BOOK
Sleep in Older Adults, An Issue of Sleep Medicine Clinics, E-Book
Cathy A. Alessi | Jennifer L. Martin
(2018)
Additional Information
Book Details
Abstract
This issue of Sleep Medicine Clinics focuses on Sleep in Older Adults, with topics including: Sleep in Normal Aging; Insomnia in the Older Adult; Sleep Apnea in the Older Adult; Circadian Rhythm Sleep-Wake Disorders in the Older Adult; Restless Legs Syndrome; Periodic Limb Movement Disorder and Other Sleep Related Movement Disorders in the Older Adult; REM Sleep Behavior Disorder and Other Parasomnias in the Older Adult; Neurodegenerative Disorders and Sleep; Medical Conditions and Sleep in the Older Adult; Psychiatric Illness and Sleep in the Older Adult; Sleep and Cognition in the Older Adult; Sleep and Nocturia in the Older Adult; Sleep and Long Term Care; and Sleep in the Hospitalized Older Adult.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Sleep in Older Adults\r | i | ||
| Copyright\r | ii | ||
| CME Accreditation Page | iii | ||
| PROGRAM OBJECTIVE | iii | ||
| TARGET AUDIENCE | iii | ||
| LEARNING OBJECTIVES | iii | ||
| ACCREDITATION | iii | ||
| DISCLOSURE OF CONFLICTS OF INTEREST | iii | ||
| UNAPPROVED/OFF-LABEL USE DISCLOSURE | iii | ||
| TO ENROLL | iii | ||
| METHOD OF PARTICIPATION | iv | ||
| CME INQUIRIES/SPECIAL NEEDS | iv | ||
| SLEEP MEDICINE CLINICS\r | v | ||
| FORTHCOMING ISSUES | v | ||
| June 2018 | v | ||
| September 2018 | v | ||
| December 2018 | v | ||
| RECENT ISSUES | v | ||
| December 2017 | v | ||
| September 2017 | v | ||
| June 2017 | v | ||
| Contributors | vii | ||
| CONSULTING EDITOR | vii | ||
| EDITORS | vii | ||
| AUTHORS | vii | ||
| Contents | xi | ||
| Preface: Sleep in Older Adults: Challenges and Opportunities | xi | ||
| Sleep in Normal Aging | xi | ||
| Insomnia in the Older Adult | xi | ||
| Apnea in Older Adults | xi | ||
| Circadian Rhythm Sleep-Wake Disorders in Older Adults | xi | ||
| Parasomnias and Sleep-Related Movement Disorders in Older Adults | xii | ||
| Neurodegenerative Disorders and Sleep | xii | ||
| Chronic Medical Conditions and Sleep in the Older Adult | xii | ||
| Psychiatric Illness and Sleep in Older Adults: Comorbidity and Opportunities for Intervention | xii | ||
| Sleep and Cognition in Older Adults | xiii | ||
| Sleep and Nocturia in Older Adults | xiii | ||
| Sleep and Long-Term Care | xiii | ||
| Sleep in Hospitalized Older Adults | xiii | ||
| Preface:\rSleep in Older Adults: Challenges and Opportunities | xv | ||
| Sleep in Normal Aging | 1 | ||
| Key points | 1 | ||
| INTRODUCTION | 1 | ||
| AGE-RELATED CHANGES IN SLEEP | 1 | ||
| Sleep Duration | 2 | ||
| Sleep Initiation | 2 | ||
| Sleep Efficiency | 2 | ||
| Sleep Maintenance | 2 | ||
| Sleep Stages | 2 | ||
| Daytime Napping and Daytime Sleepiness | 3 | ||
| Self-Reported Sleep Quality | 4 | ||
| AGE-RELATED CHANGES IN CIRCADIAN RHYTHMS | 4 | ||
| Phase Advance | 4 | ||
| Reduced Amplitude in Circadian Rhythms | 4 | ||
| Decreased Ability Adjusting to Phase Shifting | 5 | ||
| Changes in Sleep Homeostasis | 5 | ||
| SLEEP-RELATED HORMONES, AGING, AND SLEEP | 5 | ||
| Growth Hormone | 5 | ||
| Cortisol | 6 | ||
| Prolactin | 6 | ||
| Thyroid-Stimulating Hormone | 6 | ||
| Melatonin | 6 | ||
| Sex Hormones | 6 | ||
| RISK FACTORS FOR SLEEP DISTURBANCES IN OLDER ADULTS | 6 | ||
| Medical Comorbidities and Psychiatric Illness | 7 | ||
| Primary Sleep Disorders | 7 | ||
| Social, Lifestyle, and Environmental Factors | 7 | ||
| SUMMARY | 7 | ||
| REFERENCES | 8 | ||
| Insomnia in the Older Adult | 13 | ||
| Key points | 13 | ||
| INTRODUCTION | 13 | ||
| Prevalence and Diagnosis of Insomnia | 13 | ||
| Risk Factors of Insomnia | 14 | ||
| EVALUATION OF INSOMNIA | 15 | ||
| TREATMENTS FOR INSOMNIA | 16 | ||
| Nonpharmacologic Treatment Options | 16 | ||
| Pharmacologic Treatment Options | 17 | ||
| Comparative Effectiveness of Cognitive-Behavioral Therapy for Insomnia and Medications | 18 | ||
| SUMMARY | 18 | ||
| REFERENCES | 18 | ||
| Apnea in Older Adults | 21 | ||
| Key points | 21 | ||
| INTRODUCTION | 21 | ||
| EPIDEMIOLOGY | 21 | ||
| CLINICAL MANIFESTATIONS | 22 | ||
| DIAGNOSTIC TESTING | 22 | ||
| PATHOPHYSIOLOGY | 22 | ||
| CONSEQUENCES OF SLEEP-DISORDERED BREATHING IN OLDER ADULTS | 23 | ||
| Hypertension | 24 | ||
| Cardiovascular Events | 24 | ||
| Cerebrovascular Disease | 29 | ||
| Excessive Daytime Sleepiness and Cognitive Function | 29 | ||
| Depression | 29 | ||
| Type 2 Diabetes | 29 | ||
| Function and Quality of Life | 32 | ||
| THERAPY | 32 | ||
| Positive Airway Pressure Therapy | 32 | ||
| Oral appliance | 32 | ||
| SUMMARY | 33 | ||
| REFERENCES | 33 | ||
| Circadian Rhythm Sleep-Wake Disorders in Older Adults | 39 | ||
| Key points | 39 | ||
| INTRODUCTION | 39 | ||
| CIRCADIAN RHYTHM SLEEP-WAKE DISORDERS | 40 | ||
| THE CIRCADIAN TIMING SYSTEM IN HUMANS | 40 | ||
| CIRCADIAN REGULATION OF SLEEP AND WAKEFULNESS | 40 | ||
| AGE-RELATED CHANGES IN CIRCADIAN RHYTHMS | 41 | ||
| DIAGNOSIS OF CIRCADIAN RHYTHM SLEEP-WAKE DISORDERS | 42 | ||
| PREVALENCE OF CIRCADIAN RHYTHM SLEEP-WAKE DISORDERS IN OLDER ADULTS | 42 | ||
| NEUROLOGIC IMPLICATIONS OF CIRCADIAN RHYTHM CHANGES IN OLDER ADULTS | 42 | ||
| CIRCADIAN RHYTHM DISRUPTION IN OLDER PATIENTS WITH NEURODEGENERATIVE DISEASE | 44 | ||
| TREATMENT OF CIRCADIAN SLEEP-WAKE DISORDERS IN OLDER ADULTS | 45 | ||
| LIGHT THERAPY | 45 | ||
| TREATMENT OF IRREGULAR SLEEP-WAKE RHYTHM DISORDER IN OLDER ADULTS | 45 | ||
| TREATMENT OF SHIFT-WORK SLEEP DISORDER IN OLDER ADULTS | 45 | ||
| SUMMARY | 46 | ||
| ACKNOWLEDGMENTS | 46 | ||
| REFERENCES | 46 | ||
| Parasomnias and Sleep-Related Movement Disorders in Older Adults | 51 | ||
| Key points | 51 | ||
| INTRODUCTION | 51 | ||
| SLEEP PARALYSIS | 51 | ||
| DISORDERS OF AROUSALS | 52 | ||
| RAPID EYE MOVEMENT SLEEP BEHAVIOR DISORDER | 52 | ||
| Idiopathic Rapid Eye Movement Sleep Behavior Disorder | 53 | ||
| The Transition Between Idiopathic Rapid Eye Movement Sleep Behavior Disorder and Clinical Diagnosis of Parkinson Disease, D ... | 53 | ||
| Rapid Eye Movement Sleep Behavior Disorder in Patients Already Diagnosed with Parkinson Disease | 54 | ||
| Rapid Eye Movement Sleep Behavior Disorder in Patients Already Diagnosed with Multiple System Atrophy | 55 | ||
| Rapid Eye Movement Sleep Behavior Disorder in Patients Already Diagnosed with Dementia with Lewy Bodies | 55 | ||
| PARASOMNIA OVERLAP DISORDER | 56 | ||
| ANTI-IGLON5 DISEASE | 56 | ||
| RESTLESS LEGS SYNDROME | 57 | ||
| PERIODIC LIMB MOVEMENTS IN SLEEP | 58 | ||
| SUMMARY | 59 | ||
| REFERENCES | 59 | ||
| Neurodegenerative Disorders and Sleep | 63 | ||
| Key points | 63 | ||
| INTRODUCTION | 63 | ||
| PARKINSON DISEASE AND OTHER SYNUCLEINOPATHIES | 63 | ||
| Insomnia | 64 | ||
| Hypersomnia | 65 | ||
| Sleep-Disordered Breathing | 66 | ||
| Parasomnias | 66 | ||
| ALZHEIMER DEMENTIA AND OTHER TAUOPATHIES | 67 | ||
| Insomnia | 67 | ||
| Obstructive Sleep Apnea | 68 | ||
| PROGRESSIVE SUPRANUCLEAR PALSY | 68 | ||
| SUMMARY | 68 | ||
| REFERENCES | 69 | ||
| Chronic Medical Conditions and Sleep in the Older Adult | 71 | ||
| Key points | 71 | ||
| INTRODUCTION | 71 | ||
| CHRONIC MEDICAL CONDITIONS AND SLEEP INTERACTIONS | 72 | ||
| Pain | 72 | ||
| Clinical aspects and dual relationship between pain and sleep disturbance | 72 | ||
| Interventions to improve comorbid sleep disturbance and pain | 73 | ||
| Cancer | 73 | ||
| Clinical aspects and dual relationship between cancer and sleep disturbance | 73 | ||
| Interventions to improve sleep disturbance for patients with cancer | 74 | ||
| Falls | 74 | ||
| Clinical aspects and relationship between falls, insomnia, sedative drugs, and sleep apnea | 74 | ||
| Interventions to improve sleep disturbance in older fallers | 75 | ||
| Chronic Heart Failure | 75 | ||
| Clinical aspects and dual relationship between congestive heart failure and sleep disturbance | 75 | ||
| Interventions to improve sleep apnea (central and obstructive sleep apnea) for patients with congestive heart failure | 76 | ||
| SUMMARY | 77 | ||
| REFERENCES | 77 | ||
| Psychiatric Illness and Sleep in Older Adults | 81 | ||
| Key points | 81 | ||
| SLEEP DISTURBANCES AND DISORDERS | 82 | ||
| DEPRESSION AND SLEEP DISORDERS | 82 | ||
| Depression and Insomnia | 82 | ||
| Depression and Obstructive Sleep Apnea | 82 | ||
| Depression and Nightmares | 84 | ||
| Depression and Sleep Quality | 84 | ||
| ANXIETY AND SLEEP DISORDERS | 84 | ||
| Anxiety and Insomnia | 84 | ||
| Anxiety and Obstructive Sleep Apnea | 85 | ||
| Anxiety and Nightmares | 85 | ||
| SUICIDE AND SLEEP DISORDERS | 85 | ||
| Suicide and Insomnia | 85 | ||
| Suicide and Nightmares | 86 | ||
| Suicide and Obstructive Sleep Apnea | 86 | ||
| NEURODEGENERATIVE DISEASES AND SLEEP DISORDERS | 86 | ||
| Rapid Eye Movement Sleep Behavior Disorder and Parkinson Disease | 86 | ||
| Sleep in Dementia | 86 | ||
| SUMMARY | 87 | ||
| Summary of Findings and Conclusions | 87 | ||
| REFERENCES | 88 | ||
| Sleep and Cognition in Older Adults | 93 | ||
| Key points | 93 | ||
| INTRODUCTION | 93 | ||
| SLEEP AND COGNITION IN NORMAL-SLEEPING OLDER ADULTS | 94 | ||
| Self-Reported Sleep Duration and Cognition | 94 | ||
| Polysomnography-Measured Sleep and Cognition | 94 | ||
| Actigraphy-Measured Sleep and Cognition | 94 | ||
| Sleep Deprivation and Cognition | 94 | ||
| Sleep Restriction and Cognition | 95 | ||
| Sleep and Learning | 95 | ||
| SLEEP AND COGNITION IN OLDER ADULTS WITH INSOMNIA | 95 | ||
| Insomnia Status and Normal Cognitive Aging | 95 | ||
| Insomnia and Cognitive Decline/Dementia Diagnoses | 96 | ||
| Insomnia Treatment and Cognitive Functioning | 97 | ||
| SLEEP AND COGNITION IN OLDER ADULTS WITH SLEEP DISORDERED BREATHING | 97 | ||
| Sleep Disordered Breathing Severity and Cognitive Performance | 100 | ||
| Sleep Disordered Breathing Treatment and Cognitive Performance | 102 | ||
| UNIFYING THEORIES AND MECHANISMS | 103 | ||
| SUMMARY AND FUTURE DIRECTIONS | 103 | ||
| REFERENCES | 103 | ||
| Sleep and Nocturia in Older Adults | 107 | ||
| Key points | 107 | ||
| INTRODUCTION | 107 | ||
| MULTIFACTORIAL ASSESSMENT OF CONTRIBUTING CONDITIONS | 107 | ||
| Common Comorbid Conditions | 107 | ||
| Medication Review | 108 | ||
| Physical Examination and Clinical Evaluation | 108 | ||
| MULTICOMPONENT TREATMENT APPROACH | 109 | ||
| Lifestyle and Behavioral Treatment | 109 | ||
| Pharmacologic Treatment | 110 | ||
| Minimally Invasive and Surgical Treatment | 113 | ||
| SUMMARY | 114 | ||
| REFERENCES | 114 | ||
| Sleep and Long-Term Care | 117 | ||
| Key points | 117 | ||
| POOR SLEEP AND THE RISK OF LONG-TERM CARE PLACEMENT | 117 | ||
| SLEEP DISTURBANCE IN LONG-TERM CARE | 118 | ||
| CONSEQUENCES OF SLEEP DISTURBANCE IN LONG-TERM CARE | 118 | ||
| CLINICAL ASSESSMENT OF SLEEP DISTURBANCE IN LONG-TERM CARE | 118 | ||
| FACTORS THAT CONTRIBUTE TO SLEEP DISTURBANCE IN LONG-TERM CARE | 118 | ||
| Age-Related Factors | 118 | ||
| Environmental Factors | 119 | ||
| Behavioral Factors | 119 | ||
| Medical and Psychiatric Factors | 119 | ||
| MANAGEMENT OF SLEEP DISTURBANCE IN LONG-TERM CARE | 120 | ||
| Summary and Management Goals | 120 | ||
| Nonpharmacologic Strategies | 120 | ||
| Bright light | 120 | ||
| Exercise and social activity | 120 | ||
| Multicomponent interventions | 121 | ||
| Continuous positive airway pressure and other treatments for obstructive sleep apnea | 121 | ||
| Pharmacologic Strategies | 122 | ||
| Complementary and Alternative Treatments | 122 | ||
| Dietary and herbal supplements | 122 | ||
| Massage and acupressure | 122 | ||
| IMPLICATIONS FOR RESEARCH AND PRACTICE | 122 | ||
| Implications for Future Research | 122 | ||
| Recommendations for Practice | 123 | ||
| REFERENCES | 123 | ||
| Sleep in Hospitalized Older Adults | 127 | ||
| Key points | 127 | ||
| INTRODUCTION | 127 | ||
| SLEEP LOSS IN OLDER ADULTS | 127 | ||
| HEALTH EFFECTS OF SLEEP LOSS FOR HOSPITALIZED OLDER ADULTS | 128 | ||
| BARRIERS TO PROPER SLEEP FOR HOSPITALIZED OLDER ADULTS | 129 | ||
| Medical Care Interruptions | 129 | ||
| Patient Factors | 129 | ||
| Environmental Disruptions | 129 | ||
| PREVALENCE OF SLEEP DISORDERS AMONG HOSPITALIZED OLDER ADULTS | 129 | ||
| INTERVENTIONS TO IMPROVE SLEEP IN HOSPITALIZED ADULTS | 130 | ||
| Pharmacologic Interventions | 130 | ||
| Melatonin | 130 | ||
| Sleep aids | 130 | ||
| Pain treatment | 131 | ||
| Nonpharmacologic Interventions | 131 | ||
| Relaxation techniques | 131 | ||
| Sleep hygiene program | 131 | ||
| Bright light therapy | 131 | ||
| Noise reduction | 132 | ||
| Reducing nighttime interruptions | 132 | ||
| Sleep education and empowerment | 132 | ||
| Multifaceted Protocols | 132 | ||
| Assessment and Treatment of Underlying Sleep Disorders | 132 | ||
| SUMMARY | 132 | ||
| REFERENCES | 132 |