Bloom Harrison G, Ahmed Imran, Alessi Cathy A, Ancoli-Israel Sonia, Buysse Daniel J, Kryger Meir H, Phillips Barbara A, Thorpy Michael J, Vitiello Michael V, Zee Phyllis C
International Longevity Center-USA, 60 East 86th Street New York, NY 10028, USA.
J Am Geriatr Soc. 2009 May;57(5):761-89. doi: 10.1111/j.1532-5415.2009.02220.x.
Sleep-related disorders are most prevalent in the older adult population. A high prevalence of medical and psychosocial comorbidities and the frequent use of multiple medications, rather than aging per se, are major reasons for this. A major concern, often underappreciated and underaddressed by clinicians, is the strong bidirectional relationship between sleep disorders and serious medical problems in older adults. Hypertension, depression, cardiovascular disease, and cerebrovascular disease are examples of diseases that are more likely to develop in individuals with sleep disorders. Conversely, individuals with any of these diseases are at a higher risk of developing sleep disorders. The goals of this article are to help guide clinicians in their general understanding of sleep problems in older persons, examine specific sleep disorders that occur in older persons, and suggest evidence- and expert-based recommendations for the assessment and treatment of sleep disorders in older persons. No such recommendations are available to help clinicians in their daily patient care practices. The four sections in the beginning of the article are titled, Background and Significance, General Review of Sleep, Recommendations Development, and General Approach to Detecting Sleep Disorders in an Ambulatory Setting. These are followed by overviews of specific sleep disorders: Insomnia, Sleep Apnea, Restless Legs Syndrome, Circadian Rhythm Sleep Disorders, Parasomnias, Hypersomnias, and Sleep Disorders in Long-Term Care Settings. Evidence- and expert- based recommendations, developed by a group of sleep and clinical experts, are presented after each sleep disorder.
与睡眠相关的障碍在老年人群中最为普遍。医学和心理社会合并症的高患病率以及多种药物的频繁使用，而非衰老本身，是造成这种情况的主要原因。一个主要问题，往往未得到临床医生充分认识和处理，是睡眠障碍与老年人严重医疗问题之间存在强烈的双向关系。高血压、抑郁症、心血管疾病和脑血管疾病就是在患有睡眠障碍的个体中更易发生的疾病例子。相反，患有这些疾病中的任何一种的个体发生睡眠障碍的风险更高。本文的目的是帮助指导临床医生全面了解老年人的睡眠问题，研究老年人中出现的特定睡眠障碍，并就老年人睡眠障碍的评估和治疗提出基于证据和专家意见的建议。目前没有此类建议可帮助临床医生进行日常患者护理工作。文章开头的四个部分分别题为背景与意义、睡眠概述、建议制定以及在门诊环境中检测睡眠障碍的一般方法。随后是特定睡眠障碍的概述：失眠、睡眠呼吸暂停、不宁腿综合征、昼夜节律睡眠障碍、异态睡眠、发作性睡病以及长期护理环境中的睡眠障碍。一组睡眠和临床专家制定的基于证据和专家意见的建议在每种睡眠障碍之后给出。
