Sleep and Circadian Rhythm Sleep-Wake Disorders

Back to table of contents previous chapternext chapter No AccessChapter 16.Sleep and Circadian Rhythm Sleep-Wake DisordersEdited by:https://doi.org/10.1176/appi.books.9781615375196.ds16AboutSectionsView chapterExcerptView Full Text ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View chapterSectionsNormal Age-Related Changes | Sleep Disorders | Psychiatric and Medical Comorbidities | Medications | Behaviors | Assessment | Treatment | Conclusion | ReferencesExcerptMore than half of persons age 65 years and older report some type of sleep disturbance (Foley et al. 1995), and sleep disturbance is associated with increased risk of significant health consequences in older adults such as increased emergency department use, hospitalization, falls, nursing home placement, and mortality (Spira et al. 2012; Stone et al. 2008; Tzuang et al. 2021; Wallace et al. 2019). Unfortunately, a widespread misconception is that increased sleep disturbance is a normal function of aging. Although some normative changes in sleep are related to aging (Ohayon et al. 2004), sleep disturbance in older adults is not normative and is more likely to occur when common medical and psychiatric issues are present (Foley et al. 1995). Moreover, historically, sleep disturbance has been considered a secondary symptom of medical and psychiatric issues (e.g., chronic pain, depression). However, epidemiological data have supported a comorbid model in which sleep disturbance and medical and psychiatric issues have bidirectional relationships (Afolalu et al. 2018; Bao et al. 2017; Finan et al. 2013). This model supports the idea that all issues may warrant clinical attention, including the often-ignored issue of sleep disturbance. Thus, sleep disturbance is a key area to consider within geriatric psychiatry. In this chapter, we review normative age-related changes in sleep and the most common sleep disorders, medical and psychiatric comorbidities, medications and substances, and psychosocial stressors associated with sleep disturbance in older adults (Table 16–1). We also consider sleep assessment and treatment approaches in older adults. Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byNone The American Psychiatric Association Publishing Textbook of Geriatric Psychiatry Information©American Psychiatric Association Publishing History Published online 8 January 2023 Published in print 9 August 2022