Attali P, Coquelin JP: Multicenter, doubleblind, controlled comparison of zolpidem and triazolam in elderly patients with insomnia. Clin Ther 1993, 15:127–136.

    PubMed  CAS  Google Scholar 

  30. Salva P, Costa J: Clinical pharmacokinetics and pharmacodynamics of zolpidem. Therapeutic implications. Clin Pharmacokinet 1995, 29:142–153.

    PubMed  CAS  Google Scholar 

  31. Krystal AD, Walsh JK, Laska E, et al.: Sustained efficacy of eszopiclone over 6 months of nightly treatment: results of a randomized, double-blind, placebocontrolled study in adults with chronic insomnia. Sleep 2003, 26:793–799.

    PubMed  Google Scholar 

  32. Hajak G, Muller WE, Wittchen HU, et al.: Abuse and dependence potential for the non-benzodiazepine hypnotics zolpidem and zopiclone: a review of case reports and epidemiological data. Addiction 2003, 98:1371–1378.

    Article  PubMed  CAS  Google Scholar 

  33. Sunderram J, Parisi RA, Strobel RJ: Serotonergic stimulation of the genioglossus and the response to nasal continuous positive airway pressure. Am J Respir Crit Care Med 2000, 162:925–929.

    PubMed  CAS  Google Scholar 

  34. Quinnell TG, Smith IE: Obstructive sleep apnoea in the elderly: recognition and management considerations. Drugs Aging 2004, 21:307–322. This is a timely review of the management of sleep apnea in the elderly.

    Article  PubMed  Google Scholar 

  35. Cook WR, Benich JJ, Wooten SA: Indices of severity of obstructive sleep apnea syndrome do not change during medroxyprogesterone acetate therapy. Chest 1989, 96:262–266.

    PubMed  CAS  Google Scholar 

  36. Jasinski DR, Kovacevic-Ristanovic R: Evaluation of the abuse liability of modafinil and other drugs for excessive daytime sleepiness associated with narcolepsy. Clin Neuropharmacol 2000, 23:149–156.

    Article  PubMed  CAS  Google Scholar 

  37. Broughton RJ, Fleming JA, George CF, et al.: Randomized, double-blind, placebo-controlled crossover trial of modafinil in the treatment of excessive daytime sleepiness in narcolepsy. Neurology 1997, 49:444–451.

    PubMed  CAS  Google Scholar 

  38. Moldofsky H, Broughton RJ, Hill JD: A randomized trial of the long-term, continued efficacy and safety of modafinil in narcolepsy. Sleep Med 2000, 1:109–116.

    Article  PubMed  Google Scholar 

  39. Pack AI, Black JE, Schwartz JR, Matheson JK: Modafinil as adjunct therapy for daytime sleepiness in obstructive sleep apnea. Am J Respir Crit Care Med 2001, 164:1675–1681.

    PubMed  CAS  Google Scholar 

  40. Dinges DF, Weaver TE: Effects of modafinil on sustained attention performance and quality of life in OSA patients with residual sleepiness while being treated with nCPAP. Sleep Med 2003, 4:393–402.

    Article  PubMed  Google Scholar 

  41. Schenck CH, Mahowald MW: A polysomnographic, neurologic, psychiatric and clinical outcome report on 70 consecutive cases with REM sleep behavior disorder (RBD): Sustained clonazepam efficacy in 89.5% of 57 treated patients. Cleve Clin J Med 1990, 57(Suppl):10.

    Google Scholar 

  42. Uchiyama M, Tanaka K, Isse K, et al.: [Parasomnia associated with abnormal REM sleep in the aged]. Seishin Shinkeigaku Zasshi 1990, 92:213–226.

    PubMed  CAS  Google Scholar 

  43. Schenck CH, Mahowald MW: Long-term, nightly benzodiazepine treatment of injurious parasomnias and other disorders of disrupted nocturnal sleep in 170 adults. Am J Med 1996, 100:333.

    Article  PubMed  CAS  Google Scholar 

  44. Calkin PA, Kunik ME, Orengo CA, et al.: Tolerability of clonazepam in demented and non-demented geropsychiatric patients. Int J Geriatr Psychiatry 1997, 12:745–749.

    Article  PubMed  CAS  Google Scholar 

  45. Lapierre O, Montplaisir J: Polysomnographic features of REM sleep behavior disorder: development of a scoring method. Neurology 1992, 42:1371–1374.

    PubMed  CAS  Google Scholar 

  46. Fantini ML, Gagnon JF, Filipini D, Montplaisir J: The effects of pramipexole in REM sleep behavior disorder. Neurology 2003, 61:1418–1420.

    PubMed  CAS  Google Scholar 

  47. Schenck CH, Mahowald MW: REM sleep parasomnias. Neurol Clin 1996, 14:697–720.

    Article  PubMed  CAS  Google Scholar 

  48. Ringman JM, Simmons JH: Treatment of REM sleep behavior disorder with donepezil: a report of three cases. Neurology 2000, 55:870–871.

    PubMed  CAS  Google Scholar 

  49. Boeve BF, Silber MH, Ferman TJ: Melatonin for treatment of REM sleep behavior disorder in neurologic disorders: results in 14 patients. Sleep Med 2003, 4:281–284.

    Article  PubMed  Google Scholar 

  50. Takeuchi N, Uchimura N, Hashizume Y, et al.: Melatonin therapy for REM sleep behavior disorder. Psychiatry Clin Neurosci 2001, 55:267–269.

    Article  PubMed  CAS  Google Scholar 

  51. Krause DN, Barrios VE, Duckles SP: Melatonin receptors mediate potentiation of contractile responses to adrenergic nerve stimulation in rat caudal artery. Eur J Pharmacol 1995, 276:207–213.

    Article  PubMed  CAS  Google Scholar 

  52. O’Keeffe ST, Gavin K, Lavan JN: Iron status and restless legs syndrome in the elderly. Age Aging 1994, 23:200–203.

    Article  CAS  Google Scholar 

  53. Earley CJ, Heckler D, Allen RP: The treatment of restless legs syndrome with intravenous iron dextran. Sleep Med 2004, 5:231–235.

    Article  PubMed  Google Scholar 

  54. Chesson Jr AL, Wise M, Davila D, et al.: Practice parameters for the treatment of restless legs syndrome and periodic limb movement disorder. An American Academy of Sleep Medicine Report. Standards of Practice Committee of the American Academy of Sleep Medicine. Sleep 1999, 22:961–968.

    PubMed  Google Scholar 

  55. Hening WA, Allen RP, Earley CJ, et al.: An update on the dopaminergic treatment of restless legs syndrome and periodic limb movement disorder. Sleep 2004, 27:560–583.

    PubMed  Google Scholar 

  56. Happe S, Klosch G, Saletu B, Zeitlhofer J: Treatment of idiopathic restless legs syndrome (RLS) with gabapentin. Neurology 2001, 57:1717–1719.

    PubMed  CAS  Google Scholar 

  57. Garcia-Borreguero D, Larrosa O, de la Llave Y, et al.: Treatment of restless legs syndrome with gabapentin: a double-blind, cross-over study. Neurology 2002, 59:1573–1579.

    PubMed  CAS  Google Scholar 

  58. Happe S, Sauter C, Klosch G, et al.: Gabapentin versus ropinirole in the treatment of idiopathic restless legs syndrome. Neuropsychobiology 2003, 48:82–86.

    Article  PubMed  CAS  Google Scholar 

  59. Walters AS, Wagner ML, Hening WA, et al.: Successful treatment of the idiopathic restless legs syndrome in a randomized double-blind trial of oxycodone versus placebo. Sleep 1993, 16:327–332.

    PubMed  CAS  Google Scholar 

  60. Tribl GG, Sycha T, Kotzailias N, et al.: Apomorphine in idiopathic restless legs syndrome: an exploratory study. J Neurol Neurosurg Psychiatry 2005, 76:181–185.

    Article  PubMed  CAS  Google Scholar 

  61. Reuter I, Ellis CM, Ray Chaudhuri K: Nocturnal subcutaneous apomorphine infusion in Parkinson’s disease and restless legs syndrome. Acta Neurol Scand 1999, 100:163–167.

    Article  PubMed  CAS  Google Scholar 

  62. Hornyak M, Voderholzer U, Hohagen F, et al.: Magnesium therapy for periodic leg movementsrelated insomnia and restless legs syndrome: an open pilot study. Sleep 1998, 21:501–505.

    PubMed  CAS  Google Scholar 

  63. Lauerma H, Markkula J: Treatment of restless legs syndrome with tramadol: an open study. J Clin Psychiatry 1999, 60:241–244.

    Article  PubMed  CAS  Google Scholar 

  64. Reid KJ, Zee PC: Circadian rhythm disorders. Semin Neurol 2004, 24:315–325.

    Article  PubMed  Google Scholar 

  65. Zisapel N: Circadian rhythm sleep disorders: pathophysiology and potential approaches to management. CNS Drugs 2001, 15:311–328.

    Article  PubMed  CAS  Google Scholar 

  66. Hauri PJ, Wisbey J: Wrist actigraphy in insomnia. Sleep 1992, 15:293–301.

    PubMed  CAS  Google Scholar 

  67. Bootzin RR: Behavioral Treatments for Insomnia. New York: Academic Press, Inc.; 1978.

    Google Scholar 

  68. Spielman AJ, Saskin P, Thorpy MJ: Treatment of chronic insomnia by restriction of time in bed. Sleep 1987, 10:45–56.

    PubMed  CAS  Google Scholar 

  69. Morin CM, Colecchi C, Stone J, et al.: Behavioral and pharmacological therapies for late-life insomnia: a randomized controlled trial. JAMA 1999, 281:991–999.

    Article  PubMed  CAS  Google Scholar 

  70. Montgomery P, Dennis J: A systematic review of non-pharmacological therapies for sleep problems in later life. Sleep Med Rev 2004, 8:47–62. A comprehensive review of the effectiveness of three interventions; cognitive behavioral therapy (CBT), bright light, and physical exercise for the treatment of late life sleep disturbances.

    Article  PubMed  Google Scholar 

  71. Baillargeon L, Landreville P, Verreault R, et al.: Discontinuation of benzodiazepines among older insomniac adults treated with cognitive-behavioural therapy combined with gradual tapering: a randomized trial. CMAJ 2003, 169:1015–1020.

    PubMed  Google Scholar 

  72. Morin CM, Mimeault V, Gagne A: Nonpharmacological treatment of late-life insomnia. J Psychosom Res 1999, 46:103–116.

    Article  PubMed  CAS  Google Scholar 

  73. Li F, Fisher KJ, Harmer P, et al.: Tai chi and self-rated quality of sleep and daytime sleepiness in older adults: a randomized controlled trial. J Am Geriatr Soc 2004, 52:892–900.

    Article  PubMed  Google Scholar 

  74. King AC, Oman RF, Brassington GS, et al.: Moderateintensity exercise and self-rated quality of sleep in older adults. A randomized controlled trial. JAMA 1997, 277:32–37.

    Article  PubMed  CAS  Google Scholar 

  75. Suhner AG, Murphy PJ, Campbell SS: Failure of timed bright light exposure to alleviate age-related sleep maintenance insomnia. J Am Geriatr Soc 2002, 50:617–623.

    Article  PubMed  Google Scholar 

  76. Forbes D, Morgan DG, Bangma J, et al.: Light therapy for managing sleep, behaviour, and mood disturbances in dementia. Cochrane Database Syst Rev 2004: CD003946.

  77. Satlin A, Volicer L, Ross V, et al.: Bright light treatment of behavioral and sleep disturbances in patients with Alzheimer’s disease. Am J Psychiatry 1992, 149:1028–1032.

    PubMed  CAS  Google Scholar 

  78. Ancoli-Israel S, Martin JL, Kripke DF, et al.: Effect of light treatment on sleep and circadian rhythms in demented nursing home patients. J Am Geriatr Soc 2002, 50:282–289. This publication shows the potential applicability of bright light therapy for nursing home residents.

    Article  PubMed  Google Scholar 

  79. Fetveit A, Skjerve A, Bjorvatn B: Bright light treatment improves sleep in institutionalised elderly--an open trial. Int J Geriatr Psychiatry 2003, 18(6):520–526.

    Article  PubMed  Google Scholar 

  80. Montgomery P, Dennis J: Physical exercise for sleep problems in adults aged 60+. Cochrane Database Syst Rev 2002:CD003404.

  81. Kirisoglu C, Guilleminault C: Twenty minutes versus forty-five minutes morning bright light treatment on sleep onset insomnia in elderly subjects. J Psychosom Res 2004, 56:537–542.

    Article  PubMed  CAS  Google Scholar 

  82. Campbell SS, Dawson D, Anderson MW: Alleviation of sleep maintenance insomnia with timed exposure to bright light. J Am Geriatr Soc 1993, 41:829–836.

    PubMed  CAS  Google Scholar 

  83. Murphy PJ, Campbell SS: Enhanced performance in elderly subjects following bright light treatment of sleep maintenance insomnia. J Sleep Res 1996, 5:165–172.

    Article  PubMed  CAS  Google Scholar 

  84. Lack L, Wright H: The effect of evening bright light in delaying the circadian rhythms and lengthening the sleep of early morning awakening insomniacs. Sleep 1993, 16:436–443.

    PubMed  CAS  Google Scholar 

  85. Lack L, Schumacher K: Evening light treatment of early morning insomnia. Sleep Res 1993, 22:225.

    Google Scholar 

  86. Campbell SS: Intrinsic disruption of normal sleep and circadian patterns. In Regulation of Sleep and Circadian Rhythms, Volume 33. Edited by Turek FW, Zee PC. New York: Marcel Dekker; 1999:465–486.

    Google Scholar 

  87. Campbell SS, Terman M, Lewy AJ, Dijk DJ, Eastman CI, Boulos Z: Light treatment for sleep disorders: consensus report. V. Age-related disturbances. J Biol Rhythms 1995, 10:151–154.

    Article  PubMed  CAS  Google Scholar 

  88. Terman M, Terman JS: Light therapy. In Principles and Practice of Sleep Medicine, Third Edition. Edited by Kryger MH, Roth T, Dement WC, Philadelphia: WB Saunders Company; 2000: 1258–1274.

    Google Scholar 

  89. Van Someren EJ, Kessler A, Mirmiran M, Swaab DF: Indirect bright light improves circadian rest-activity rhythm disturbances in demented patients. Biol Psychiatry 1997, 41:955–963.

    Article  PubMed  Google Scholar 

  90. Ancoli-Israel S, Poceta JS, Stepnowsky C, et al.: Identification and treatment of sleep problems in the elderly. Sleep Med Rev 1997, 1:3–17.

    Article  PubMed  CAS  Google Scholar 

  91. Weaver EM: Sleep apnea devices and sleep apnea surgery should be compared on effectiveness, not efficacy. Chest 2003, 123: 961–962; author reply 962.

    Article  PubMed  Google Scholar 

  92. Dattilo DJ, Drooger SA: Outcome assessment of patients undergoing maxillofacial procedures for the treatment of sleep apnea: comparison of subjective and objective results. J Oral Maxillofac Surg 2004, 62:164–168.

    Article  PubMed  Google Scholar 

  93. Ayalon L, Liu L, Ancoli-Israel S: Diagnosing and treating sleep disorders in the older adult. Med Clin North Am 2004, 88:737–750, ix-x. A comprehensive review of the diagnosis and management of sleep problems in the geriatric patient written by one of the most authoritative groups on the subject.

    Article  PubMed  Google Scholar 

  94. Fujita S, Conway W, Zorick F, Roth T: Surgical correction of anatomic abnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg 1981, 89:923–934.

    PubMed  CAS  Google Scholar 

  95. Han S, Kern RC: Staging of obstructive sleep apnea syndrome. Minerva Med 2004, 95:454–459.

    Google Scholar 

  96. Friedman M, Ibrahim H, Lee G, Joseph NJ: Combined uvulopalatopharyngoplasty and radiofrequency tongue base reduction for treatment of obstructive sleep apnea/hypopnea syndrome. Otolaryngol Head Neck Surg 2003, 129:611–621.

    Article  PubMed  Google Scholar 

  97. Han S, Kern RC: Laser-assisted uvulopalatoplasty in the management of snoring and obstructive sleep apnea syndrome. Minerva Med 2004, 95:337–345.

    PubMed  CAS  Google Scholar 

  98. Littner M, Kushida CA, Hartse K, Javaheri S: A randomized trial of laser-assisted uvulopalatoplasty: an update for 2000. Sleep 2001, 24:603–619.

    PubMed  CAS  Google Scholar 

  99. Woodson BT, Steward DL, Weaver EM, Javaheri S: A randomized trial of temperature-controlled radiofrequency, continuous positive airway pressure, and placebo for obstructive sleep apnea syndrome. Otolaryngol Head Neck Surg 2003, 128:848–861.

    Article  PubMed  Google Scholar 

  100. Sullivan CE, Issa FG, Berthon-Jones M, Eves L: Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares. Lancet 1981, 1:862–865.

    Article  PubMed  CAS  Google Scholar 

  101. Engleman HM, McDonald JP, Graham D, et al.: Randomized crossover trial of two treatments for sleep apnea/hypopnea syndrome: continuous positive airway pressure and mandibular repositioning splint. Am J Respir Crit Care Med 2002, 166:855–859.

    Article  PubMed  Google Scholar 

  102. Parish JM, Lyng PJ, Wisbey J: Compliance with CPAP in elderly patients with OSA. Sleep Med 2000, 1:209–214.

    Article  PubMed  Google Scholar 

  103. Pelletier-Fleury N, Rakotonanahary D, Fleury B: The age and other factors in the evaluation of compliance with nasal continuous positive airway pressure for obstructive sleep apnea syndrome. A Cox’s proportional hazard analysis. Sleep Med 2001, 2:225–232.

    Article  PubMed  Google Scholar 

  104. Hukins C: Comparative study of autotitrating and fixed-pressure CPAP in the home: a randomized, single-blind crossover trial. Sleep 2004, 27:1512–1517.

    PubMed  Google Scholar 

  105. Lowe AA: Dental appliances for the treatment of snoring and obstructive sleep apnea. Philadelphia: W.B. Saunders; 1994.

    Google Scholar 

  106. Schmidt-Nowara W, Lowe A, Wiegand L, et al.: Oral appliances for treatment of snoring and obstructive sleep apnea: a review. Sleep 1995, 19:501–510.

    Google Scholar 

  107. Lim J, Lasserson TJ, Fleetham J, Wright J: Oral appliances for obstructive sleep apnoea. Cochrane Database Syst Rev 2004: CD004435.

  108. Sullivan SK, Petroski RE, Verge G, et al.: Characterization of the interaction of indiplon, a novel pyrazolopyrimidine sedative-hypnotic, with the GABAA receptor. J Pharmacol Exp Ther 2004, 311:537–546.

    Article  PubMed  CAS  Google Scholar 

  109. Mathias S, Zihl J, Steiger A, Lancel M: Effect of repeated gaboxadol administration on night sleep and next-day performance in healthy elderly subjects. Neuropsychopharmacology 2005, 30:833–841.

    PubMed  CAS  Google Scholar 

  110. Zemlan FP, Mulchahey JJ, Scharf MB, et al.: The efficacy and safety of the melatonin agonist beta-methyl-6-chloromelatonin in primary insomnia: a randomized, placebo-controlled, crossover clinical trial. J Clin Psychiatry 2005, 66:384–390.

    Article  PubMed  CAS  Google Scholar 

  111. Garrigue S, Bordier P, Jais P, et al.: J: Benefit of atrial pacing in sleep apnea syndrome. N Engl J Med 2002, 346:404–412.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Harrington, J.J., Avidan, A.Y. Treatment of sleep disorders in elderly patients. Curr Treat Options Neurol 7, 339–352 (2005). https://doi.org/10.1007/s11940-005-0027-x

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11940-005-0027-x

Keywords

Navigation