Prevalence and Comorbidity of Insomnia and Effect on Functioning in Elderly Populations

Abstract

A good night's sleep is often more elusive as we age, because the prevalence of insomnia in older people is high. Insufficient sleep can have important effects on daytime function by increasing the need to nap, reducing cognitive ability including attention and memory, slowing response time, adversely affecting relationships with friends and family, and contributing to a general sense of being unwell. However, rather than aging per se, circadian rhythm shifts, primary sleep disorders, comorbid medical/psychiatric illnesses, and medication use cause sleep difficulties in older people, which psychosocial factors may also affect. Clinicians should ask elderly patients about satisfaction with sleep. Any sleep complaints warrant careful evaluation of contributing factors and appropriate treatment.

Stress-related sleep disturbance and polysomnographic response to caffeine

“…The importance of the generalizability of the current study as well as the previous research regarding vulnerability to acute sleep disturbance is apparent when considering that it provides evidence for an overall vulnerability or predisposition to sleep disturbance rather than a distinct vulnerability to a specific stressor. While it is possible that some individuals will react more or less prominently to a specific stressor, our current data and that of others [32] imply that there may be individuals who have a trait vulnerability to sleep disturbance from a very broad range of challenges to the sleep system. These findings suggest why multiple stressors across an array of categories such as medical or psychiatric disease and psychosocial stress may trigger chronic insomnia in some individuals but not others [31][32][33].…”

“…While it is possible that some individuals will react more or less prominently to a specific stressor, our current data and that of others [32] imply that there may be individuals who have a trait vulnerability to sleep disturbance from a very broad range of challenges to the sleep system. These findings suggest why multiple stressors across an array of categories such as medical or psychiatric disease and psychosocial stress may trigger chronic insomnia in some individuals but not others [31][32][33]. As the current data and other research [25] has suggested, there are specific individual differences responsible for the sleep-response to stress [7,20] and these differences may be markedly important in terms of the longitudinal development of insomnia [21].…”

Association between memory impairment and insomnia among older adults

“…Whereas only 9% of individuals between the ages of 20 and 30 complain of insomnia, some 35-50% of those over the age of 65 voice this complaint. Compared to young adults, healthy older people require more time to fall asleep, awaken more frequently during the night, have difficulty returning to sleep after mid-sleep awakenings, and do not feel rested in the morning (AncoliIsrael 2004;Ancoli-Israel and Cooke 2005;Foley et al 1999;Ohayon 2002). These alterations in sleep structure often lead to daytime sleepiness, fatigue, and frequent daytime napping (Carskadon et al 1982).…”

The relative importance of specific risk factors for insomnia in women treated for early‐stage breast cancer

“…being female [12], older age [13][14][15][16], lower education/socioeconomic status [17][18][19], being divorced/single [20], obesity [21,22]), unhealthy behaviors (e.g. low physical activity [15,23,24], alcohol intake [25,26], smoking [27][28][29][30][31]), poor physical health [32,33] and physical symptoms (e.g. pain [23,[34][35][36][37], vasomotor symptoms [38][39][40][41][42][43]), and poor psychosocial functioning (e.g.…”