Sleep disorders in the elderly: Diagnosis and management

Compared with younger people, elderly people show age‐related sleep changes, including an advanced sleep phase and decreased slow‐wave sleep, which result in fragmented sleep and early awakening. Multiple etiologies contribute to insomnia in the elderly, consistent with the observation that elderly people are likely to have comorbid conditions and medications. When elderly individuals complain of insomnia, it is important to assess treatable medical conditions and medication use that may be responsible for the insomnia before the use of hypnotics is initiated. Also, screening for primary sleep disorders, such as sleep apnea syndrome, restless legs syndrome and rapid eye movement sleep behavior disorder, is essential. We review sleep disorders commonly observed in the elderly and describe their diagnosis and management.

• Publication year

  2017

• Venue

  Journal of general and family medicine

• Publication date

  2017-03-30

• Fields of study

  Medicine

• Identifiers
  DOI 10.1002/jgf2.27PMID 29263993PMCID 5689397
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Chapter 86 – Psychological and Behavioral Treatments for Insomnia II: Implementation and Specific Populations

  2017cited by this paper
• Sleep disorders in the elderly: Diagnosis and management

  2017cited by this paper
• Gender Differences in the Efficacy and Safety of Chronic Nightly Zolpidem

  2016cited by this paper
• Effects of Suvorexant, an Orexin Receptor Antagonist, on Respiration during Sleep In Patients with Obstructive Sleep Apnea

  2016cited by this paper
• Benzodiazepine, psychotropic medication, and dementia: A population‐based cohort study

  2016cited by this paper
• Relationship between sleep-disordered breathing and metabolic syndrome after adjustment with cardiovascular risk factors.

  2016cited by this paper
• Pharmacotherapy Treatment Options for Insomnia: A Primer for Clinicians

  2015cited by this paper
• Effects of suvorexant, an orexin receptor antagonist, on breathing during sleep in patients with chronic obstructive pulmonary disease.

  2015cited by this paper
• Insulinoma Masquerading as Rapid Eye Movement Sleep Behavior Disorder

  2015cited by this paper
• Suvorexant in insomnia: efficacy, safety and place in therapy

  2015cited by this paper
• Rapid Eye Movement Sleep Behavior Disorder and Neurodegenerative Disease.

  2015cited by this paper
• Probable RBD and association with neurodegenerative disease markers: A population‐based study

  2015cited by this paper
• Sleep in older adults: normative changes, sleep disorders, and treatment options.

  2014cited by this paper
• [Neurological common diseases in the super-elder society. Topics: V. Dizziness, faintness, numbness and insomnia: 3. Characteristics and treatment of sleep disorders in the elderly].

  2014cited by this paper
• Preventive effects of ramelteon on delirium: a randomized placebo-controlled trial.

  2014cited by this paper
• Sleep Apnea and 20-Year Follow-Up for All-Cause Mortality, Stroke, and Cancer Incidence and Mortality in the Busselton Health Study Cohort

  2014cited by this paper
• Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria--history, rationale, description, and significance.

  2014cited by this paper
• Thalamic glutamate/glutamine in restless legs syndrome

  2013cited by this paper
• Rapid eye movement sleep behavior disorder in adults younger than 50 years of age.

  2013cited by this paper
• Benzodiazepine use and risk of dementia: prospective population based study

  2012cited by this paper
• [The impact of sleep disturbances on neuroendocrine and autonomic functions].

  2012cited by this paper
• Sleep Apnoea Syndrome as a Risk for Mortality in Elderly Inpatients

  2012cited by this paper
• Chapter 36 – Melatonin and the Regulation of Sleep and Circadian Rhythms

  2011cited by this paper
• Benzodiazepine use and risk of dementia: evidence from the Caerphilly Prospective Study (CaPS)

  2011cited by this paper
• Chapter 57 – Cardinal Manifestations of Sleep Disorders

  2011cited by this paper
• A Neurobiological Model of Insomnia.

  2011cited by this paper
• Best practice guide for the treatment of REM sleep behavior disorder (RBD).

  2010cited by this paper
• Treatment of insomnia in depressed insomniacs: effects on health-related quality of life, objective and self-reported sleep, and depression.

  2010cited by this paper
• Violent behavior during sleep: prevalence, comorbidity and consequences.

  2010cited by this paper
• Cardiovascular disease risk reduction with sleep apnea treatment

  2010cited by this paper
• REM sleep behavior disorder

  2010cited by this paper
• Effectiveness of ramelteon for insomnia symptoms in older adults with obstructive sleep apnea: a randomized placebo-controlled pilot study.

  2010cited by this paper
• Treatment of insomnia in Parkinson's disease: A controlled trial of eszopiclone and placebo

  2010cited by this paper
• Physician-diagnosed restless legs syndrome in a large sample of primary medical care patients in western Europe: Prevalence and characteristics.

  2010cited by this paper
• Pharmacology of Ramelteon, a Selective MT1/MT2 Receptor Agonist: A Novel Therapeutic Drug for Sleep Disorders

  2009cited by this paper
• The clinical and pathophysiological relevance of REM sleep behavior disorder in neurodegenerative diseases.

  2009cited by this paper
• The REM sleep behavior disorder screening questionnaire: validation study of a Japanese version.

  2009cited by this paper
• Sleep and society: an epidemiological perspective.

  2009cited by this paper
• A review of ramelteon in the treatment of sleep disorders

  2008cited by this paper
• Suprachiasmatic nucleus and melatonin

  2008cited by this paper
• Sleep apnea as an independent risk factor for all-cause mortality: the Busselton Health Study.

  2008cited by this paper
• Subjective and Objective Sleep Quality and Aging in the Sleep Heart Health Study

  2008cited by this paper
• Actigraphy-measured sleep characteristics and risk of falls in older women.

  2008cited by this paper
• Association Between Sleep and Physical Function in Older Men: The Osteoporotic Fractures in Men Sleep Study

  2008cited by this paper
• Successful treatment with Yi-Gan San for rapid eye movement sleep behavior disorder.

  2008cited by this paper
• The REM sleep behavior disorder screening questionnaire—A new diagnostic instrument

  2007cited by this paper
• Brief introduction to second edition of International Classification of Sleep Disorders:Diagnostic and Coding Manual

  2007cited by this paper
• Circadian control of the sleep-wake cycle.

  2007cited by this paper
• Insomnia in the elderly: cause, approach, and treatment.

  2006cited by this paper
• Insomnia as a Risk Factor for Onset of Depression in the Elderly

  2006cited by this paper
• Consequences of comorbid insomnia symptoms and sleep-related breathing disorder in elderly subjects.

  2006cited by this paper
• Overview of currently available benzodiazepine and nonbenzodiazepine hypnotics

  2006cited by this paper
• Does insomnia kill?

  2005cited by this paper
• Correlates of sleep complaints in adults: the ARIC study.

  2005cited by this paper
• Long-term effects of nasal continuous positive airway pressure therapy on cardiovascular outcomes in sleep apnea syndrome.

  2005cited by this paper
• Excessive Daytime Sleepiness among the Japanese General Population

  2005cited by this paper
• Severe obstructive sleep apnea/hypopnea mimicking REM sleep behavior disorder.

  2005cited by this paper
• A systematic review of non-pharmacological therapies for sleep problems in later life.

  2004cited by this paper
• Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan.

  2004cited by this paper
• Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health.

  2003cited by this paper
• Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study.

  2002cited by this paper
• Non-benzodiazepines for the treatment of insomnia.

  2000cited by this paper
• An epidemiological study of insomnia among the Japanese general population.

  2000cited by this paper
• Incidence and remission of insomnia among elderly adults in a biracial cohort.

  1999cited by this paper
• Incidence and remission of insomnia among elderly adults: an epidemiologic study of 6,800 persons over three years.

  1999cited by this paper
• Insomnia in older adults.

  1998cited by this paper
• REM sleep behaviour disorder in the elderly

  1997cited by this paper
• Violent behavior during sleep.

  1997cited by this paper
• Terry: Violent Behavior During Sleep

  1997cited by this paper
• The International Classification of Sleep Disorders

  1992cited by this paper
• A behavioral perspective on insomnia treatment.

  1987cited by this paper

• Sleep deprivation and memory: A neurobiological perspective

  2026cites this paper
• Experience of patients suffering from insomnia with a focus on their perceptions and therapeutic journey.

  2026cites this paper
• Do your exercise and you’ll sleep well: interweaving sleep quality and physical activity engagement

  2026cites this paper
• Effects of bright light and near-infrared light on insomnia symptoms in community-dwelling older adults: a randomized clinical trial.

  2026cites this paper
• Joint associations of device-measured step count and sleep duration with incident major adverse cardiovascular events: prospective analysis of the UK Biobank

  2026cites this paper
• Cognitive and behavioral therapies for insomnia: must they always be in bed together?

  2025cites this paper
• Evaluating Suicidal Ideation and Anhedonic Symptoms in Obstructive Sleep Apnea Patients with Insomnia

  2025cites this paper
• Loneliness and Mental Health Disorders in Older Adults Living in Portugal During the COVID-19 Pandemic: A Cross-Sectional Study

  2025cites this paper
• Molecular and Clinical Perspectives on the Regulation of Sleep and Uric Acid Metabolism

  2025cites this paper
• Impact of insomnia: Cultural and societal aspects from a European survey.

  2025cites this paper
• Long sleep duration and good sleep quality reduced incident peptic ulcer disease in a large Taiwanese population follow-up study

  2025cites this paper
• Yaşlılarda Uyku Bozuklukları

  2025cites this paper
• Wakefulness after sleep offset and the elevated risk of mortality in older adults with evening preferences: A community-based 5-year longitudinal study.

  2025cites this paper
• Effect of a home-based videoconferencing exercise training program on circadian rhythms and sleep quality in healthy older adults.

  2025cites this paper
• Association of multiple symptoms with sleep quality and duration: a cross-sectional population-based study of older men in Sweden

  2025cites this paper
• Edge Intelligence: A Deep Distilled Model for Wearables to Enable Proactive Eldercare

  2025cites this paper
• Association Between Kyphosis and Sleep Disturbance in Community-Dwelling Older Adults: The Locomotive Syndrome and Health Outcome in Aizu Cohort Study

  2025cites this paper
• The Relationship Between Sleep Quality and Emotional Well-Being in Older Adults

  2025cites this paper
• Combined Auricular Acupoint Pressing and Intradermal Acupuncture for Insomnia and Glycemic Control in Elderly Patients with Type 2 Diabetes: A Retrospective Study

  2025cites this paper
• Phenomenological Experiences of Grief Among Elderly Following Family Loss in Indonesia: A Roy’s Adaptation Model–Based Inquiry

  2025cites this paper
• Association Between Preoperative Sleep Disturbance and Postoperative Delirium in Adults Undergoing Elective Surgery

  2025cites this paper
• Recreational cannabis use and sleep in the general population: a systematic review and meta-analysis.

  2025cites this paper
• Excess risk of falls and fractures amongst older people with sedative-hypnotic polypharmacy: an analysis of Korean National Health Insurance Senior Cohort Database.

  2025cites this paper
• The Impact of Wet Cupping on Sleep Quality in Healthy People at Medan City Health Clinic

  2025cites this paper
• ИНСОМНИЯ КАК ТРАНСДИАГНОСТИЧЕСКИЙ ФЕНОМЕН У ПОЖИЛЫХ С ДЕПРЕССИВНЫМИ И ТРЕВОЖНЫМИ РАССТРОЙСТВАМИ

  2024cites this paper
• Análise da situação de saúde dos idosos usuários de uma política municipal de atividades físicas

  2024cites this paper
• Impact of sleep duration and sleep disturbances on the incidence of dementia and Alzheimer's disease: A 10-year follow-up study.

  2024cites this paper
• The predictors of sleep quality in mothers of children with autism spectrum disorders in the west of Iran: A path analysis

  2024cites this paper
• Sleep health challenges among women: insomnia across the lifespan

  2024cites this paper
• Associations between self-reported sleep duration and incident cardiovascular diseases in a nationwide prospective cohort study of Chinese middle-aged and older adults

  2024cites this paper
• The context of COVID-19 affected the long-term sleep quality of older adults more than SARS-CoV-2 infection

  2024cites this paper
• Prevalence of Poor Quality of Sleep among the Elderly Population: A Community-based Cross-sectional Study

  2024cites this paper
• The lifestyle of new middle-aged and older adults in Taiwan described by wearable device: age and gender differences

  2024influential citation
• Sleep Deficiency in the Elderly.

  2024cites this paper
• [Effectiveness of Anvifen in the treatment of insomnia in elderly patients].

  2024cites this paper
• Intervention for sleep problems in nursing home residents with dementia: a cluster-randomized study

  2024cites this paper
• Comparing the Prevalence of Sleep Disorders Among Underweight, Normal, Overweight, and Obese Adults in Riyadh, Saudi Arabia

  2024cites this paper
• Multiarmed Bandits for Sleep Recognition of Elderly Living in Single-Resident Smart Homes

  2024cites this paper
• The relationship between childhood adversity and sleep quality among rural older adults in China: the mediating role of anxiety and negative coping

  2024cites this paper
• Increased Steps in Japanese Older Adults Associated with Improved Winter Sleep Quality

  2024cites this paper
• Evaluating the efficacy of a modified mindfulness program in enhancing psychosocial wellbeing and cognitive functions of community dwelling older adults

  2024cites this paper
• Relationship of Physical Activity with Sleep Disturbance and Anxiety in Medical Students of Sahiwal

  2024cites this paper
• Effect of Care-as-Usual Plus Intervention on Sleep, Fatigue, and Quality of Life Among Geriatric Persons With Insomnia

  2024cites this paper
• Sex disparity in stroke risk among patients with insomnia: a 19-year prospective cohort study

  2024cites this paper
• Use of mHealth Technologies to Increase Sleep Quality among Older Adults: A Scoping Review

  2024cites this paper
• Association between sleep quality and blood pressure control among hypertensive patients at a rural tertiary hospital in Southern Nigeria: a cross-sectional study

  2024cites this paper
• Relationship between traits and sleep quality of hospitalized elderly patients and sleep quality of family caregivers

  2023cites this paper
• Associations between Sleep Quality, Frailty, and Quality of Life among Older Adults in Community and Nursing Home Settings

  2023cites this paper
• Mediation of the association between multi-morbidity and sleep problems by pain and depressive symptoms among older adults: Evidence from the Longitudinal Aging Study in India, wave- 1

  2023cites this paper
• Yaşlı Hastalarda Uyku Süresi İle Koroner Arter Hastalığı İlişkisi

  2023cites this paper
• The Impact of the Six Pillars of Lifestyle Medicine on Brain Health

  2023cites this paper
• A Comparative Study on Health Risks, Lifestyle Behaviors, Health Perceptions, and Health Seeking Patterns between Older and Younger Filipinos in the Rural Areas.

  2023cites this paper
• The influencing factors of night sleep time and nap time among older adults in China: a national study

  2023cites this paper
• The unintended consequences of COVID-19 pandemic in Argentina: the case of sleep disorders during lockdown

  2023cites this paper
• Sleep Disorders and Cognitive Aging among Cognitively Impaired vs. Unimpaired Older Adults.

  2023cites this paper
• Mindfulness-based therapy improves brain functional network reconfiguration efficiency

  2023cites this paper
• Parasomnias and Associated Factors Among University Students: A Cross-Sectional Study in Saudi Arabia

  2023cites this paper
• Relationship between hypercholesterolemia and sleep quality among older adults

  2023cites this paper
• Sintomas depressivos e sono de idosos cuidadores inseridos em contexto de alta vulnerabilidade social

  2023cites this paper
• The Relationship Between Sleep and Brain Function in Older Adults With Chronic Kidney Disease and Self-Identified Cognitive Impairment.

  2023cites this paper
• Concurrence of insomnia and daytime sleepiness predicted 9-year mortality risk in community-dwelling older adults: the Yilan study, Taiwan.

  2023cites this paper
• Laughter Therapy Card for Sleep Disorder Older Adults in Lubuklinggau City

  2023cites this paper
• Prevalence of poor sleep quality and associated factors among the elderly in Amirkola, Iran

  2023cites this paper
• Sleep and insomnia.

  2023cites this paper
• Prevalence, Severity, and Predictors of Insomnia in Advanced Colorectal Cancer.

  2023cites this paper
• Examining Physical Wellness as the Fundamental Element for Achieving Holistic Well-Being in Older Persons: Review of Literature and Practical Application in Daily Life

  2023cites this paper
• Attitudes and knowledge of nurses working at night and sleep promotion in nursing home residents: multicenter cross-sectional survey

  2023cites this paper
• How Does Chronobiology Contribute to the Development of Diseases in Later Life

  2023cites this paper
• Is Burning Mouth Syndrome Associated with Extraoral Dryness? A Systematic Review

  2023cites this paper
• Computerized detection of cyclic alternating patterns of sleep: A new paradigm, future scope and challenges

  2023cites this paper
• Visual red-light stimulation for improving sleep quality in older adults

  2023cites this paper
• Depressive symptoms and sleep in aged caregivers in a context of high social vulnerability.

  2023cites this paper
• University of Birmingham Active aging and public health

  2022cites this paper
• Factors associated with short and long sleep duration in older adults: Analysis of a national survey in Japan

  2022cites this paper
• Prevalence and determinants of physical activity, sedentary behaviour and fatigue five years after total knee replacement

  2022cites this paper
• Effectiveness of aquatic therapy on sleep in persons with fibromyalgia. A meta-analysis.

  2022cites this paper
• Healthy Lifestyle, Autonomic Nervous System Activity, and Sleep Status for Healthy Aging

  2022cites this paper
• Hand Grip Strength as an Index of Health Does Not Associate With Insomnia: A Cross-Sectional Study

  2022cites this paper
• Effect of sleep hygiene training given to elderly individuals on daytime sleepiness and fatigue: A randomized controlled trial.

  2022cites this paper
• Contributing risk factors of common psychiatric disorders in the Pakistani population

  2022cites this paper
• A protocol for systematic review and meta-analysis

  2022cites this paper
• Using a Non-Wearable Actigraphy in Nursing Care for Dementia With Lewy Bodies

  2022influential citation
• The association between loneliness and sleep quality among older adults: A systematic review and meta-analysis.

  2022cites this paper
• The Use of Visual Material on Sleep Hygiene in Improving Sleep Quality in Patients Prior to Colorectal Surgery: A Randomized Controlled Study

  2022cites this paper
• Factors Associated With Experiences of Fear, Anxiety, Depression, and Changes in Sleep Pattern During the COVID-19 Pandemic Among Adults in Nigeria: A Cross-Sectional Study

  2022cites this paper
• Time-restricted feeding and cognitive function in sedentary and physically active elderly individuals: Ramadan diurnal intermittent fasting as a model

  2022cites this paper
• SLEEP QUALITY AND AFFECTING FACTORS AMONG ELDERLY LIVING IN A NURSING HOME AT EAST NUSA TENGGARA INDONESIA

  2022cites this paper
• mPFC-rTMS for patients with insomnia disorder using resting-state functional magnetic resonance imaging: a protocol for a randomized controlled trial

  2022cites this paper
• Correlates of Sleep Disturbance Experienced by Informal Caregivers of Persons Living with Dementia: A Systematic Review

  2022cites this paper
• Linking chronic stress to insomnia symptoms in older adults: The role of stress co‐occurrence during the pandemic

  2022cites this paper
• Incidence Of Restless Leg Syndrome Among Medical School Faculty Members

  2022cites this paper
• Yaşlı depresyon hastalarında uykusuzluk tedavisinde kullanılan uyku ilaçları ve uyku hijyeninin rolü

  2022cites this paper
• Gut microbiome changes due to sleep disruption in older and younger individuals: a case for sarcopenia?

  2022cites this paper
• Sleep Quality in the Admitted Elderly: A Prospective Observational Study in Eastern India

  2022cites this paper
• Sleep Deficiency in the Elderly.

  2022cites this paper
• Clinical Differences of Insomnia Subtype According to Actigraphy Based Objective Short Sleep, Subjective Short Sleep, and Normal Sleep

  2022cites this paper
• The effects of a real-life lifestyle program on physical activity and objective and subjective sleep in adults aged 55+ years

  2022cites this paper
• The Effectiveness of a Multi-Sensory Sleep-Promotion Program on Sleep Quality among Hospitalized Older Adults of Thailand: A Quasi-Experimental Study

  2022cites this paper
• Effects of mindfulness‐based therapy for insomnia and a sleep hygiene/exercise programme on subjective‐objective sleep discrepancy in older adults with sleep disturbances: Exploratory secondary analysis of a randomised clinical trial

  2022cites this paper
• Efficacy and safety of tuina for senile insomnia

  2022cites this paper