Insomnia. Safe and effective therapy for sleep problems in the older patient.
Insomnia is a problem in all stages of life but is particularly common after age 65. A number of factors--including advanced age, psychosocial influences, medical illness, and the use of medications and alcohol--may disturb sleep architecture. Evaluation of insomnia in the older patient requires a careful history and physical examination, supplemented by a sleep diary. Treatment of underlying conditions and nonpharmacologic improvements in sleep hygiene are first-line therapy, but pharmacologic agents such as benzodiazepines, nonbenzodiazepine hypnotics, or antidepressants may be needed. Nonbenzodiazepines with rapid elimination may offer a lower side-effect profile than other hypnotic agents when used for insomnia in the older population.
Schneider
Diane L
DL
Department of Medicine, Division of General Medicine and Geriatrics, University of California, San Diego, USA.
D000223:Adaptation, Psychological; D000368:Aged; D000375:Aging / Q000502:physiology*; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects / Q000627:therapeutic use*; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006304:Health Status; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D001523:Mental Disorders / Q000150:complications; D012064:Relaxation Therapy; D012651:Self Medication / Q000009:adverse effects; D012890:Sleep / Q000502:physiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology
D000929:Antidepressive Agents, Tricyclic; D006993:Hypnotics and Sedatives