The demented elder with insomnia.
Elders with dementia experience a high prevalence of disordered sleep that can present as agitation, sleep-disordered breathing, or excessive daytime napping. One must also consider broader contextual issues in the evaluation and treatment of the demented elder with insomnia, such as the caregiver and staff, as well as the setting in which the patient resides. The treatment approach to the demented elder with insomnia is difficult and largely based on clinical experience rather than a broad evidence base. Using a "less is better" approach in attempting nonpharmacologic interventions before initiating a trial of drug therapy is the optimal first step.
Paniagua
Miguel A
MA
Division of Gerontology & Geriatric Medicine, Saint Louis University School of Medicine, 1402 South Grand Boulevard, Room M238, Saint Louis, MO 63104, USA. mpaniag1@slu.edu
Paniagua
Elizabeth W
EW
D000544:Alzheimer Disease / Q000453:epidemiology; D003704:Dementia / Q000453:epidemiology*; D004032:Diet; D004777:Environment; D015438:Health Behavior; D006801:Humans; D010789:Phototherapy; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology*