Sleep disorders in the elderly

Sleep is important for health and quality of life at all ages, and poor sle ep interacts with many medical conditions. Somatic and psychiatric diseases , and unfavourable habits and life-style factors, increase the propensity t o insomnia in older persons. As health deteriorates with age, sleep becomes poorer. Heart disease and stroke, cancer, painful conditions, breathing di sorders and nocturnal polyuria syndrome often disturb sleep. Dementia and d epression, which are often associated with sleep disturbances, are also mor e prevalent in the elderly. More over, true age-related sleep deterioration occurs after the age of 75 years. Attempts to improve sleep should first and foremost be focused on eliminati on of somatic and psychiatric symptoms as far as possible, and on modificat ion of lifestyle factors that may affect sleep quality. For short term trea tment, hypnotics are appropriate: for longer periods, nonpharmacological me thods. for example light therapy or behavioural modification techniques, sh ould be considered, as many hypnotic drugs are less suitable for long term use. However, there are situations when sleep medication must continue for long periods, especially in elderly patients with severe diseases and poor quality of life. In these patients, careful individualisation of therapy is appropriate.