Copyright
ELSEVIER (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - June 29, 2021 Category: Geriatrics Source Type: research
Contributors
MARGARITA OKS, MD (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - June 29, 2021 Category: Geriatrics Source Type: research
Contents
Margarita Oks and Steven H. Feinsilver (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - June 29, 2021 Category: Geriatrics Source Type: research
Clinics in Geriatric Medicine
Women's Health (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - June 29, 2021 Category: Geriatrics Source Type: research
Normal and Abnormal Sleep in the Elderly
This article briefly describes normal sleep in general, the clinical assessment of sleep complaints, and expected changes with aging, with an overview of the epidemiology of insomnia and sleep apnea in this age group. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - June 4, 2021 Category: Geriatrics Authors: Steven H. Feinsilver Source Type: research
Insomnia
Sleep quality in elderly individuals is affected by increased mental and physical health issues associated with aging, but also a decrease in sleep drive and an advance of the circadian phase. These issues may, in part, be due to lifestyle changes in older adults, such as retirement and/or reduced social and physical activity, which can lead to spending more time in bed, resulting in chronic insomnia. Cognitive behavioral therapy for insomnia has been shown to be an effective treatment method for difficulty sleeping in elderly individuals and should be the first-line treatment due to its efficacy and safety profile. (Sourc...
Source: Clinics in Geriatric Medicine - June 4, 2021 Category: Geriatrics Authors: Matthew R. Ebben Source Type: research
Insomnia
afflicts many geriatric patients worldwide and results in both clinical and economic consequences. Prescribing hypnotics to the elderly is particularly challenging due to multitudes of adverse effects and drug interactions. Although benzodiazepines and “Z” drugs such as zolpidem have been popular in the past, they carry a high risk of adverse effects in the elderly, such as devastating falls and injuries as well as potentially an increase in mortality. Newer classes of hypnotics such as dual orexin receptor antagonists are much better tolerate d and can be explored as a potential treatment for insomnia in the elderly....
Source: Clinics in Geriatric Medicine - June 4, 2021 Category: Geriatrics Authors: Becky X. Lou, Margarita Oks Source Type: research
Obstructive Sleep Apnea
This article discusses issues in prescribing this treatment, including those related specifically to elderly individuals. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - June 4, 2021 Category: Geriatrics Authors: Steven H. Feinsilver Source Type: research
Obstructive Sleep Apnea
Undiagnosed and untreated obstructive sleep apnea (OSA) is associated with health comorbidities and negatively affects quality of life. Alternative treatments should be considered in patients who are unable to tolerate or benefit from positive airway pressure treatment. When properly indicated, positional devices, oral appliances, airway surgery, and hypoglossal nerve stimulation have been shown to be effective in treating OSA. Hypoglossal nerve stimulation is a successful second-line treatment with low associated morbidity and complication rate. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - June 4, 2021 Category: Geriatrics Authors: Maria V. Suurna, Ana C. Krieger Source Type: research
Obstructive Sleep Apnea and Cardiovascular Disease
Obstructive sleep apnea (OSA) presents as repetitive interruptions of ventilation >10 seconds during sleep as a result of upper airway obstruction resulting in increased respiratory effort. Intermittent hypoxia causes physiologic changes resulting in increased catecholamine production, increased total peripheral resistance, tachycardia, and increased venous return, leading to incre ased cardiac output, hypertension, tachyarrhythmias, left ventricular hypertrophy, and heart failure. OSA causes an abnormal dip on 24-hour ambulatory blood pressure monitoring. Definitive diagnosis is made by polysomnography. Continuous pos...
Source: Clinics in Geriatric Medicine - June 4, 2021 Category: Geriatrics Authors: Joseph A. Diamond, Haisam Ismail Source Type: research
Rapid Eye Movement Behavior Disorder and Other Parasomnias
Rapid eye movement (REM) behavior disorder (RBD) is characterized by loss of skeletal muscle atonia that can lead to dream enactment. This condition can cause harm to patients and their bed partners if appropriate safety measures are not ensured. This condition is often the initial presenting symptom in a group of complex neurodegenerative processes. Definitive diagnosis requires a thorough history and an in-laboratory polysomnogram to look for evidence of REM sleep without atonia. Treatment options are limited but consist of sleep safety measures and pharmacotherapy. Patients diagnosed with idiopathic RBD associated with ...
Source: Clinics in Geriatric Medicine - June 4, 2021 Category: Geriatrics Authors: Maksim Korotun, Luis Quintero, Stella S. Hahn Source Type: research
Central Sleep Apnea
This article discusses the prevalence of CSA in the general population and within each of these at-risk populations, and clinical presentation, diagnostic methods, and treatment. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - June 4, 2021 Category: Geriatrics Authors: Oki Ishikawa, Margarita Oks Source Type: research
Sleep in the Elderly: A Common and Growing Problem
The elderly are the fastest growing segment of the world ’s population. Sleep complaints increase with aging, but it is often difficult to distinguish the effects of aging from the effects of diseases and lifestyle changes in this population. It remains unclear exactly what the expected changes in quality and quantity of sleep are in the elderly. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - June 4, 2021 Category: Geriatrics Authors: Margarita Oks, Steven H. Feinsilver Tags: Preface Source Type: research
Coronavirus Disease 2019
In this article, the authors review manifestations of COVID-19 in older adults, normal physiologic changes and frequent comorbidities of aging that increase pathogenicity, factors contributing to overwhelming viral spread among seniors, negative effects on health and well-being resulting from measures to control the virus, and health-system improvements necessary to protect and care for this vulnerable population. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - May 26, 2021 Category: Geriatrics Authors: Sophie Lin, Rachael Kantor, Elizabeth Clark Source Type: research
Covid-19
In this chapter, we review manifestations of COVID-19 in older adults, normal physiologic changes and frequent comorbidities of aging that increase pathogenicity, factors contributing to overwhelming viral spread among seniors, negative effects on health and wellbeing resulting from measures to control the virus, and health-system improvements necessary to protect and care for this vulnerable population. (Source: Clinics in Geriatric Medicine)
Source: Clinics in Geriatric Medicine - May 26, 2021 Category: Geriatrics Authors: Sophie Lin, Rachael Kantor, Elizabeth Clark Source Type: research
