Diagnosis and management of geriatric insomnia: a guide for nurse practitioners.
OBJECTIVE
To discuss the assessment, diagnosis, and management of geriatric insomnia, a challenging clinical condition of older adults frequently seen by primary care providers.


METHODS
Extensive literature review of the published research articles and textbooks.


CONCLUSIONS
Complaints of insomnia among older adults are frequently ignored, considered a part of the normal aging process or viewed as a difficult to treat condition. Geriatric insomnia remains a challenge for primary care providers because of the lack of evidence-based clinical guidelines and limited treatment options available. Effective management of this condition is necessary for improved quality of life, which is a primary issue for the elderly and their families. Therefore, geriatric insomnia warrants thorough attention from the nurse practitioners (NPs) who provide care for older adults.


CONCLUSIONS
Undiagnosed or under treated insomnia can cause increased risk for falls, motor vehicle accidents, depression, and shorter survival. Insomniacs double their risk for cardiovascular disease, stroke, cancer, and suicide compared to their counterparts. Insomnia is also associated with increased healthcare utilization and institutionalization. NPs could play a central role in reducing the negative consequences of insomnia through a systematic approach for diagnosis, evaluation, and management.
Krishnan
Preetha
P
Winnipeg Regional Health Authority, Long Term Care, Personal Care Home Program, Winnipeg, Manitoba, Canada. preethakri@gmail.com
Hawranik
Pamela
P
D000368:Aged; D000375:Aging / Q000502:physiology; D015984:Causality; D015928:Cognitive Behavioral Therapy; D003937:Diagnosis, Differential; D016903:Drug Monitoring; D015577:Geriatric Assessment; D005851:Geriatric Nursing; D006801:Humans; D006993:Hypnotics and Sedatives / Q000145:classification / Q000494:pharmacology / Q000627:therapeutic use; D008487:Medical History Taking; D009722:Nurse Practitioners / Q000458:organization & administration; D009730:Nursing Assessment; D010353:Patient Education as Topic; D011320:Primary Health Care / Q000379:methods*; D012064:Relaxation Therapy; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*
D006993:Hypnotics and Sedatives