Abstract
Insomnia is a problem in all stages of life but is particularly common after age 65. A number of factors--including advanced age, psychosocial influences, medical illness, and the use of medications and alcohol--may disturb sleep architecture. Evaluation of insomnia in the older patient requires a careful history and physical examination, supplemented by a sleep diary. Treatment of underlying conditions and nonpharmacologic improvements in sleep hygiene are first-line therapy, but pharmacologic agents such as benzodiazepines, nonbenzodiazepine hypnotics, or antidepressants may be needed. Nonbenzodiazepines with rapid elimination may offer a lower side-effect profile than other hypnotic agents when used for insomnia in the older population.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Adaptation, Psychological
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Aged
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Aging / physiology*
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Antidepressive Agents, Tricyclic / adverse effects
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Antidepressive Agents, Tricyclic / therapeutic use*
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Drug-Related Side Effects and Adverse Reactions
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Female
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Health Status
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Humans
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Hypnotics and Sedatives / adverse effects
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Hypnotics and Sedatives / therapeutic use*
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Male
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Mental Disorders / complications
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Relaxation Therapy
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Self Medication / adverse effects
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Sleep / physiology*
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Sleep Initiation and Maintenance Disorders / drug therapy*
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Sleep Initiation and Maintenance Disorders / etiology*
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Sleep Initiation and Maintenance Disorders / physiopathology
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Sleep Initiation and Maintenance Disorders / psychology
Substances
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Antidepressive Agents, Tricyclic
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Hypnotics and Sedatives