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 A special issue of the Journal of the American Geriatrics Society is devoted to insomnia and the elderly. W. Vaughn McCall, MD, MS, author of one of the articles outlines five basic steps to help doctors identify and treat insomnia in elderly patients. The steps include (1) detection through asking patients questions, (2) elaboration of the problem, (3) determining if there is a medical or psychiatric emergency, (4) further evaluation of chronic insomnia, if present, and (5) intervention, which can include pharmacological treatment.
Researchers say insomnia is a common problem that warrants increased attention from doctors who care for older adults. Data suggests that by using the 5-step approach, doctors could help to reduce sleep disturbances in the geriatric population. Nonpharmacological strategies are a mainstay of treatment for chronic insomnia, but hypnotics have a role in treating transient insomnia and chronic insomnia that does not improve with nonpharmacological treatment or treatment of associated primary conditions. Pharmacological therapy usually consists of benzodiazepines or nonbenzodiazepines. Emerging nonbenzodiazepine agents may specifically address sleep maintenance problems that are common in elderly patients.
Journal of the American Geriatrics Society, July 2005 - Volume 53 Issue S7 Page S257-S278
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