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Clin Geriatr Med. 2014 Aug;30(3):591-627. doi: 10.1016/j.cger.2014.04.007. Epub 2014 Jun 12.

Sleep in older adults: normative changes, sleep disorders, and treatment options.

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Division of Geriatric Medicine, Department of Medicine, University of Pennsylvania, 3615 Chestnut Street, Philadelphia, PA 19104, USA; Division of Sleep Medicine, Center for Sleep and Circadian Neurobiology, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Electronic address:
Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA.


Approximately 5% of older adults meet criteria for clinically significant insomnia disorders and 20% for sleep apnea syndromes. It is important to distinguish age-appropriate changes in sleep from clinically significant insomnia, with the latter having associated daytime impairments. Non-pharmacologic therapies, such as cognitive-behavioral therapy for insomnia, can be highly effective with sustained benefit. Pharmacologic therapies are also available, but may be associated with psychomotor effects. A high index of suspicion is crucial for effective diagnosis of sleep apnea because symptoms commonly noted in younger patients, such as obesity or loud snoring, may not be present in older patients.


Cognitive-behavioral therapy (CBT); Dementia; Depression; Insomnia; Polysomnography; Positive airway pressure; Sedative-hypnotic; Sleep apnea

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