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KMID : 0978920130140010001
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Korean Journal of Clinical Geriatrics
2013 Volume.14 No. 1 p.1 ~ p.10
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Clinical Approach to Elderly Insomnia
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Lee Dong-Kuck
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Abstract
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Sleep occupies approximately one-third of the adult life. Although the full function of sleep is not understood, the inherent
necessity for sleep is widely recognized. Wake-sleep complaints are second only to complaints of pain as the reason that
patients seek medical attention. Undiagnosed and untreated wake-sleep complaints extract an enormous toll at the personal level in terms of misery and at the societal level in socioeconomic consequences. Insomnia is defined not simply by total sleep time but rather by difficulty in initiation and maintenance of sleep, poor quality of sleep, and a insufficient duration of sleep, such that functioning in the awake state is impaired. Chronic insomnia is prevalent in about 10% of the adult population. However, increasing age is a risk factor for the development of insomnia, especially in women. Late-life insomnia is usually attributed to medical and psychiatric morbidity rather than to age-related changes. Other factors associated with insomnia in the elderly include medications or other substances and primary sleep disorders. Key elements in appropriate evaluation and management include considering the type of insomnia complaint and assessing sleep patterns, including daytime napping, day time consequences, and comorbidity. The effectiveness of phamacologic and nonphamacologic treatments has been demonstrated for late-life insomnia.
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KEYWORD
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Insomnia, Elderly
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