Department of Geriatrics, Wayne State University School of Medicine, Detroit, Michigan.
J Clin Sleep Med. 2018 Jun 15;14(6):1017-1024. doi: 10.5664/jcsm.7172.
Insomnia remains one of the most common sleep disorders encountered in the geriatric clinic population, frequently characterized by the subjective complaint of difficulty falling or maintaining sleep, or nonrestorative sleep, producing significant daytime symptoms including difficulty concentrating and mood disturbances.
A search of the literature was conducted to review the epidemiology, definition, and age-related changes in sleep, as well as factors contributing to late-life insomnia and scales utilized for the assessment of insomnia in older people. The aim is to summarize recent diagnostic guidelines and both nonpharmacological and pharmacological strategies for the management of insomnia in the older population.
Insomnia remains a clinical diagnosis. There are several demographic, psychosocial, biologic, and behavioral factors that can contribute to late-life insomnia. Older adults are at higher risk for the medical and psychiatric effects of insomnia.
The most important aspect in evaluation of insomnia is detailed history taking and thorough physical examination. Nonpharmacological treatment options have favorable and enduring benefits compared to pharmacological therapy.
失眠仍然是老年诊所人群中最常见的睡眠障碍之一,其特征通常是主观抱怨入睡困难或难以维持睡眠,或睡眠质量差,导致白天出现明显的症状,包括注意力不集中和情绪紊乱。
对文献进行了检索,以综述流行病学、定义以及与年龄相关的睡眠变化,以及导致老年人失眠的因素和用于评估老年人失眠的量表。目的是总结老年人失眠的最新诊断指南以及非药物和药物治疗策略。
失眠仍然是一种临床诊断。有几个人口统计学、心理社会、生物和行为因素可能导致老年人失眠。老年人更容易受到失眠的医学和精神影响。
评估失眠的最重要方面是详细的病史采集和全面的体格检查。与药物治疗相比,非药物治疗方案具有更好的和持久的益处。