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Sleep disorders in the elderly and their management
1Unité d'explorations fonctionnelles du sujet âgé, AP-HP. Sorbonne Université, Hôpital Charles-Foix, Ivry-sur-Seine, France.
L'Encephale
|April 10, 2026
Summary
Sleep aging involves circadian changes but preserved homeostatic drive. Management prioritizes non-pharmacological Cognitive Behavioral Therapy for Insomnia (CBT-I) for older adults with sleep disturbances.
Area of Science:
- Gerontology
- Sleep Medicine
- Neuroscience
Background:
- Sleep aging is a complex process involving circadian rhythm alterations like phase advance and reduced melatonin.
- Homeostatic sleep drive is generally preserved in older adults.
- Sleep changes include fragmentation, decreased slow-wave sleep, and reduced efficiency, often compensated by adaptation.
Purpose of the Study:
- To review the physiological changes in sleep during aging.
- To discuss factors contributing to sleep disturbances in older adults.
- To outline current management strategies for geriatric sleep issues.
Main Methods:
- Literature review of sleep aging mechanisms.
- Analysis of factors contributing to sleep disturbances in the elderly.
- Evaluation of non-pharmacological and pharmacological treatment approaches.
Main Results:
- Circadian regulation changes (phase advance, less melatonin) characterize sleep aging.
- Sleep fragmentation, reduced deep sleep, and lower efficiency are common.
- Comorbidities, polypharmacy, and external factors significantly impact sleep in 50% of older adults.
Conclusions:
- Comprehensive management is essential for geriatric sleep disturbances.
- Cognitive Behavioral Therapy for Insomnia (CBT-I) is the recommended first-line treatment.
- Vigilance for conditions like Restless Legs Syndrome and REM Sleep Behavior Disorder is crucial, especially in alpha-synucleinopathies.
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