Treatment of insomnia in older adults

• Published in: Clinical psychology review Vol. 25; no. 5; pp. 645 - 672
• Main Authors: Nau, Sidney D., McCrae, Christina S., Cook, Kristen G., Lichstein, Kenneth L.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.07.2005
• Subjects: Aged; Aging - psychology; Chronic Disease; Humans; Hypnotics and Sedatives - therapeutic use; Incidence; Middle Aged; Placebos; Randomized Controlled Trials as Topic; Sleep Initiation and Maintenance Disorders - etiology; Sleep Initiation and Maintenance Disorders - physiopathology; Sleep Initiation and Maintenance Disorders - therapy
• ISSN: 0272-7358; 1873-7811
• DOI: 10.1016/j.cpr.2005.04.008

Insomnia outcome studies from the last 15 years show consistent success for behavioral treatment with older adults. The present review of evaluation and treatment covers the effects of aging on ability to sleep, the insomnia classification system, the treatment efficacy database, and critical outcome research methodology. Clinical trial methodology with older adults includes familiar challenges; for example, the need for placebo controls, and frequent failures to document the adequacy of treatment implementation. Recommendations for improving methodology are offered. A new review of treatment for primary insomnia in older adults shows strong improvement and consistent results for popular behavioral treatments. Older adult clinical trials show proven efficacy of behavioral treatment for primary insomnia, efficacy for secondary insomnia, and efficacy for insomnia associated with hypnotic dependency.