McCall W V
Department of Psychiatry and Behavioral Medicine, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina 27157.
Psychiatr Serv. 1995 Jan;46(1):49-55. doi: 10.1176/ps.46.1.49.
Sleep complaints are common in geriatric patients. The clinician's first task is to separate sleep problems originating in the physiologic changes of aging from those originating in pathological processes. Normal elderly persons have greater difficulty falling asleep and staying asleep, compared with younger persons, and sleep is qualitatively more shallow with more involuntary movements and abnormal breathing. Sleep complaints reach a pathological level as elders begin to experience deterioration of function during their period of normal wakefulness, manifested as excessive sleepiness, concentration deficits, and mood changes, or the emergence of bizarre or dangerous behavior during sleep. Sleep disorders are associated with excess physical and psychiatric morbidity and are treatable. An approach focused on sleep-related syndromes is a useful basis for rational treatment, and the treatment of many sleep disorders can be provided without expensive sleep laboratory testing.
睡眠问题在老年患者中很常见。临床医生的首要任务是将源于衰老生理变化的睡眠问题与源于病理过程的睡眠问题区分开来。与年轻人相比，正常老年人入睡和保持睡眠的难度更大，睡眠质量更浅，有更多不自主运动和异常呼吸。当老年人在正常清醒期开始出现功能衰退时，睡眠问题就达到了病理水平，表现为过度嗜睡、注意力不集中和情绪变化，或睡眠中出现怪异或危险行为。睡眠障碍与过多的身体和精神疾病相关，并且是可治疗的。关注与睡眠相关综合征的方法是合理治疗的有用基础，并且许多睡眠障碍的治疗无需昂贵的睡眠实验室检测即可提供。
