Non-pharmacological management of primary and secondary insomnia among older people: review of assessment tools and treatments.
BACKGROUND
primary and secondary insomnia, especially among older adults, is frequently encountered by family physicians. Pharmacological interventions, although effective in some circumstances, can be detrimental in others. Non-pharmacological management of insomnia may allow the patients to self-administer the treatment.


OBJECTIVE
review of published literature of assessment tools and treatments for primary and secondary insomnia.


RESULTS
two frequently used self-reporting methods for obtaining sleep data are sleep diaries and Pittsburg Sleep Quality Index. A large amount of research supports the use of non-pharmacological treatments such as stimulus control, sleep restriction, sleep hygiene education, cognitive therapy, multi-component therapy and paradoxical intention.


CONCLUSIONS
assessing the nature of insomnia by using an effective assessment tool and providing patients with a non-pharmacological treatment should be the first intervention for insomnia. It is shown that non-pharmacological treatments for primary and secondary insomnia are feasible and effective alternatives to the use of benzodiazepines, and that family physicians should consider these when managing older patients with insomnia.
Petit
Lyndal
L
The Ottawa Hospital Civic Campus, 1053 Carling Avenue Ottawa, Ontario, Canada.
Azad
Nahid
N
Byszewski
Anna
A
Sarazan
Francine F-A
FF
Power
Barbara
B
D000368:Aged; D014151:Anti-Anxiety Agents / Q000008:administration & dosage / Q000009:adverse effects; D001521:Behavior Therapy / Q000379:methods; D001569:Benzodiazepines; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005194:Family Practice; D015438:Health Behavior; D006801:Humans; D010353:Patient Education as Topic; D012648:Self Care; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology / Q000628:therapy*
D014151:Anti-Anxiety Agents; D001569:Benzodiazepines