299 SLEEP MEDICINE CLINICS Sleep Med Clin 1 (2006) 299 303 Note: Page numbers of article titles are in boldface type. A Acid reflux, sleep disturbances in older adults related to, 238 Aging, alterations in Circadian rhythms with, Circadian amplitude, 189 Circadian clock, 188 responsiveness of to photic and nonphotic stimuli, 188 189 Circadian phase, 189 190 decreased exposure to synchronizing agents, 190 192 entrainment of, 190 manipulation of, therapeutic implications, 192 neurobiology of, 187 188 normal, sleep and cognition in, 207 220 normal, sleep in, 171 176 causes of disturbed sleep in, 174 175 Circadian rhythms in, 173 napping and excessive daytime sleepiness in, 173 174 Alcohol dependence, sleep disturbances in older adults due to, 235 236 Alternative therapies, non-hormonal, impact on sleep in midlife women, 202 Alzheimer s disease, sleep disturbances in patients with, 274 277 Circadian rhythm disturbances in, 276 sleep architecture in, 275 276 sleep-disordered breathing in, 276 treatment of, 276 277 Amyotrophic lateral sclerosis, sleep disturbances in elderly patients with, 284 Anxiety disorders, sleep disturbances in older adults due to, 234 235 Arthritis, sleep disturbances in older adults related to, 237 B Behavioral treatments, for sleep disturbances in nursing homes, 295 296 Bereavement, sleep disturbances in older adults due to stresses of, 234 Bipolar affective disorder, sleep disturbances in older adults due to, 234 Breathing disorders, sleep-related, in the elderly, 247 262 clinical assessment and management, 255 257 presentation and diagnosis, 255 256 treatment, 256 257 clinical features, 248 249 epidemiology, 249 250 prevalence and incidence, 249 250 risk factors, 250 in nursing home patients, 296 morbidity and mortality associated with, 250 255 cardiovascular consequences, 250 252 cognitive impairment and dementia, 253 254 falls and fractures, 254 255 metabolic consequences, 252 253 mortality, 254 physiologic features, 248 C Caffeine, sleep disturbances in older adults due to, 236 Cancer, sleep disturbances in older adults related to, 239 Cardiovascular consequences, of sleep-disordered breathing in the elderly, 250 252 Caregiving, sleep disturbances in older adults due to demands of, 234 1556-407X/06/$ see front matter ª 2006 Elsevier Inc. All rights reserved. sleep.theclinics.com doi:10.1016/s1556-407x(06)00049-x
300 Circadian rhythms, alterations in, with aging, Circadian amplitude, 189 Circadian clock, 188 responsiveness of to photic and nonphotic stimuli, 188 189 Circadian phase, 189 190 decreased exposure to synchronizing agents, 190 192 entrainment of, 190 manipulation of, therapeutic implications, 192 neurobiology of, 187 188 disturbances of, in Alzheimer s diseases, 276, in normal aging, 173 Cognition, sleep and, in older adults, 207 220 aging and sleep, 207 208 diagnosed sleep disorders, 211 212 insomnia and, 212 213 napping and, 211 normal aging and cognition, 208 209 obstructive sleep apnea and, 213 214 perceived poor sleep quality and excessive daytime sleepiness, 209 210 potential mechanisms of relationship between, 214 215 sleep deprivation, 210 211 Cognitive behavior therapy, for insomnia in the elderly, 224 227 common models of, 226 hypnotic-dependent, 227 primary, 225 secondary or comorbid, 225, 227 Cognitive impairment, as consequence of sleepdisordered breathing in the elderly, 253 254 Comorbidities, affecting sleep in older adults, 231 245 medical conditions, 237 239 acid reflux and gastroesophageal reflux disease, 238 arthritis, 237 cancer, 239 chronic lung disease, 238 239 diabetes and endocrine disorders, 239 heart disease, 238 pain, 237 renal and urologic disorders, 239 medications, 240 241 that activate or stimulate the CNS, 240 that affect sleep architecture by other mechanisms, 241 that affect sleep by worsening other conditions, 240 241 that exacerbate primary sleep disorders, 241 that promote daytime sleepiness, 240 psychiatric conditions, 233 235 anxiety disorders, 234 235 bipolar affective disorder, 234 D caregiving and bereavement, 234 depressive disorders, 233 substance abuse, 235 237 alcohol dependence, 235 236 caffeine, 236 neurotransmitter overlap between psychiatric illness and, 236 237 tobacco and nicotine, 236 Daytime sleepiness, in older adults, correlates and consequences of napping and, 180 184 excessive, in normal aging, 173 Circadian rhythm changes, 180 disruption of nighttime sleep, 180 medical and psychiatric factors, 180 Daytime sleeping, in nursing home patients, interventions to reduce, 296 Dementia, as consequence of sleep-disordered breathing in the elderly, 253 254 diffuse Lewy body, sleep disturbances in elderly patients with, 281 restless legs syndrome in, 266 267 Depressive disorders, sleep disturbances in older adults due to, 233 Diabetes, sleep disturbances in older adults related to, 239 Diffuse Lewy body dementia, sleep disturbances in elderly patients with, 281 Disruption, of sleep, in nursing home patients, 294 Disturbances, sleep, in normal aging, 174 175 in nursing home patients, consequences of, 294 295 disruption of sleep, 294 environmental influences on, 294 interventions to reduce daytime sleeping in, 296 methods used to study, 294 sleep-disordered breathing, 296 treatment of, 295 296 behavioral, 295 296 pharmacologic, 295 Drugs, pharmaceutical, for treatment of sleep disturbances in nursing homes, 295 E Elderly, sleep in, 171 298 breathing disorders, sleep-related, 247 262 circadian rhythm alterations with aging, cognition and, in older adults, 207 220 comorbidities and, 231 245 in midlife women, 197 205 in normal aging, 171 176 insomnia, 221 229
301 napping in older adults, 177 186 neurologic problems and, 273 292 periodic leg movements and restless legs syndrome, 263 271 sleep disturbances in nursing home patients, Endocrine disorders, sleep disturbances in older adults Environment, in nursing homes, influence on sleep, 294 Epilepsy, sleep disturbances in elderly patients with, 282 283 Excessive daytime sleepiness, in normal aging, 173 174 in older adults, impact on cognition, 209 210 F Falls, as consequence of sleep-disordered breathing in the elderly, 254 255 Fractures, as consequence of sleep-disordered breathing in the elderly, 254 255 G Gastroesophageal reflux disease, sleep disturbances in older adults related to, 238 Geriatrics. See Elderly and Older adults. H Health outcomes, in older adults, effect of napping and daytime sleepiness on, 182 184 Heart disease, sleep disturbances in older adults related to, 238 Hormone replacement therapy, impact on sleep in midlife women, 201 202 Huntington s disease, sleep disturbances in elderly patients with, 285 Hypnotics, for treatment of insomnia in the elderly, 223 224 cognitive behavior therapy for hypnoticdependent insomnia, 227 types of, 223 224 I Insomnia, in older adults, impact on cognition, 212 213 in the elderly, 221 229 assessment, 223 cognitive behavior therapy for, 224 227 common models of, 226 hypnotic-dependent, 227 primary, 225 secondary or comorbid, 225, 227 L diagnosis, 222 223 clinical features, 222 contributing factors, 222 daytime functioning in, 223 epidemiology, 221 222 pharmacologic treatments, 223 224 types of hypnotics, 223 224 Lung disease, chronic, sleep disturbances in older adults related to, 238 239 M Medical conditions, comorbidities affecting sleep in older adults, 237 239 acid reflux and gastroesophageal reflux disease, 238 arthritis, 237 cancer, 239 chronic lung disease, 238 239 diabetes and endocrine disorders, 239 heart disease, 238 pain, 237 renal and urologic disorders, 239 sleep disturbances due to, in older adults, 231 245 Medications. See also Pharmacologic therapy. comorbidities affecting sleep in older adults, 240 241 that activate or stimulate the CNS, 240 that affect sleep architecture by other mechanisms, 241 that affect sleep by worsening other conditions, 240 241 that exacerbate primary sleep disorders, 241 that promote daytime sleepiness, 240 Menopause, sleep in midlife women, 197 205 Metabolic consequences, of sleep-disordered breathing in the elderly, 252 253 Midlife women, sleep in, 197 205 menopause and, 198 Mortality, due to sleep-disordered breathing in the elderly, 254
302 Multiple sclerosis, sleep disturbances in elderly patients with, 283 Multiple Sleep Latency Test, for sleep disorders in elderly patients with neurodegenerative disease, 286 Multiple system atrophy, sleep disturbances in elderly patients with, 281 282 Myotonic dystrophy, sleep disturbances in elderly patients with, 285 N Napping, in older adults, 177 186 beneficial effects of, 184 correlates and consequences of daytime sleepiness and, 180 184 daytime sleepiness in, 179 180 causes, 180 in normal aging, 173 174 prevalence, 177 179 in older adults, impact on cognition, 211 Neurobiology, of Circadian rhythms, 187 188 Neurodegenerative diseases, sleep disturbances in elderly patients with, 273 292 Alzheimer s disease, 274 277 amyotrophic lateral sclerosis, 284 diagnostic approaches to, 286 clinical assessment, 286 laboratory assessment, 286 Multiple Sleep Latency Test, 286 polysomnography, 286 diffuse Lewy body dementia, 281 epilepsy, 282 283 Huntington s disease, 285 multiple sclerosis, 283 multiple system atrophy, 281 282 myotonic dystrophy, 285 olivopontocerebellar degeneration, 282 Parkinson s disease, 277 279 postpolio syndrome, 284 285 progressive supranuclear palsy, 282 rapid eye movement sleep behavior disorder, 279 281 Shy-Drager syndrome, 282 sleep and stroke, 283 284 spinal cord diseases, 284 Neurologic problems, sleep disturbances in elderly patients with neurodegenerative diseases, 273 292 Neurotransmitters, for psychiatric illness, substance abuse, and sleep, overlap between, 236 237 Nicotine, sleep disturbances in older adults due to, 236 Normal aging. See Aging, normal. Nursing home patients, sleep disturbances in, consequences of, 294 295 disruption of sleep, 294 environmental influences on, 294 O interventions to reduce daytime sleeping in, 296 methods used to study, 294 sleep-disordered breathing, 296 treatment of, 295 296 behavioral, 295 296 pharmacologic, 295 Obstructive sleep apnea, in older adults, impact on cognition, 213 214 Older adults. See also Elderly., napping in, 177 186 beneficial effects of, 184 correlates and consequences of daytime sleepiness and, 180 184 daytime sleepiness in, 179 180 causes, 180 prevalence, 177 179 sleep and cognition in, 207 220 aging and sleep, 207 208 diagnosed sleep disorders, 211 212 insomnia and, 212 213 napping and, 211 normal aging and cognition, 208 209 obstructive sleep apnea and, 213 214 perceived poor sleep quality and excessive daytime sleepiness, 209 210 potential mechanisms of relationship between, 214 215 sleep deprivation, 210 211 Olivopontocerebellar degeneration, sleep disturbances in elderly patients with, 282 P Pain, sleep disturbances in older adults related to, 237 Parkinson s disease, sleep disturbances in elderly patients with, 277 279 Perceived sleep quality, poor, in older adults, impact on cognition, 209 210 Periodic leg movements in sleep, in geriatric patients, 263 271 prevalence and associated factors, 263 264 technical considerations in recording of, 264 265 treatment, 267 268 Pharmacologic treatments. See also Medications. for insomnia in the elderly, 223 224 types of hypnotics, 223 224 for sleep disturbances in nursing homes, 295 296 Polysomnography, for sleep disorders in elderly patients with neurodegenerative disease, 286 Postpolio syndrome, sleep disturbances in elderly patients with, 284 285
303 Progressive supranuclear palsy, sleep disturbances in elderly patients with, 282 Psychiatric conditions, comorbidities affecting sleep in older adults, 233 235 anxiety disorders, 234 235 bipolar affective disorder, 234 caregiving and bereavement, 234 depressive disorders, 233 sleep disturbances due to, in older adults, 231 245 Q Quality of sleep, perceived, poor, in older adults, impact on cognition, 209 210 R Rapid eye movement sleep behavior disorder, sleep disturbances in elderly patients with, 279 281 Renal disease, sleep disturbances in older adults Restless legs syndrome, in geriatric patients, 263 271 in dementia, 266 267 prevalence and associated factors, 265 266 treatment, 267 268 S Shy-Drager syndrome, sleep disturbances in elderly patients with, 282 Sleep, in the elderly, 171 298 breathing disorders, sleep-related, 247 262 circadian rhythm alterations with aging, cognition and, in older adults, 207 220 comorbidities and, 231 245 in midlife women, 197 205 in normal aging, 171 176 insomnia, 221 229 napping in older adults, 177 186 neurologic problems and, 273 292 periodic leg movements and restless legs syndrome, 263 271 sleep disturbances in nursing home patients, Sleep deprivation, in older adults, impact on cognition, 210 211 Sleep disorders, diagnosed, in older adults, impact on cognition, 211 214 insomnia, 212 213 obstructive sleep apnea, 213 214 Sleep-disordered breathing, in Alzheimer s disease patients, 276 in the elderly, 247 262 clinical assessment and management, 255 257 presentation and diagnosis, 255 256 treatment, 256 257 clinical features, 248 249 epidemiology, 249 250 prevalence and incidence, 249 250 risk factors, 250 in nursing home patients, 296 morbidity and mortality associated with, 250 255 cardiovascular consequences, 250 252 cognitive impairment and dementia, 253 254 falls and fractures, 254 255 metabolic consequences, 252 253 mortality, 254 physiologic features, 248 Spinal cord diseases, sleep disturbances in elderly patients with, 284 Stroke, sleep disturbances in elderly patients with, 283 284 Substance abuse, sleep disturbances in older adults due to, 235 237 alcohol dependence, 235 236 caffeine, 236 neurotransmitter overlap between psychiatric illness and, 236 237 tobacco and nicotine, 236 T Tobacco, sleep disturbances in older adults due to, 236 U Urologic disease, sleep disturbances in older adults W Women, midlife, sleep in, 197 205 menopause and, 198