Lemoine P, Nicolas A, Faivre T
Unité clinique de Psychiatrie biologique, CH Le Vinatier, 95, boulevard Pinel, F69677 Bron.
Presse Med. 2001 Mar 10;30(9):417-24.
A COMMON DISORDER: Sleep is one of the most often altered functions in elderly people. Obviously, insomnia is one of the main complain, inducing benzodiazepine (BSD) abuse, but we must keep in mind that sleep apnoea syndrome (SAS) and restless legs syndrome (RLS) are also frequent in this group of age. After exclusion of the various age-related conditions that could induce sleep disorders, we must focalise on primary and secondary sleep disorders. As an introduction, methods of sleep analysis are described and qualitative and quantitative sleep variables are given. PHYSIOLOGICAL SLEEP: Comparing the sleep of elderly people to the one of young adult give us the opportunity to define the limits of the physiological sleep aging. It seems that the main age-induced sleep disturbances are problems to maintain sleep and chronobiological disorganisation of the sleep-wake rhythm, both responsible for insomnia complains. It is important to note that SAS and RLS prevalence are correlated with age. Also crucial is the complex association between sleep, depression and dementia. These interactions are addressed from a diagnostic and a therapeutic point of view.
Lastly, concerning insomnia we emphasise the importance of therapeutic alternative to BZD, responsible for addictions and cognitive impairment, mainly behavioural and chronotherapeutic methods (phototherapy, melatonin). For clinicians, it is recommended to respect the individual rhythms of each elderly patient and to prefer nonpharmacological methods.
一种常见病症：睡眠是老年人中最常发生改变的功能之一。显然，失眠是主要的主诉之一，会导致苯二氮䓬（BZD）滥用，但我们必须牢记，睡眠呼吸暂停综合征（SAS）和不宁腿综合征（RLS）在这个年龄段也很常见。在排除了各种可能导致睡眠障碍的与年龄相关的病症后，我们必须关注原发性和继发性睡眠障碍。作为引言，描述了睡眠分析方法并给出了定性和定量的睡眠变量。
将老年人的睡眠与年轻人的睡眠进行比较，使我们有机会界定生理睡眠衰老的界限。似乎主要的年龄诱导性睡眠障碍是维持睡眠的问题以及睡眠 - 觉醒节律的生物钟紊乱，这两者都是失眠主诉的原因。需要注意的是，SAS和RLS的患病率与年龄相关。睡眠、抑郁和痴呆之间的复杂关联也至关重要。从诊断和治疗的角度探讨了这些相互作用。
最后，关于失眠，我们强调替代BZD进行治疗的重要性，BZD会导致成瘾和认知障碍，主要是行为和时间治疗方法（光疗、褪黑素）。对于临床医生，建议尊重每位老年患者的个体节律并优先选择非药物方法。
