Geriatric Sleep Medicine PDF

Preface

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.

Chapters in this text are organized to cover the range of topics of greatest importance providers involved in the recognition and management of sleep problems in the older adult. First, a forward by Dr. Vitiello summarizes important aspects of sleep in aging, and sets the stage for the remaining chapters of the textbook. Then, there are several chapters addressing key concepts in the understanding of sleep in aging and disease. This includes a chapter by Drs. Wright and Frey that summarizes important issues in sleep physiology in the geriatric patient. Next, Dr. Barczi provides a comprehensive summary of sleep problems associated with medical illness and comorbidities in the older adult. Drs. Pigeon and Perlis then provide a careful review of sleep and psychiatric illness, followed by a review of sleep in neurological and neurodegenerative disorders by Dr. Avidan.

The next several chapters focus on the important topic of insomnia in aging. First, Drs. Choi and Irwin provide a comprehensive review of key aspects of insomnia in aging, followed by a careful review of pharmacological treatment of insomnia in the older adult by Drs. Lee-Chiong and Harrington. This is followed by a careful review of behavioral treatment of insomnia by Drs. Morin and Belanger.

The textbook then addresses several additional important sleep disorders in the older adult, including a review of sleep-related breathing disorders in aging by Dr. Gooneratne and a comprehensive review of central sleep apnea by Drs. Chowdhuri and Badr. This is followed by a comprehensive review of circadian rhythm disorders in aging by Drs. Naylor and Zee, and a careful discussion of periodic limb movement disorder and restless legs syndrome by Dr. Bliwise.

Finally, the textbook addresses several special topics of sleep in aging. First, Drs. Martin and Alessi review sleep in nursing home residents. Then, Drs. Misra and Malow provide a careful summary of sleep in the older woman. The next chapter, by Drs. Stone and Ancoli-Israel, reviews the literature on napping in older adults. Finally, Drs. Nazir and Richards review sleep in late-stage dementia and end of life.

We would like to conclude by providing our sincerest thanks to the authors for their dedication and outstanding contributions to this textbook.We have had the pleasure of working with many of them as colleagues and good friends for many years in this ever evolving and exciting field, and we sincerely appreciate their contributions to this textbook. Finally, we would like to thank Ms. Dana Bigelow, Development Editor, U.S. Books Informa Healthcare for her direction and guidance as this project evolved from an idea into an indispensible educational product.