TAILIEUCHUNG - Sleep disorders in the elderly

Stroke is a vascular disease for which mortality and morbidity are relatively well-documented because most stroke victims are admitted to hospitals. Trends in stroke mortality, incidence, and prevalence are somewhat similar to those for other cardiovascular conditions. Stroke mortality has been decreasing since the 1960s, but without a consistent decrease in stroke incidence. Stroke incidence has even been reported to have been higher in the 1980s than during the 1970s, and there was no sustained decline in incidence during the 1990s | Review Article Indian J Med Res 131 February 2010 pp 302-310 Sleep disorders in the elderly Susan K. Roepke Sonia Ancoli-Israel San Diego State University University of California San Diego Joint Doctoral Program in Clinical Psychology Department of Psychiatry University of California San Diego California USA Received November 14 2008 Nearly half of older adults report difficulty initiating and maintaining sleep. With age several changes occur that can place one at risk for sleep disturbance including increased prevalence of medical conditions increased medication use age-related changes in various circadian rhythms and environmental and lifestyle changes. Although sleep complaints are common among all age groups older adults have increased prevalence of many primary sleep disorders including sleep-disordered breathing periodic limb movements in sleep restless legs syndrome rapid eye movement REM sleep behaviour disorder insomnia and circadian rhythm disturbances. The present review discusses age-related changes in sleep architecture aetiology presentation and treatment of sleep disorders prevalent among the elderly and other factors relevant to ageing that are likely to affect sleep quality and quantity. Key words Ageing - circadian - insomnia - REM sleep - sleep - sleep-disordered breathing Introduction Several physical and psychological changes are known to occur with normal ageing however adjustment to changes in sleep quantity and quality can be among the most difficult. Although sleep disturbance is a common complaint among patients of all ages research suggests that older adults are particularly vulnerable. A large study of over 9 000 older adults age of 65 yr found that 42 per cent of participants reported difficulty initiating and maintaining sleep. Follow up assessment 3 yr later revealed that 15 per cent of participants who did not report sleep difficulty at baseline had disturbed sleep suggesting an annual incidence rate of approximately 5 per cent1. .

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