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Current Treatment Options in Psychiatry

, Volume 5, Issue 2, pp 195–210 | Cite as

Recent Developments in the Management of Insomnia in Later Life

  • Caitlan A. Tighe
  • Adam D. Bramoweth
Geriatric Disorders (K Zdanys, Section Editor)
  • 67 Downloads
Part of the following topical collections:
  1. Topical Collection on Geriatric Disorders

Abstract

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.

Recent findings

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.

Summary

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.

Keywords

Insomnia Sleep Aging Older adults Therapy Treatment 

Abbreviation

ACP

American College of Physicians

AASM

American Academy of Sleep Medicine

BBTI

Brief behavioral treatment for insomnia

CBT-I

Cognitive behavioral therapy for insomnia

IC

Information control

ISI

Insomnia Severity Index [57]

MBSR

Mindfulness-based stress reduction

MBTI

Mindfulness-based therapy for insomnia

OTC

Over-the-counter

PSQI

Pittsburgh Sleep Quality Index [58]

RCT

Randomized controlled trial

SDB

Sleep disordered breathing

SE

Sleep efficiency

SOL

Sleep onset latency

TST

Total sleep time

TWT

Total wake time

WASO

Wake after sleep onset

WL

Wait list

Notes

Funding information

Dr. Tighe is supported by the Advanced Fellowship Program in Mental Illness Research and Treatment, VISN 4 MIRECC (Director: D. Oslin; Pittsburgh Site Director: G. Haas), VA Pittsburgh Healthcare System. Dr. Bramoweth is supported by Career Development Award 13-260 from the Department of Veterans Affairs, Health Services Research and Development Service. The contents of this paper do not represent the views of the Department of Veterans Affairs or the United States Government.

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.

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Copyright information

© This is a U.S. government work and its text is not subject to copyright protection in the United States; however, its text may be subject to foreign copyright protection 2018

Authors and Affiliations

  1. 1.VISN 4 Mental Illness Research, Education and Clinical Center (MIRECC)VA Pittsburgh Healthcare SystemPittsburghUSA
  2. 2.Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghUSA
  3. 3.Center for Health Equity Research and Promotion (CHERP)VA Pittsburgh Healthcare SystemPittsburghUSA

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