Insomnia In Older Adults
Insomnia in the older adult significantly impacts the normal physical functioning and quality of life of patients. Evidence suggests that insomnia in the elderly is often overlooked, or undertreated by healthcare professionals (Moren & Benka, 2012). Cognitive behavioral strategies have been recommended to help relieve and even treat insomnia in the elderly (Moren & Benka, 2012). The purpose of this paper is to examine the current evidence supporting the use of cognitive behavioral therapy (CBT) in the management of insomnia in the older adult. Analysis of evidence derived from current studies will influence practice change recommendations and provider interventions at the primary care level. The change in practice at the primary care
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The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders defines insomnia as (a) difficulty initiating sleep (sleep onset), maintaining sleep (sleep maintenance), and/or poor quality of sleep for at least 1 month and (b) causing clinically significant distress or impairment in social, occupational, or other areas of functioning (American Psychiatric Association, 2013). Insomnia can be classified into acute (less than 4 weeks) and chronic (more than 4 weeks) depending upon duration. Chronic insomnia can be further divided into primary or secondary insomnia. Primary insomnia is sleeplessness that cannot be attributed to an existing medial, psychiatric or environmental cause (such as drug abuse or medications). Secondary insomnia is when symptoms of insomnia arise from a primary medical illness, mental disorders or other sleep disorders. It may also arise from the use, abuse or exposure to certain substances (American Academy of Sleep Medicine, …show more content…
Pharmacotherapy usually involves the use of both benzodiazepines, or hypnotic agents, and non-benzodiazepines (Doghramji, 2010). These medications have been shown to improve insomnia symptoms in the short term, but there is minimal evidence for the effective ness of these medications in the long-term. Additionally, this particular population is at an increased risk of polypharmacy, falls, and adverse reactions related to declining renal function to these types of medications. The 2012 Beers Criteria recommends against the use of all benzodiazepine medications in threating insomnia among older adults (American Geriatrics Society,
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders defines insomnia as (a) difficulty initiating sleep (sleep onset), maintaining sleep (sleep maintenance), and/or poor quality of sleep for at least 1 month and (b) causing clinically significant distress or impairment in social, occupational, or other areas of functioning (American Psychiatric Association, 2013). Insomnia can be classified into acute (less than 4 weeks) and chronic (more than 4 weeks) depending upon duration. Chronic insomnia can be further divided into primary or secondary insomnia. Primary insomnia is sleeplessness that cannot be attributed to an existing medial, psychiatric or environmental cause (such as drug abuse or medications). Secondary insomnia is when symptoms of insomnia arise from a primary medical illness, mental disorders or other sleep disorders. It may also arise from the use, abuse or exposure to certain substances (American Academy of Sleep Medicine, …show more content…
Pharmacotherapy usually involves the use of both benzodiazepines, or hypnotic agents, and non-benzodiazepines (Doghramji, 2010). These medications have been shown to improve insomnia symptoms in the short term, but there is minimal evidence for the effective ness of these medications in the long-term. Additionally, this particular population is at an increased risk of polypharmacy, falls, and adverse reactions related to declining renal function to these types of medications. The 2012 Beers Criteria recommends against the use of all benzodiazepine medications in threating insomnia among older adults (American Geriatrics Society,