Sleep in older adults: normative changes, sleep disorders, and treatment options

Abstract

Approximately 5% of older adults meet criteria for clinically significant insomnia disorders and 20% for sleep apnea syndromes. It is important to distinguish age-appropriate changes in sleep from clinically significant insomnia, with the latter having associated daytime impairments. Non-pharmacologic therapies, such as cognitive-behavioral therapy for insomnia, can be highly effective with sustained benefit. Pharmacologic therapies are also available, but may be associated with psychomotor effects. A high index of suspicion is crucial for effective diagnosis of sleep apnea because symptoms commonly noted in younger patients, such as obesity or loud snoring, may not be present in older patients.

Keywords: Cognitive-behavioral therapy (CBT); Dementia; Depression; Insomnia; Polysomnography; Positive airway pressure; Sedative-hypnotic; Sleep apnea.