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A ustralian and N ew Z ealand Society for Geriatric Medicine
Author(s) -
Shabana Ahamed
Publication year - 2015
Publication title -
australasian journal on ageing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.63
H-Index - 34
eISSN - 1741-6612
pISSN - 1440-6381
DOI - 10.1111/ajag.12192
Subject(s) - position statement , statement (logic) , citation , position (finance) , geriatrics , older people , library science , medicine , gerontology , political science , psychology , family medicine , law , psychiatry , computer science , business , finance
Overview 1 Normal ageing is associated with multiple physiological changes in sleep; however, these changes alone should not impact on sleep quality or quantity. 2 The prevalence of sleep disorders does increase with age. 3 Poor sleep quality may result in cognitive impairment and reduced quality of life, so this requires careful assessment, investigation and treatment. 4 There are multiple medical and psychiatric comorbidities that may be the cause of the sleep disorder or arise as a consequence of it. 5 Sleep disorders in older persons are often considered difficult to treat by health professionals, possibly due to a lack of awareness and expertise in these areas; yet older persons are among those in the greatest need of treatment. 6 Management of sleep disorders should start with acknowledging the existence of the problem before conducting a comprehensive assessment of the patient, which should include a psychosocial review. 7 The clinical assessment of the older patient with sleep disorders or complaints involves a multidisciplinary approach. 8 Investigations and treatment options should be tailored towards the individual. 9 Both non-pharmacological and pharmacological treatments should be considered, and in some cases, these may need to be used concurrently in order to achieve long-term remission. 10 If a pharmacological treatment is used, it should be commenced at the lowest dose and up-titrated slowly, with frequent review of the patient to assess treatment response and potential adverse effects. Pharmacological agents should always be used sparingly in older people, ideally only after the underlying cause of the sleep disorder has been addressed. 11 Areas for future research may include the following: • Further elucidation of the role of sleep and the impact of sleep disorders in cognitive decline and dementia; • Optimal interventions in and treatment of sleep disorders in residential aged care facilities and management of sleep disorders in older persons with dementia. Context Sleep is an important part of life, irrespective of one’s age. Sufficient good-quality sleep is essential in maintaining good health, and this need does not lessen with age. Normal ageing is associated with physiological changes in sleep; however, these changes should not impact on sleep quality or quantity. It is a common misconception that sleeping problems are a natural consequence of ageing.