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The demented elder with insomnia.

Miguel A Paniagua1, Elizabeth W Paniagua

  • 1Division of Gerontology & Geriatric Medicine, Saint Louis University School of Medicine, 1402 South Grand Boulevard, Room M238, Saint Louis, MO 63104, USA. mpaniag1@slu.edu

Clinics in Geriatric Medicine
|November 24, 2007
PubMed
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Elderly individuals with dementia often suffer from sleep problems. Non-pharmacologic interventions are recommended before considering medication for insomnia in this population.

Area of Science:

  • Gerontology
  • Sleep Medicine
  • Neurology

Background:

  • High prevalence of sleep disturbances in elders with dementia.
  • Sleep issues manifest as agitation, sleep-disordered breathing, and daytime napping.
  • Contextual factors like caregivers and living environment influence sleep in demented elders.

Purpose of the Study:

  • To discuss the challenges in evaluating and treating insomnia in elderly patients with dementia.
  • To outline an optimal treatment approach for insomnia in this demographic.

Main Methods:

  • Literature review and clinical experience synthesis.
  • Emphasis on non-pharmacologic interventions.
  • Consideration of broader patient context.

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Main Results:

  • Treatment for insomnia in demented elders is complex and lacks extensive evidence.
  • Non-pharmacologic strategies are often the initial approach.

Conclusions:

  • A 'less is better' strategy is advised for non-pharmacologic interventions.
  • Prioritizing non-drug therapies before medication is the optimal first step for managing insomnia in elders with dementia.