Sleep disorders in the older patient

Many seniors have readily diagnosable sleep disorders that can be treated effectively to improve daytime somnolence and cognitive impairments. Older patients often suffer from a variety of sleep disturbances that may be caused by age-related physiologic changes, polypharmacy, changes in circadian rhythm, retirement, and loss of spouse. This article discusses normal predictable age-related changes in sleep and sleep physiology and describes specific sleep pathologies common in older people in a case vignette format. Specific sleep disorders, including insomnia; obstructive sleep apnea; restless legs syndrome and periodic leg movement disorder of sleep; advanced sleep phase syndrome; and rapid eye movement sleep behavior disorder are discussed in the context of the older patient. Diagnostic criteria, clinical presentation, polysomnographic features (when appropriate), and treatment options are presented for each of these sleep disorders.