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age-associated changes in sleep

Sleep regulation undergoes change with aging. Physiology: 1) decreased total sleep time 2) no change or increase in sleep latency (time to fall asleep) 3) increased awakenings 4) decreased sleep efficiency (time asleep/time in bed) 5) increase in daytime napping 6) reduced REM sleep latency 7) decreased REM sleep 8) reduced slow-wave sleep (stages 3 & 4 or deep sleep) - reduced slow-wave sleep may reduce glymphatic clearance along brain perivascular spaces 9) breakdown of the segregation of the sleep-wake cycle [1,4] Clinical manifestations: - earlier bedtime & earlier awakenings common Management: - cognitive behavioral therapy is first line treatment of insomnia in the elderly [1] Notes: - comorbid psychiatric disease &/or medical disease contribute to the prevalence of insomnia in the elderly more than aging does [1]

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sleep sleep disorder

General

age-related physiological changes

References

  1. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004 - Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010 - Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
  2. Essentials of Clinical Geriatrics, 4th ed, Kane RL et al (eds) McGraw Hill, NY, 1999
  3. UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 29-Oct 2, 2004
  4. The Merck Manual of Geriatrics, 3rdh ed, Merck & Co, Rahway NJ, 2000
  5. Taffet GE, Physiology of Aging, In: Geriatric Medicine: An Evidence-Based Approach, 4th ed, Cassel CK et al (eds), Springer-Verlag, New York, 2003
  6. Mander BA, Winer JR, Walker MP Sleep and Human Aging. (Review) Neuron 94(1):19-36. April 5, 2017 PMID: 28384471 http://www.cell.com/neuron/abstract/S0896-6273(17)30088-0