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Insomnia in older people

Part of: Bespoke shallow archive Weizmann

Published online by Cambridge University Press:  28 June 2010

Paul Montgomery  and
Lindsay D Shepard
Paul Montgomery*
Affiliation:
Centre for Evidence-Based Intervention, University of Oxford, UK
Lindsay D Shepard
Affiliation:
Centre for Evidence-Based Intervention, University of Oxford, UK
*
Address for correspondence: Paul Montgomery, Centre for Evidence-Based Intervention, Barnett House, 32 Wellington Square, Oxford, Oxfordshire OX1 2ER, UK. Email: paul.montgomery@psych.ox.ac.uk
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Summary

Insomnia is a prevalent sleep complaint amongst older people, affecting physical and mental health as well as many aspects of life quality and well-being. For the lack of explicit guidelines for the assessment and treatment of insomnia in older people, this summary of available information represents the best evidence to inform current practice. Clinicians need to be more aware of their patients’ sleep and conduct formal assessments as appropriate. Despite past practice trends, non-pharmacological treatments should be considered first for chronic insomnia as a means to reduce dependency, adverse effects, and polypharmacy. Behavioural treatment methods such as stimulus control and sleep restriction are especially beneficial for older insomniacs as they target maladaptive sleep habits. Pharmacological treatment should be employed only if insomnia persists, involving the careful patient-specific consideration of the lowest effective dose, best intermittence of dosing, shortest effective duration, best gradual discontinuation scheme, and most effective elimination half-life.

Keywords

insomniaelderlytreatmentsleepreview
Type
Clinical geriatrics section
Information
Reviews in Clinical Gerontology , Volume 20 , Issue 3 , August 2010 , pp. 205 - 218
Copyright
Copyright © Cambridge University Press 2010

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