Sleep in the elderly: A practical approach

The elderly commonly complain about the quality and quantity of their sleep. The family physician can assess accurately such symptoms in the office. It is important for the physician to recognize age-related changes in sleep and obtain an accurate history. The correction of enviromental disruptions and transient psychophysiologic problems, the critical evaluation of drug use, and the treatment of underlying medical conditions are important first steps in addressing the complaint of insomnia. Appropriate sleep hygiene and pharmacologic therapy can be helpful in many instances. The family physician, however, must remember that primary sleep disorders are more common in the elderly, and sleep-center referral should be considered if such a disturbance is suspected or if problems persist after conservative therapy.