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Sleep disorders in the elderly

Published online by Cambridge University Press:  02 January 2018

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Sleep disorders are common among elderly people, affecting about 50% compared with about 26% of younger adults. About two-thirds of residents in long-term care have sleep disturbance (Karacan & Williams, 1983; Becker & Jamieson, 1992). This high prevalence of sleep disorders results in excessive daytime napping, fatigue, cognitive impairment, increased psychiatric morbidity and increased prescribing of hypnotics, with an associated increase in mortality (Kripke et al, 1979). Karacan & Williams (1983) quote figures varying from 26 to 100% for the prescribing of hypnotics to residents in institutional care. This has major implications. There is a risk of both accidental and deliberate overdose. There may be interactions with other drugs and a hangover effect can impair daytime functioning. Excessive sedation can make the patient difficult to rouse in an emergency. Dependence may occur and the drugs may further disrupt sleep. They also increase the likelihood of sleep apnoea.

Type
Research Article
Copyright
Copyright © The Royal College of Psychiatrists 1999 

References

American Sleep Disorders Association (1997) International Classification of Sleep Disorders, Revised: Diagnostic and Coding Manual. Rochester, MN: ASDA.Google Scholar
Bachman, D. L. (1992) Sleep disorders with aging: evaluation and treatment. Geriatrics, 47, 5361.Google Scholar
Becker, P. M. & Jamieson, A. O. (1992) Common sleep disorders in the elderly: Diagnosis and treatment. Geriatrics, 47, 4152.Google Scholar
Bixler, E. O., Kales, A., Jacoby, J. A. et al (1984) Nocturnal sleep and wakefulness: effects of age and sex in normal sleepers. International Journal of Neuroscience, 23, 3342.CrossRefGoogle ScholarPubMed
Bootzin, R. R. & Perlis, M. L. (1992) Nonpharmacologic treatments of insomnia. Journal of Clinical Psychiatry, 53 (suppl. 6), 3741.Google Scholar
Burns, A., Jacoby, R. & Levy, R. (1990) Psychiatric phenomena in Alzheimer's disease. IV: Disorders of behaviour. British Journal of Psychiatry, 157, 8694.Google Scholar
Chiu, H. F., Wing, Y. K., Chung, D. W. et al (1997) REM sleep behaviour disorder in the elderly. International Journal of Geriatric Psychiatry, 12, 888891.Google Scholar
Evans, B. D. & Rogers, A. E. (1994) 24-hour sleep/wake patterns in healthy elderly persons. Applied Nursing Research, 7, 7583.CrossRefGoogle ScholarPubMed
Fleury, B. (1992) Sleep apnoea syndrome in the elderly. Sleep, 15, S39S41.CrossRefGoogle ScholarPubMed
Ford, D. E. & Kamerow, D. B. (1989) Epidemiologic study of sleep disturbances and psychiatric disorder. Journal of the American Medical Association, 262, 14791484.Google Scholar
Hartford, J. T. & Samorajski, T. (1982) Alcoholism in the geriatric population. Journal of the American Geriatrics Society, 30, 1824.Google Scholar
Kales, A., Soldatos, C. R. & Kales, J. D. (1987) Sleep disorders: insomnia, sleepwalking, night terrors, nightmares and enuresis. Annals of Internal Medicine, 106, 582592.Google Scholar
Karacan, I. & Williams, R. L. (1983) Sleep disorders in the elderly. American Family Physician, 27, 143152.Google ScholarPubMed
Kripke, D. F., Simons, R. N., Garfinkel, L. et al (1979) Short and long sleep and sleeping pills: is increased mortality associated? Archives of General Psychiatry, 37, 103116.Google Scholar
Middelkoop, H. A., Kerkhof, G. A., Smilde-van-den-Doel, D. A. et al (1994) Sleep and ageing: the effect of institutionalisation on subjective and objective characteristics of sleep. Age and Ageing, 23, 411417.CrossRefGoogle ScholarPubMed
Morfis, L., Schwarz, R. S. & Cistulli, P. A. (1997) REM sleep behaviour disorder: a treatable cause of falls in elderly people. Age and Ageing, 26, 4344.Google Scholar
Partinen, M. (1997) Sleep disorder related to Parkinson's disease. Journal of Neurology, 244 (suppl. 1), S3S6.Google Scholar
Pressman, M. R., Figueroa, W. G., Kendrick-Mohamed, J. et al (1996) Nocturia: A rarely recognized symptom of sleep apnoea and other occult sleep disorders. Archives of Internal Medicine, 156, 545550.CrossRefGoogle ScholarPubMed
Reynolds, C. F., Hoch, C. C., Buysse, D. J. et al (1993) Sleep after spousal bereavement: a study of recovery from stress. Biological Psychiatry, 34, 791797.CrossRefGoogle ScholarPubMed
Snyder, F., Hobson, J. A., Morrison, D. F. et al (1964) Changes in respiration, heart rate, and systolic blood pressure in human sleep. Journal of Applied Physiology, 19, 417.Google Scholar
Spielman, A. J., Saskin, P. & Thorpy, M. J. (1987) Treatment of chronic insomnia by restriction of time spent in bed. Sleep, 10, 4556.Google Scholar
Vaughn McCall, W. (1995) Management of primary sleep disorders among elderly persons. Psychiatric Services, 46, 4955.Google Scholar
Vitellio, M. V. & Prinz, P. N. (1990a) Sleep and sleep disorders in normal aging. In Handbook of Sleep Disorders (ed. Thorpy, M. J.) pp. 139151. New York & Basel: Marcel Dekker.Google Scholar
Vitellio, M. V. & Prinz, P. N. (1990b) Sleep/wake patterns and sleep disorders in Alzheimer's disease. In Handbook of Sleep Disorders (ed. Thorpy, M. J.) pp. 703718. New York & Basel: Marcel Delker.Google Scholar
Wooten, V. (1992) Sleep disorders in geriatric patients. Clinics in Geriatric Medicine, 8, 427439.Google Scholar
World Health Organization (1992) The ICD–10 Classification of Mental and Behavioural Disorders. Geneva: WHO.Google Scholar
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