Effective treatments for age-related sleep disturbances.

Fundamental changes in sleep patterns are associated with normal aging, but disturbed sleep with resultant daytime sleepiness and fatigue is an extremely common occurrence among older persons and a frequent catalyst for physician visits. Sleep disorders result from multiple factors--including pharmacologic, physiologic, biologic, and behavioral--and can be mildly debilitating or life-threatening. Diagnosis includes consideration of the presence of physical or mental illness, drug and/or alcohol use or abuse, a primary sleep disorder such as sleep-disordered breathing or periodic limb movements during sleep, changes in circadian rhythms, or poor sleep hygiene. Despite a high rate of use, hypnotics are best suited for periodic rather than chronic sleep disorder symptoms and, in general, should be used only after adjustments in sleep hygiene prove unsuccessful as first-line therapy.