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Primary Care Sleep Medicine pp 311–325Cite as

Sleep in the Elderly

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Abstract

Sleep complaints are highly prevalent in older adults, and typically present to the primary care clinician. They are associated with potentially catastrophic consequences, such as injuries from falls and motor vehicle accidents. Typical changes in sleep associated with age include delayed sleep onset, frequent awakenings, and a phase shift to earlier sleep and earlier awakening. Some primary sleep disorders are more common in older adults, such as restless legs syndrome and sleep-disordered breathing. In most cases, the cause of sleep complaints is multifactorial, involving primary sleep disorders, comorbid medical and psychiatric illnesses, and the effects of medications and polypharmacy. Whenever possible, treatment of insomnia in older adults should include treatment of contributing factors, adjustment of current medications, and non-pharmacologic measures, such as exercise. Medications to treat insomnia should be selected and used judiciously, utilizing the lowest effective doses. The evaluation and treatment of sleep disturbances requires special considerations in the growing population of individuals with dementia. When sleep complaints are successfully addressed, there is often an increase in quality of life, both for the patient and family members/caregivers.

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Abbreviations

AD:

Alzheimer’s disease

BLT:

Bright light therapy

CBT:

Cognitive behavioral therapy

EEG:

Electroencephalography

EPESE:

Established populations for epidemiologic studies of the elderly

HEDIS:

Health plan employer data information set

LBD:

Lewy body dementia

OTC:

Over the counter

PDD:

Parkinson’s disease dementia

PLMS:

Periodic limb movements of sleep

PSQI:

Pittsburgh sleep quality index

RBD:

REM sleep behavior disorder

REM:

Rapid eye movement

RLS:

Restless legs syndrome

SDB:

Sleep disordered breathing

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Authors and Affiliations

  1. Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, 12631 East 17th Avenue, B-179, Aurora, CO, 80045, USA

    Kerry L. Hildreth M.D. & Bennett Parnes M.D.

  2. Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, University of Colorado Anschutz Medical Campus, 12850 E. Montview Blvd, C238, Aurora, CO, 80045, USA

    Sunny A. Linnebur Pharm.D.

  3. Department of Family Medicine, University of Colorado Health Sciences Center, B179, 12631 E. 17th Ave, Aurora, CO, 80045, USA

    Bennett Parnes M.D.

Authors
  1. Kerry L. Hildreth M.D.
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  2. Sunny A. Linnebur Pharm.D.
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  3. Bennett Parnes M.D.
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Corresponding author

Correspondence to Kerry L. Hildreth M.D. .

Editor information

Editors and Affiliations

  1. Sleep Disorders Center, Pueblo, Colorado, USA

    James F. Pagel

  2. Department of Population Health, New York University School of Medicine / Center for Healthful Behavior Change, New York, New York, USA

    S. R. Pandi-Perumal

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Hildreth, K.L., Linnebur, S.A., Parnes, B. (2014). Sleep in the Elderly. In: Pagel, J., Pandi-Perumal, S. (eds) Primary Care Sleep Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1185-1_28

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  • DOI: https://doi.org/10.1007/978-1-4939-1185-1_28

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