Insomnia in the elderly: cause, approach, and treatment.
Insomnia is a prevalent problem in late life. Sleep problems in the elderly are often mistakenly considered a normal part of aging. Insomnia, the most common sleep disorder, is a subjective report of insufficient or nonrestorative sleep despite adequate opportunity to sleep. Despite the fact that more than 50% of elderly people have insomnia, it is typically undertreated, and nonpharmacologic interventions are underused by health care practitioners. This article will review the causes of insomnia in the elderly, the approach to patient evaluation, and the nonpharmacologic and pharmacologic treatment of insomnia.
Kamel
Nabil S
NS
Division of Geriatric Medicine, Saint Louis University Health Sciences Center; GRECC, St. Louis VA Medical Center, St. Louis, Mo, USA. n_kamel@excite.com
Gammack
Julie K
JK
D000081:Acetamides / Q000627:therapeutic use; D000368:Aged; D000375:Aging; D000928:Antidepressive Agents / Q000627:therapeutic use; D053961:Azabicyclo Compounds; D001521:Behavior Therapy; D001569:Benzodiazepines / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D004366:Nonprescription Drugs / Q000627:therapeutic use; D010879:Piperazines / Q000627:therapeutic use; D011725:Pyridines / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D044122:Receptor, Melatonin, MT1 / Q000819:agonists; D044123:Receptor, Melatonin, MT2 / Q000819:agonists; D012890:Sleep / Q000187:drug effects*; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D012895:Sleep, REM / Q000187:drug effects; D013876:Thiophenes / Q000627:therapeutic use; D014196:Trazodone / Q000627:therapeutic use; D000077334:Zolpidem
D000081:Acetamides; D000928:Antidepressive Agents; D053961:Azabicyclo Compounds; D006993:Hypnotics and Sedatives; D004366:Nonprescription Drugs; D010879:Piperazines; D011725:Pyridines; D011743:Pyrimidines; D044122:Receptor, Melatonin, MT1; D044123:Receptor, Melatonin, MT2; D013876:Thiophenes; C515050:zopiclone; D001569:Benzodiazepines; D000077334:Zolpidem; C469870:indiplon; C085665:zaleplon; D014196:Trazodone