ABSTRACT: Insomnia is common among older adults, who should routinely be screened for sleep-related problems. When patients experience insomnia, consider other treatable sleep disorders, such as obstructive sleep apnea, restless legs syndrome, and periodic limb movement disorder. Keep in mind that comorbid medical and mental health conditions can contribute to insomnia as well. Recommend cognitive-behavioral therapy for insomnia whenever practical. Treatment of sleep-related problems can improve quality of life and reduce the impact of poor sleep on comorbid conditions.

Many older patients struggle to get a good night of sleep, and in fact, insomnia is more common in older adults than in younger persons. It is associated with medical and mental health problems across the adult lifespan; untreated insomnia can negatively impact quality of life and predispose patients to exacerbation of other symptoms, such as pain and depression. Appropriate treatment can improve health, mood, and overall well-being.

In this article, we discuss the factors that control sleep, how sleep changes normally with age, and what goes wrong when insomnia develops. We also provide an overview of other prevalent sleep disorders in older patients and outline practical recommendations for diagnosis, triage, referral, and treatment of older patients who present with insomnia.

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