Management of late-life insomnia

Abstract

Insomnia is a common complaint that can have significant daytime consequences. The prevalence of chronic insomnia may increase with age. The management of late-life insomnia can be complicated because aging is associated with normal changes in sleep structure, continuity, and timing, as well as a higher rate of medical and psychiatric disorders. A thorough evaluation and conceptualization of patients’ problems should be conducted for effective treatment planning. Both non-pharmacological and pharmacological strategies have been proven effective in treating insomnia in elderly populations. Behavioral intervention and cognitive behavioral therapy for insomnia are recommended as first considerations. Light therapy may be administered for misalignment of the circadian phase. When necessary, hypnotic medications may be added with adequate safety precautions and consideration of comorbid conditions.