Advertisement

Sleep and Aging: Insomnia in the Geriatric Population

  • Clifford Singer
  • Francine Nanda
Chapter
Part of the Current Clinical Neurology book series (CCNEU)

Abstract

Sleep complaints are common among older adults. About 20% of older adults who responded to the 2003 National Sleep Foundation poll admitted taking a sleep pill prescribed by a doctor or use over-the-counter sleep pills or drink alcohol, wine, or beer to promote sleep with 15% admitting using these aids every or almost every night. Overall, those who report a good health have a better quality of sleep than those who estimate having a fair or poor health. Sleep patterns are affected by age-related changes in circadian rhythms, medications, pain and medical conditions, neurodegenerative diseases, excessive daytime sleep, and specific sleep pathologies. Inadequate quality and quantity of sleep impact daytime alertness, physical, mood, and cognitive function. Neuropsychiatric disorders (e.g., depression and dementia), digestive system diseases (e.g., esophageal reflux), pain, heart disease, and chronic pulmonary problems increase risk of insomnia. Insomnia itself may increase risk of chronic disease.

Keywords

Elderly Insomnia Depression Dementia Pain Medications Neurodegenerative conditions Daytime alertness 

References

  1. 1.
    Shochat T, UJ, Israel AG, Ancoli-Israel S (1999) Insomnia in primary care patients. Sleep 22(Suppl 2):S359–S365, abstractPubMedGoogle Scholar
  2. 2.
    Foundation NS (2003) Sleep in America poll (on-line). Available at http://www.sleepfoundation.org. Accessed 30 Oct 2008
  3. 3.
    Dinges DF, PF, Williams K, Gillen KA, Powell JW, Ott GE et al (1997) Cumulative sleepiness, mood disturbance, and psychomotor vigilance performance decrements during a week of sleep restricted to 4–5 hours per night. Sleep 20(4):267–277PubMedGoogle Scholar
  4. 4.
    Ancoli-Israel S (1997) Sleep problems in older adults. Geriatrics 52:20–30PubMedGoogle Scholar
  5. 5.
    Foley DJ, MA, Brown SL, Simonsick EM, Wallace RB, Blazer DG (1995) Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep 18(6):425–432PubMedGoogle Scholar
  6. 6.
    Bliwise D (1993) Sleep in normal aging and dementia. Sleep 16(1):40–81PubMedGoogle Scholar
  7. 7.
    Unruh ML, RS, An MW, Buysse DJ, Nieto FJ, Yeh JL, Newman AB (2008) Subjective and objective sleep quality and aging in the sleep heart health study. J Am Geriatr Soc 56:1218–1227PubMedCrossRefGoogle Scholar
  8. 8.
    Gangwisch JE, HS, Boden-Albala B, Buijs RM, Kreier F, Opler MG, Pickering TG, Rundle AG, Zammit KG, Malaspina D (2008) Sleep duration associated with mortality in elderly, but not middle-aged, adults in a large US sample. Sleep 31(8):1087–1096PubMedPubMedCentralGoogle Scholar
  9. 9.
    Flaherty JH (2008) Insomnia among hospitalized older persons. Clin Geriatr Med 24(1):51–67PubMedCrossRefGoogle Scholar
  10. 10.
    Bliwise DL, RD, Dihenia B, Gurecki P (2002) Greater daytime sleepiness in subcortical stroke relative to Parkinson’s disease and Alzheimer’s disease. J Geriatr Psychiatry Neurol 15(2):61–67PubMedCrossRefGoogle Scholar
  11. 11.
    Dew MA, HC, Buysse DJ, Monk TH, Begley AE, Houck PR, Hall M, Kupfer DJ, Reynolds III CF (2003) Healthy older adults’ sleep predicts all-cause mortality at 4 to 19 years of follow-up. Psychosom Med 65(1):63–73PubMedCrossRefGoogle Scholar
  12. 12.
    Van Cauter E, LR, Plat L (2000) Age-related changes in slow wave sleep and REM sleep and relationship with growth hormone and cortisol levels in healthy men. JAMA 284:861–868PubMedCrossRefGoogle Scholar
  13. 13.
    Ohayon MM, CM, Guilleminault C, Vitiello MV (2004) Meta-analysis of quantitative sleep parameters from childhood to old-age in healthy individuals: developing normative sleep values across the human lifespan. Sleep 27(7):1255–1273PubMedGoogle Scholar
  14. 14.
    Darchia N, CI, Feinberg I (2002) Rapid eye movement density is reduced in the normal elderly. Sleep 26(8):973–977Google Scholar
  15. 15.
    Baker SK, ZP (2000) Circadian disorders of the sleep-wake cycle. In: Kyeger MH, Roth T, Dement WC (eds) Principles and Practice of Sleep Medicine, 3rd edn. Saunders, PhiladelphiaGoogle Scholar
  16. 16.
    Van Someren EJ, RR, Swaab DF (2002) Functional plasticity of the circadian timing system in old age: light exposure. Prog Brain Res 138:205–231PubMedCrossRefGoogle Scholar
  17. 17.
    Skene DJ, V-RB, Sparks DL, Hunsaker JC, Pevet P, Ravid D, Swaab DF (1990) Daily variation in the concentration of melatonin and 5-methoxytryptophol in the human pineal gland: effect of age and Alzheimer’s disease. Brain Res 528(1):170–174PubMedCrossRefGoogle Scholar
  18. 18.
    Buysse DJ, RC, Monk TH, Hoch CC, Yeager AL, Kupfer DJ (1991) Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh Sleep Quality Index (PSQI). Sleep 14(4):331–338PubMedGoogle Scholar
  19. 19.
    Wallander MA, JS, Ruigomez A, Rodriguez LAG, Jones R (2007) Morbidity associated with sleep disorders in primary care: a longitudinal cohort study. Prim Care Companion J Clin Psychiatry 9:338–345PubMedPubMedCentralCrossRefGoogle Scholar
  20. 20.
    Wallander MA, JS, Rodriguez LAG, Jones R (2007) Morbidity associated with sleep disorders in primary care: a longitudinal cohort study. Prim Care Companion J Clin Psychiatry 9:338–345PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    Gangwisch JE, HS, Boden-Albala B, Buijs RM, Kreier F, Opler MG, Pickering TG, Rundle AG, Zammit GK, Malaspina D (2008) Sleep duration associated with mortality in elderly, but not middle-aged, adults in a large US sample. Sleep 31(8):1087–1096PubMedPubMedCentralGoogle Scholar
  22. 22.
    Wingard DL, BL (1983) Mortality risk associated with sleeping patterns among adults. Sleep 6:102–107PubMedGoogle Scholar
  23. 23.
    Foley D, A-IS, Britz P, Walsh J (2004) Sleep disturbance and chronic disease in older adults: results of the 2003 National Sleep Foundation Sleep in America survey. J Psychom Med 56(5):497–502CrossRefGoogle Scholar
  24. 24.
    Veiel H (1997) A preliminary profile of neuropsychological deficits associated with major depression. J Clin Exp Neuropsychol 19(4):587–603PubMedCrossRefGoogle Scholar
  25. 25.
    Zakzanis K (1998) Neurocognitive deficit in fronto-temporal dementia. Neuropsychiatry Neuropsychol Behav Neurol 11(3):127–35PubMedGoogle Scholar
  26. 26.
    Breslau N, RT, Rosenthal L, Andreski P (1996) Sleep disturbance and psychiatric disorders: a longitudinal epidemiological study of young adults. Biol Psychiatry 39(11):411–418PubMedCrossRefGoogle Scholar
  27. 27.
    Cricco M, SE, Foley DJ (2001) The impact of insomnia on cognitive functioning in older adults. JAGS 49:1185–1189CrossRefGoogle Scholar
  28. 28.
    Kripke DF, GL, Wingard DL, Klauber MR, Marler MR (2002) Mortality associated with sleep duration and insomnia. Arch Gen Psychiatry 59:131–136PubMedCrossRefGoogle Scholar
  29. 29.
    Ayas NT, WD, Manson JE et al (2003) A prospective study of sleep duration and coronary heart disease in women. Arch Intern Med 163:205–209PubMedCrossRefGoogle Scholar
  30. 30.
    Spiegel K, LR, Van Cauter E (1999) Impact of sleep debt on metabolic and endocrine function. Lancet 354:1435–1439PubMedCrossRefGoogle Scholar
  31. 31.
    Ayas NT, WD, Al-Delaimy WK et al (2004) A prospective study of self-reported sleep duration and incidence diabetes in women. Diabetes Care 27:282–283CrossRefGoogle Scholar
  32. 32.
    Nilsson PM, RM, Engstrom G, Hedblad B, Berglund G (2004) Incidence of diabetes in middle-aged men is related to sleep disturbances. Diabetes Care 27:2464–2469PubMedCrossRefGoogle Scholar
  33. 33.
    Meisinger C, HM, Loewel H (2005) Sleep disturbance as a predictor of diabetes mellitus in men and women from the general population. Diabetologia 48:235–241PubMedCrossRefGoogle Scholar
  34. 34.
    Kawakami N, TN, Shimizu H (2004) Sleep disturbance and onset of type 2 diabetes. Diabetes Care 27:282–283PubMedCrossRefGoogle Scholar
  35. 35.
    Nofzinger EA, BD, Germain A, Price JC et al (2004) Fonctional neuroimaging evidence of hyperarousal in insomnia. Am J Psychiatry 161(11):2126–2128PubMedCrossRefGoogle Scholar
  36. 36.
    Thomas M, SH, Belenky G, Holcomb H, Mayberg H et al (2000) Neural basis of alertness and cognitive performance impairments during sleepiness. I. Effects of 24 h of sleep deprivation on waking human regional brain activity. J Sleep Res 9(4):335–352PubMedCrossRefGoogle Scholar
  37. 37.
    Cricco M, SE, Foley DJ (2001) The impact of insomnia on Cognitive functioning in older adults. J Am Geriatr Soc 49:1185–1189PubMedCrossRefGoogle Scholar
  38. 38.
    Erlik Y, TI, Meldrum DR, Lomax P, Bajorek JG, Judd HL (1981) Association of waking episodes with menopausal hot flashes. JAMA 245(17):1741–1744PubMedCrossRefGoogle Scholar
  39. 39.
    Freedman RR, RT (2004) Lack of sleep disturbance from menopausal hot flashes. Fertil Steril 82(1):138–144PubMedCrossRefGoogle Scholar
  40. 40.
    Polo-Kantola P, ER, Helenius H, Irjala K, Polo O (1998) When does estrogen replacement therapy improve sleep quality? Am J Obstet Gynecol 178(5):1002–1009PubMedCrossRefGoogle Scholar
  41. 41.
    Moe K (1999) Reproductive hormones, aging, and sleep. Semin Reprod Endocrinol 17(4):339–48PubMedCrossRefGoogle Scholar
  42. 42.
    Plaff DW, MB (1983) Actions of estrogens and progestins on nerve cells. Science 219(4586):808–814CrossRefGoogle Scholar
  43. 43.
    Bixo M, BT, Winblad B, Andersson A (1995) Estradiol and testosterone in specific regions of the human female brain in different endocrine states. J Steroid Biochem Mol Biol 55(3–4):297–303PubMedCrossRefGoogle Scholar
  44. 44.
    Foley D, MA, Masaki K, Ross W, Havlik R, White L, Launer L (2001) Daytime sleepiness is associated with incidence of dementia and 3-year follow-up of cognitive decline in older Japanese-American men. J Am Geriatr Soc 49:1628–1632PubMedCrossRefGoogle Scholar
  45. 45.
    Tractenberg R, SCaKJ (2005) Sleep symptoms in Alzheimer’s disease patients and normal elderly. J Sleep Res 14:177–185PubMedPubMedCentralCrossRefGoogle Scholar
  46. 46.
    Takegami M, SS, Yamazaki S, Nakayama T, Fukuhara S (2005) An estimation of the prevalence of excessive daytime sleepiness based on age and sex distribution of epworth sleepiness scale scores: a population based survey. Nippon Koshu Eisei Zasshi 52(2):137–145, abstractPubMedGoogle Scholar
  47. 47.
    Hays JC, BD, Foley DJ (1996) Risk of Napping: Excessive daytime sleepiness and mortality in an older community population. J Am Geriatr Soc 44(6):693–698PubMedCrossRefGoogle Scholar
  48. 48.
    Tsuno N, JI, Dauvilliers Y, Touchon J, Ritchie K, Besset A (2007) Determinants of excessive daytime sleepiness in a French community-dwelling elderly population. J Sleep Res 16:364–371PubMedCrossRefGoogle Scholar
  49. 49.
    Schmitt FA, PB, Cook YR, Berry DTR, Wekstein DR (1995) Self report of sleep symptoms in older adults: correlates of daytime sleepiness and health. Sleep 19(1):59–64Google Scholar
  50. 50.
    Ohayon MM, VM (2002) Daytime sleepiness and cognitive impairment in the elderly population. Arch Intern Med 161:201–208CrossRefGoogle Scholar
  51. 51.
    Newman AB, SC, Enright P, Lefkowitz D, Reynolds CF, Robbins J (2000) Daytime sleepiness predicts mortality and cardiovascular disease in older adults. The Cardiovascular Health Study Research Group. J Am Geriatr Soc 48(2):115–123PubMedCrossRefGoogle Scholar
  52. 52.
    Joo S, BI, Yi H, Jung K, Kim J, Shin C (2008) Prevalence of excessive daytime sleepiness and associated factors in the adult population of Korea. Sleep Med 10(2):182–188PubMedCrossRefGoogle Scholar
  53. 53.
    Coleman RM, ML, Guilleminault CC, Zarcone VP, van den Hoed J, Dement WC (1981) Sleep-wake disorders in the elderly: a polysomnography analysis. JAGS 29:289–296CrossRefGoogle Scholar
  54. 54.
    Hoch CC, RCI, Kupfer DJ, Houck PR, Berman SR, Stack JA (1986) Sleep-disordered breathing in normal and pathologic aging. J Clin Psychiatry 47:499–503PubMedGoogle Scholar
  55. 55.
    Ancoli-Israel S, KD, Klauber MR, Mason WJ, Fell R, Kaplan O (1991) Sleep-disordered breathing in community-dwelling elderly. Sleep 14(6):486–495PubMedPubMedCentralGoogle Scholar
  56. 56.
    Prinz PN, VP, Vitiello MV, Bokan J, Raskind M, Peskin E, Gerber C (1982) Sleep, EEG, and mental function changes in senile dementia of the Alzheimer’s type. Neurobiol Aging 3(4):361–370PubMedCrossRefGoogle Scholar
  57. 57.
    Vitiello MV, PP (1989) Alzheimer’s disease: sleep and sleep/wake patterns. Clin Geriatr Med 5:289–299PubMedGoogle Scholar
  58. 58.
    Moe KE, VM, Larsen LH, Prinz PN (1995) Symposium: cognitive processes and sleep disturbances: Sleep/Wake patterns in Alzheimer’s disease: relationships with cognition and function. J Sleep Res 4(1):15–20PubMedCrossRefGoogle Scholar
  59. 59.
    Bonanni E, MM, Tognoni G, Fabbrini M, Nucciarone B, Manca ML, Gori S, Iudice A, Murri L (2005) Daytime sleepiness in mild and moderate Alzheimer’s disease and its relationship with cognitive impairment. J Sleep Res 14:311–317PubMedCrossRefGoogle Scholar
  60. 60.
    Piani A, BS, Dolso P, Budai R, Gigli GL (2004) Sleep disturbances in elderly: a subjective evaluation over 65. Arch Gerontol Geriatr Suppl 38(Suppl 1):325–331CrossRefGoogle Scholar
  61. 61.
    Vgontzas A, LR, Bixler E, Grayer A, Kales A, Chrousos G (2001) Polycystic ovary syndrome is associated with obstructive sleep apnea and daytime sleepiness: role of insulin resistance. J Clin Endocrinol Metab 86:517–520PubMedGoogle Scholar
  62. 62.
    Whitney CW, EP, Newman AB, Bonckat W, Foley D, Quan SF (1998) Correlates of daytime sleepiness in 4578 elderly persons: the Cardiovascular Health Study. Sleep 21:37–36Google Scholar
  63. 63.
    Bursztyn M, GG, Stessman J (2002) The siesta and mortality in the elderly: effect of rest without sleep and daytime sleep duration. Sleep 25(2):187–191PubMedGoogle Scholar
  64. 64.
    Bassuk SS, WD, Berkman LF (2000) Cognitive impairment and mortality in the community-dwelling elderly. Am J Epidemiol 151:676–686PubMedCrossRefGoogle Scholar
  65. 65.
    Frisoni GB, FL, Fastbom J, Viitanen M, Winblad B (1999) Mortality in non-demented subjects with cognitive impairment: the influence of health-related factors. Am J Epidemiol 150(10):1031–1044PubMedCrossRefGoogle Scholar
  66. 66.
    Carmelli D, BD, Swan GE, Reed T (2001) A genetic analysis of the Epworth Sleepiness Scale in 1560 world war II male veteran twins in the NAS-NRC twin registry. J Sleep Res 10:53–58PubMedCrossRefGoogle Scholar
  67. 67.
    Lessov-Schlaggar CN, BD, Kransnow RE, Swan GE, Reed T (2008) Genetic association of daytime sleepiness and depressive symptoms in elderly men. Sleep 31(3):1111–1117PubMedPubMedCentralGoogle Scholar
  68. 68.
    American Medical Directors’ Association Clinical Practice Guidelines for Sleep Disorder in Long Term Care (2006) www.amda.com/tools/cpg/sleep.cfm
  69. 69.
    Roth T, aRT (1996) Etiologies and sequelae of ecessive daytime sleepiness. Clin Ther 18:562–575PubMedCrossRefGoogle Scholar
  70. 70.
    Briones B, AN, Straus M, Rosenberg C, Whalen C, Carskadon M, Roebuck T, Winters M, Redline S (1996) Relationship between sleepiness and general health status. Sleep 19(7):583–538PubMedGoogle Scholar
  71. 71.
    Seneviratne U, aPK (2004) Excessive daytime sleepiness in obstructive sleep apnea: prevalence, severity, and predictors. Sleep Med 5:339–343PubMedCrossRefGoogle Scholar
  72. 72.
    Bliwise DL, FD, Bliwise NG, Carskadon MA, Kraemer HC, North CS, Petta DE, Seidel WF, Dement WC (1987) Risk factors for sleep disordered breathing in heterogeneous geriatric populations. J Am Geriatr Soc 35:132–141PubMedCrossRefGoogle Scholar
  73. 73.
    Hoch CC, RIC, Monk TH, Buysse DJ, Yeager AL, Houck PR, Kupfer DJ (1990) Comparison of sleep disordered-breathing among healthy elderly in the seventh, eigth, and ninth decades of life. Sleep 13(6):502–511PubMedGoogle Scholar
  74. 74.
    Kripke DF, A-IS, Klauber MR, Wingard DL, Mason WJ, Mullaney DJ (1996) Prevalence of sleep-disordered breathing in ages 40-64 years: a population-based survey. Sleep 20(1):65–76Google Scholar
  75. 75.
    Ancoli-Israel S, aCT (1994) Are breathing disturbances in elderly equivalent to sleep apnea syndrome? Sleep 17:77–83PubMedGoogle Scholar
  76. 76.
    Mehra R, SK, Blackwell T, Ancoli-Israel S, Dam TTL, Stefanick ML; Osteoporotic Fractures in Men Study (2007) Prevalence and correlates of sleep-disordered breathing in older men: osteoporotic fractures in men sleep study. J Am Geriatr Soc 55:1356–1364PubMedPubMedCentralCrossRefGoogle Scholar
  77. 77.
    Young T, PM, Dempsey J, Skatrud J, Weber S, Badr J (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328(17):1230–1235PubMedCrossRefGoogle Scholar
  78. 78.
    Resnick HE, RS, Shahar E, Gilpin A, Newman A, Walter R (2003) Diabetes and sleep disturbances: findings from the Sleep Heart Health Study. Diabetes Care 26:702–709PubMedCrossRefGoogle Scholar
  79. 79.
    Krieger J, SE, Boudewijns A, Zamagni M, Petiau C (1997) Respiratory effort during obstructive sleep apnea: role of age and sleep state. Chest 112:875–884PubMedCrossRefGoogle Scholar
  80. 80.
    Choi JB, NR, Loredo JS, Mills PJ, Ancoli-Israel S, Ziegler MG, Dimsdale JE (2006) Sleepiness in obstructive sleep-apnea: a harbinger of impaired cardiac function? Sleep 29(12):1531–1536PubMedGoogle Scholar
  81. 81.
    Seppala T, PM, Penttila A, Aspholm R, Tiainen E, Kaukianen A (1991) Sudden death and sleeping history among Finnish men. J Intern Med 229(1):23–28PubMedCrossRefGoogle Scholar
  82. 82.
    Krieger J, SE, Boudewijns A, Zamagni M, Petiau C (1997) Respiratory effort during obstructive sleep apnea: role of age and sleep state. Chest 112:875–884PubMedCrossRefGoogle Scholar
  83. 83.
    Cohen-Zion M, SC, Marler, Shochat T, Kripke DF, Ancoli-Israel S (2001) Changes in cognitive function associated with sleep disordered breathing in older people. J Am Geriatr Soc 49:1622–1627PubMedCrossRefGoogle Scholar
  84. 84.
    Mathieu A, MS, Petit D, Decary A, Massicotte-Marquez J, Malo J, Gosselin N (2007) Does age worsen EEG slowing and attention deficits in obstructive sleep apnea syndrome? Clin Neurophysiol 118:1538–1544PubMedCrossRefGoogle Scholar
  85. 85.
    Mathieu A, MS, Decary A, Massicotte-Marquez J, Petit D, Gosselin N, Malo J, Montplaisir J (2008) Effects of obstructive sleep apnea on cognitive function: a comparison between younger and older OSAS patients. Sleep Med 9:112–120PubMedCrossRefGoogle Scholar
  86. 86.
    Johns MW (1991) new method for measuring daytime sleepiness: The Epworth Sleepiness Scale Sleep 14(6):540–545Google Scholar
  87. 87.
    Walters A, HK, Malzman J, Verrico T, Joseph D, Hening W, Wislon W, Chokroverty K (1996) A questionnaire study of 138 patients with restless legs syndrome: the ‘Night-Walkers’ survey. Neurology 46(1):92–95PubMedCrossRefGoogle Scholar
  88. 88.
    Ondo W, aJC (1996) Restless legs syndrome: clinicoetiologic correlates. Neurology 47:1435–1441PubMedCrossRefGoogle Scholar
  89. 89.
    Coleman RM, PC, Weitzman ED (1979) Periodic nocturnal myoclonus in a wide variety of sleep-wake disorders. Trans Am Neurol Assoc 103:230–233Google Scholar
  90. 90.
    Coleman RM, ML, Guilleminault CC, Zarcone VP, van den Hoed J, Dement WC (1981) Sleep-wake disorders in the elderly: a polysomnography analysis. J Am Geriatr Soc 29:289–296PubMedCrossRefGoogle Scholar
  91. 91.
    Ancoli-Israel S, KD, Klauber MR, Mason WJ, Fell R, Kaplan O (1991) Periodic limb movements in sleep in community-dwelling elderly. Sleep 14(6):496–500PubMedGoogle Scholar
  92. 92.
    Bliwise D, PD, Seidel W, Dement W (1985) Periodic leg movements during sleep in the elderly. Arch Gerontol Geriatr 4:273–281PubMedCrossRefGoogle Scholar
  93. 93.
    Dickel MJ, SJ, Mosko S (1986) Sleep disorders in an aged population: preliminary findings of a longitudinal study. Sleep Res 15:116Google Scholar
  94. 94.
    Gehrman P, SC, Cohen-Zion M, Marler M, Kripke DF, Ancoli-Israel S (2002) Long-term follow-up of periodic limb movements in sleep in older adults. Sleep 25(3):340–343PubMedGoogle Scholar
  95. 95.
    Hoch CC, RC, Kupfer DJ, Berman SR (1988) Stability of EEG sleep and sleep quality in healthy seniors. Sleep 11:521–527PubMedGoogle Scholar
  96. 96.
    Mason WJ, A-IS, Kripke DF (1989) Apnea revisited: a longitudinal follow-up. Sleep 12(5):423–429PubMedGoogle Scholar
  97. 97.
    Phoha RL, DM, Mosko SS (1990) Laboratory note. Preliminary longitudinal assessment of sleep in elderly. Sleep 13(5):425–429PubMedGoogle Scholar
  98. 98.
    Schenck CH, aMM (2002) REM sleep behavior disorder: clinical, developmental, and neuroscience perspectives 16 years after its formal identification in SLEEP. Sleep 25:120–138PubMedGoogle Scholar
  99. 99.
    Schenck CH, BS, Mahowald MH (1996) Delayed emergence of a parkinsonian disorder in 38% of 29 older men initially diagnosed with idiopathic rapid eye movement disorder. Neurology 46:388–393PubMedCrossRefGoogle Scholar
  100. 100.
    Iranzo A, MJ, Santamaria J, Mari MJ, Valldeoriola F, Tolosa E (2006) Rapid-eye-movement sleep behavior disorder as an early marker for a neurodegenerative disorder: a descriptive study. Lancet 5:572–577PubMedCrossRefGoogle Scholar
  101. 101.
    Hickey MG, DB, Caselli RJ, Parish JM, Wingerchuck DM (2007) ‘Idiopathic‘ rapid-eye-movement (REM) sleep behavior disorder is associated with future development of neurodegenerative disorders. Neurologist 13(2):98–101PubMedCrossRefGoogle Scholar
  102. 102.
    Evans L (1987) Sundown syndrome in institutionalized elderly. J Am Geriatr Soc 35(2):101–108PubMedCrossRefGoogle Scholar
  103. 103.
    Martin J, MM, Shochat T, Ancoli-Israel S (2000) Circadian rhythms of agitation in institutionalized patients with Alzheimer’s disease. Chronobiol Int 17(3):405–418PubMedCrossRefGoogle Scholar
  104. 104.
    Gallagher-Thompson D, BJI, Bliwise D, Leader J, Yesavage JA (1992) The relations among caregiver stress, “sundowning” symptoms, and cognitive decline in Alzheimer’s disease. J Am Geriatr Soc 40(8):807–810PubMedCrossRefGoogle Scholar
  105. 105.
    Grace JB, WM, McKeith IG. A comparison of sleep profiles in patients with dementia with Lewy bodies and Alzheimer’s disease. Int J Geriatr Psychiatry 15(11):1028–1033Google Scholar
  106. 106.
    Volicer L, HD, Manning BC, Goldstein R, Stalin A (2001) Sundowning and circadian rhythms in Alzheimer’s disease. Am J Psychiatry 158(5):704–711PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Clifford Singer
    • 1
  • Francine Nanda
    • 1
  1. 1.Department of PsychiatryUniversity of Vermont College of MedicineBurlingtonUSA

Personalised recommendations