Non-pharmacologic treatment of insomnia in persons with dementia.
The prevalence of insomnia increases with age and affects up to 35% of community-dwelling adults with dementia. Sleep disturbances and associated cognitive and behavioral symptoms in this patient population can be a significant contributor to morbidity, mortality, and caregiver burden. Despite the frequency with which sleep disorders are encountered in primary care, few evidence-based guidelines are available to guide physician treatment plans. Sedative-hypnotic medications are commonly prescribed but are associated with significant adverse effects and have limited efficacy data. Non-pharmacologic treatments can be safe and effective adjuncts or alternatives to medications but are often underused in clinical practice. This article reviews practical applications of modalities such as light therapy, exercise, and sleep-hygiene modification in treating insomnia in persons with dementia.
Shub
Denis
D
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA.
Darvishi
Roham
R
Kunik
Mark E
ME
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000544:Alzheimer Disease / Q000150:complications / Q000628:therapy; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage; D002940:Circadian Rhythm / Q000528:radiation effects; D003704:Dementia / Q000150:complications / Q000628:therapy*; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D005853:Geriatrics; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008803:Mianserin / Q000008:administration & dosage / Q000031:analogs & derivatives; D000078785:Mirtazapine; D009043:Motor Activity; D010789:Phototherapy / Q000379:methods*; D017410:Practice Guidelines as Topic; D011725:Pyridines / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D016138:Walking; D000077334:Zolpidem
D000929:Antidepressive Agents, Tricyclic; D006993:Hypnotics and Sedatives; D011725:Pyridines; D008803:Mianserin; D000077334:Zolpidem; D000078785:Mirtazapine