Family Medicine Department-Geriatric Medicine Division, Loma Linda University Health, Loma Linda, CA, USA.
Family Medicine Department, Loma Linda University Health, Loma Linda, CA, USA.
Perm J. 2023 Mar 15;27(1):122-132. doi: 10.7812/TPP/22.114. Epub 2022 Dec 12.
Sleep disorders in older adults increase with aging, likely due to increased sleep latency, decreased sleep efficiency, and total sleep time. Common sleep issues include chronic insomnia, circadian rhythm sleep-wake disorders, sleep-related movement disorders, and sleep-disordered breathing. Diagnostic tools, such as a comprehensive sleep history and questionnaires, or a sleep log for more specific complaints, are commonly used. Polysomnography is not recommended as a routine test; however, it can be used for abnormal behaviors during sleep or if treatment fails. Sleep disorder management is based on the etiology and may include nonpharmacological and pharmacological alternative treatments. For example, nonpharmacological management for chronic insomnia and some sleep disorders may consist of cognitive behavioral therapy, sleep hygiene education, relaxation therapy, sleep restriction, light therapy, and stimulus control therapy. Because the quality of evidence for pharmacological treatment is poor, the medication choice should be based on shared decision-making between the practitioner and the patient, with limited prescription.
老年人的睡眠障碍随着年龄的增长而增加，可能是由于睡眠潜伏期延长、睡眠效率降低和总睡眠时间减少。常见的睡眠问题包括慢性失眠、昼夜节律睡眠-觉醒障碍、与睡眠相关的运动障碍和睡眠呼吸障碍。通常使用综合睡眠史和问卷或睡眠日志等诊断工具来更具体地了解睡眠问题。多导睡眠图不建议作为常规检查；然而，如果出现睡眠期间的异常行为或治疗失败，它可以用于诊断。睡眠障碍的管理基于病因，可能包括非药物和药物替代治疗。例如，对于慢性失眠和一些睡眠障碍的非药物治疗可能包括认知行为疗法、睡眠卫生教育、放松疗法、睡眠限制、光照疗法和刺激控制疗法。由于药物治疗的证据质量较差，药物的选择应基于从业者和患者之间的共同决策，并进行有限的处方。
