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InicioE-BooksE-Books Médicos Geriatric Sleep Medicine
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Geriatric Sleep Medicine

Product details

  • Series: Sleep Disorders (Book 6)
  • Hardcover: 280 pages
  • Publisher: CRC Press; 1 edition (September 24, 2008)
  • Language: English
  • ISBN-10: 1420058681
  • ISBN-13: 978-1420058680
  • Product Dimensions: 6.2 x 0.8 x 9 inches
  • Shipping Weight: 1.1 pounds

 

The management of sleep complaints among older adults is both rewarding and challenging. Given the high prevalence of sleep disorders in this population and the ever expanding knowledge about the impact of sleep disturbances on quality of life, life expectancy, mental health, and cardiovascular and neurologic morbidity, healthcare providers are increasingly asked to address sleep problems in older people.

Unfortunately, sleep disorders in older people may go unrecognized and/or untreated, contributing to refractory neurological, psychiatric, and medical conditions. For example, obstructive sleep apnea can contribute to considerable cardiovascular disease and may be viewed as a reversible cause of dementia in elderly patients. Despite that, little time is spent in medical and postgraduate education describing the key elements of the evaluation of the sleepy patient.With these issues in mind, we now present one of the first textbooks in sleep disorders focusing on the geriatric patient.

The purpose of this educational tool is to review common sleep problems in this group and provide the reader with an updated, easily read, and practical approach to their evaluation, diagnosis, and management in a busy clinical practice. We also hope that researchers with a focus in geriatric sleep research will find this book resourceful.

We have compiled outstanding and distinguished authorities in sleep medicine for this text, representing key leaders in the field of geriatric sleep medicine. Many of them have co-authored their work with more junior faculty and trainees in the field, which offers a unique outlook on these important topics. In addition, our author list represents wide geographic distribution.

While many of our authors are geriatricians and internists, we also were fortunate to include psychiatrists, neurologists, psychologists, clinical researchers, nurses, and pulmonologists.  In fact, we hope our author list parallels the diversity of sleep medicine as a field that is probably the most interdisciplinary “subspecialty” in existence.

Categoría: E-Books Médicos Etiquetas: Geriatría, Sleep Medicine, Trastornos del Sueño
  • Descripción
  • POR QUÉ UTILIZAR ARCHIVOS PDF
Descripción

Approximately 37 million Americans are 65 years of age or older, representing 12.5% of the national population. The next 20 plus years will see a remarkable shift in the older adult population (Fig. 1). By 2030, 20% of the U.S. population, one in five persons, will be aged 65 or older, a near doubling of the present ratio of one in nine persons. This radical population shift in the proportion of older adults will have a massive negative impact on our already strained health-care systems.

Of the many major physiological changes that accompany the aging process, one change that is typically problematic for many is an often profound disruption of an older adult’s daily sleep–wake cycle. Epidemiological studies have consistently shown that the prevalence of significant sleep complaints grows steadily with advancing age.

Some 57% of adults over the age of 60 complain of significant sleep disruption, 45% have periodic limb movements during sleep (PLMS), 29% have insomnia, 24% have obstructive sleep apnea (OSA), 19% complain of early morning awakening, and 12% have restless legs syndrome (RLS). Only a minority of patients described no sleep complaints in survey of over 9000 participants aged 65 years and older in the National Institute on Aging’s multicentered study entitled “Established Populations for Epidemiologic Studies of the Elderly” (EPESE). The majority of patients described difficulties initiating sleep, nocturnal awakenings, insomnia, daytime napping, troubles falling asleep, waking up too early in the morning, and waking up too early without feeling rested (Fig. 2) (Foley DJ, Monjan AA, et al. Sleep complaints among elderly persons: An epidemiologic study of three communities. Sleep 1995; 18(6):425–432.). While sleep disturbances can have profound implications for an individual’s health, the nature of these disruptions is complex.

The most striking change in sleep in older adults is the repeated and frequent interruption of sleep by long periods of wakefulness, possibly the result of an age-dependent intrinsic change in sleep homeostatic processes. This age-dependent increase of nighttime wakefulness, as well as other well-characterized sleep–wake changes, is mirrored by increases in daytime fatigue, excessive daytime sleepiness and increased likelihood of napping, or falling asleep during the day.

Aging is also associated with a tendency to both fall asleep and awaken earlier and to be less tolerant of phase shifts in time of the sleep–wake schedule such as those produced by jet lag and shift work. These changes suggest an age-dependent breakdown of the normal adult circadian sleep–wake cycle.

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