Assessment and treatment of sleep disturbances in older adults

Sleep disturbances are common in older adults. These disturbances are often secondary to medical illness and/or medication use or are due to specific problems such as sleep disordered breathing, periodic limb movements in sle ep and circadian rhythm disturbances. The prevalence of sleep disordered br eathing and periodic limb movement in sleep increases with age. The circadi an rhythm tends to advance with age, causing older people to awaken early i n the morning. Insomnia is often caused by pain associated with medical ill ness. Insomnia can also be caused by stimulating medications. In institutio nalized elderly, sleep becomes even more disturbed and fragmented than in c ommunity-dwelling older adults. Accurate assessment and diagnosis is crucia l since Effective treatment strategies are available for these sleep distur bances. The effect, prevalence and treatment of each of these conditions is reviewed. (C) 2000 Elsevier Science Ltd.