Management of Insomnia in the Geriatric PatientInsomnia
Studies have found insomnia, defined as the inability to initiate or maintain sleep resulting in daytime consequences, to be the most common sleep disturbance in older adults (Reid et al. 2006), with up to 40%–50% of those over the age of 60 reporting disturbed sleep (Foley et al. 1995). However, the annual incidence rate is estimated to be 5% in those over the age of 65 (Foley et al. 1999). Complaints range from difficulty falling asleep, to difficulty with sleep maintenance to frequent nighttime awakenings and early morning awakenings. Gender differences exist as well, with women being more likely to complain about insomnia than men (Rediehs, Reis, & Creason 1990).
There are a variety of factors associated with the development of insomnia in the elderly including depression and psychological distress, medical conditions, medications, and circadian rhythm disturbances (Ancoli-Israel 2000). Foley et al. (Foley, Monjan, Simonsick, Wallace, & Blazer 1999) reported that while 28% of older adults suffered from complaints of chronic insomnia, only 7% of the incident cases of insomnia in the elderly occur in the absence of one of these risk factors.