Insomnia in the elderly

Sleep and aging There are many health-related changes that occur in older adulthood that are associated with reduced quality of life. Among the most prominent are changes in sleep patterns. These changes are accompanied by a greater likelihood of poor sleep and they become more significant with age. Furthermore, advancing age is also associated with a significant increase in the occurrence and severity of insomnia. This chapter will briefly address age-related changes in sleep and the nature, assessment, diagnosis, and epidemiology of older adults with insomnia (OAWI) from a behavioral sleep medicine perspective. Through the use of electroencephalography, electro-oculogram, and electromyogram, five stages of sleep have been identified that serve different and specific functions during a typical night of sleep. An in-depth discussion of these stages is beyond the scope of this chapter. However, these stages will be mentioned as they pertain to changes that occur with aging. The structure, duration, depth, and continuity of sleep changes with age. As we age, our sleep typically becomes shorter, lighter, and more disjointed. Older adults tend to spend less time in deep sleep (stages 3 and 4) and more time in stages 1 and 2, which results in overall lighter sleep. This can increase the likelihood that environmental antagonists, such as light and noise, will interrupt sleep. Older adults also tend to have shorter average sleep durations compared to younger adults, although they typically do not report a decreased need for sleep.