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Dtsch Med Wochenschr 2022; 147(05): 258-268
DOI: 10.1055/a-1495-3348
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Schlaf und Schlafstörungen im hohen Lebensalter

Sleep and sleep disorders in old age
Helmut Frohnhofen
,
Roland Popp
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Schlaf und Schlafverhalten ändern sich mit zunehmendem Lebensalter. Überlagert werden diese Veränderungen von Komorbiditäten, die ihrerseits den Schlaf beeinflussen. Schlafstörungen sind häufig im höheren Lebensalter und belasten die Betroffenen stark, da sie die Tagesbefindlichkeit und die kognitive und psychische Leistungsfähigkeit beeinträchtigen, die Lebensqualität reduzieren und das Erscheinungsbild geriatrischer Syndrome verändern. Diagnostisch und therapeutisch ist oft ein individualisiertes Vorgehen erforderlich.

Abstract

The increasing interruptions of night sleep with normal ageing must be distinguished from sleep disorders. Somatic and psychiatric morbidity as well as medication have a huge impact on sleep. Furthermore, the relationship between sleep and morbidity is mutual. Disturbed sleep modifies the clinical appearance of diseases and morbidity affects the ability to sleep. Especially in geriatric medicine, geriatric syndromes such as falls, depression or dementia are modified by sleep disorders. Therefore, treatment for sleep disorders offers the chance to improve geriatric syndromes.

When treating, it is important to identify the individual sleep disorders. Coincidences of different sleep disorders are common in the elderly. The history of a patient in connection with a sleeping diary is the basic diagnostic procedure. Sleep medicine provides further technical methods for further examination. Older people should also be examined in a sleep laboratory if the results have consequences that will be accepted by the patient. However, this should be clarified in advance.

Schlüsselwörter

geriatrische Syndrome - Senium - Multimorbidität - Insomnie - Restless-Legs-Syndrom - obstruktives Schlafapnoe-Syndrom - Schlaf-Wach-Rhythmus

Key words

sleep disorders - geriatric syndromes - elderly people - multimorbidity - insomnia - obstructive sleep apnea - restless legs syndrome


Publikationsverlauf

Artikel online veröffentlicht:
28. Februar 2022

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  • Literatur

  • 1 Bloom HG, Ahmed I, Alessi CA. et al. Evidence-based recommendations for the assessment and management of sleep disorders in older persons. J Am Geriat Soc 2009; 57 (05) 761-789
    CrossrefPubMedGoogle Scholar
  • 2 Ohayon MM, Carskadon MA, Guilleminault C. et al. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep 2004; 27 (07) 1255-1273
    CrossrefPubMedGoogle Scholar
  • 3 Ito E, Inoue Y. The International Classification of Sleep Disorders, third edition. American Academy of Sleep Medicine. Includes bibliographies and index. Nihon rinsho. Jpn J Clin Medcine 2015; 73 (06) 916-923
    PubMedGoogle Scholar
  • 4 Ancoli-Israel S. Insomnia in the elderly: a review for the primary care practitioner. Sleep 2000; 23 (Suppl. 01) S23-S30 Discussion S36–8
    PubMedGoogle Scholar
  • 5 Ohayon MM, Vecchierini MF. Daytime sleepiness and cognitive impairment in the elderly population. Arch Intern Med 2002; 162 (02) 201-208
    CrossrefPubMedGoogle Scholar
  • 6 Bahr K, Cámara RJA, Gouveris H. et al. Current treatment of comorbid insomnia and obstructive sleep apnea with CBTI and PAP-therapy: a systematic review. Frontiers in neurology 2018; 9: 804
    CrossrefPubMedGoogle Scholar
  • 7 Riemann D, Baum E, Cohrs S. et al. S3-Leitlinie Nicht erholsamer Schlaf/Schlafstörungen. Insomnie bei Erwachsenen. Somnologie 2017; 21: 2-44
    CrossrefPubMedGoogle Scholar
  • 8 Foley DJ, Monjan AA, Brown SL. et al. Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep 1995; 18 (06) 425-432
    CrossrefPubMedGoogle Scholar
  • 9 Cochen V, Arbus C, Soto ME. et al. Sleep disorders and their impacts on healthy, dependent, and frail older adults. J Nutrit Health Ageing 2009; 13 (04) 322-329
    CrossrefPubMedGoogle Scholar
  • 10 Wehling M, Burkhardt H, Kuhn-Thiel A. et al. VALFORTA: A randomised trial to validate the FORTA (Fit fOR The Aged) classification. Age Ageing 2016; 45 (02) 262-267
    CrossrefPubMedGoogle Scholar
  • 11 Rissardo JP, Caprara ALF. Mirtazapine-Associated movement disorders: A literature review. Tzu Chi Med J 2020; 32 (04) 318-330
    CrossrefPubMedGoogle Scholar
  • 12 Yaffe K, Laffan AM, Harrison SL. et al. Sleep-disordered breathing, hypoxia, and risk of mild cognitive impairment and dementia in older women. JAMA 2011; 306 (06) 613-619
    CrossrefPubMedGoogle Scholar
  • 13 Frohnhofen H, Roffe C. Intermittent nocturnal hypoxemia in individuals with dementia: prevalence and relationship with functional status. J Am Geriat Soc 2012; 60 (10) 1997-1999
    CrossrefPubMedGoogle Scholar
  • 14 Kitamura T, Miyazaki S, Sulaiman HB. et al. Insomnia and obstructive sleep apnea as potential triggers of dementia: is personalized prediction and prevention of the pathological cascade applicable?. EPMA J 2020; 11 (03) 355-365
    CrossrefPubMedGoogle Scholar
  • 15 Mayer G, Fietze I, Fischer J. et al. S3-Leitlinie Nicht erholsamer Schlaf/Schlafstörungen: Kurzfassung. Berlin, Heidelberg: Springer; 2011
    CrossrefGoogle Scholar
  • 16 Johns MW. A new method for measuring daytime sleepiness: The Epworth sleepiness scale. Sleep 1991; 14 (06) 540-545
    CrossrefPubMedGoogle Scholar
  • 17 Gronewold J, Lenuck MCI, Gülderen I. et al. Developing an alternative version of the Epworth sleepiness scale to assess daytime sleepiness in adults with physical or mental disabilities. Gerontology 2021; 67 (01) 49-59
    CrossrefPubMedGoogle Scholar
  • 18 Ancoli-Israel S, Palmer BW, Cooke JR. et al. Cognitive effects of treating obstructive sleep apnea in Alzheimerʼs disease: a randomized controlled study. J Am Geriat Soc 2008; 56 (11) 2076-2081
    CrossrefPubMedGoogle Scholar
  • 19 Frohnhofen H, Hoeltmann B, Orth G. Acceptance of NCPAP in a sample of patients admitted for geriatric rehabilitation. European journal of medical research 2009; 14 (Suppl. 04) 82-85
    CrossrefPubMedGoogle Scholar
  • 20 Netzer NC, Ancoli-Israel S, Bliwise DL. et al. Principles of practice parameters for the treatment of sleep disordered breathing in the elderly and frail elderly: The consensus of the International Geriatric Sleep Medicine Task Force. Eur Respirat J 2016; 48 (04) 992-1018
    CrossrefPubMedGoogle Scholar
  • 21 Bruni O, DelRosso LM, Melegari MG. et al. The Parasomnias. Child Adolesc Psychiat Clin North Am 2021; 30 (01) 131-142
    CrossrefPubMedGoogle Scholar
  • 22 Gilat M, Marshall NS, Testelmans D. et al. A critical review of the pharmacological treatment of REM sleep behavior disorder in adults: time for more and larger randomized placebo- controlled trials. J Neurol 2021; DOI: 10.1007/s00415-020-10353-0.
    CrossrefPubMedGoogle Scholar
  • 23 Mishima K, Okawa M, Hishikawa Y. et al. Morning bright light therapy for sleep and behavior disorders in elderly patients with dementia. Acta Psychiat Scand 1994; 89 (01) 1-7
    CrossrefPubMedGoogle Scholar
  • 24 Lemoine P, Nir T, Laudon M. et al. Prolonged-release melatonin improves sleep quality and morning alertness in insomnia patients aged 55 years and older and has no withdrawal effects. J sleep Res 2007; 16 (04) 372-380
    CrossrefPubMedGoogle Scholar
  • 25 Rothdach AJ, Trenkwalder C, Haberstock J. et al. Prevalence and risk factors of RLS in an elderly population: The MEMO study. Memory and Morbidity in Augsburg Elderly. Neurology 2000; 54 (05) 1064-1068
    CrossrefPubMedGoogle Scholar
  • 26 Garcia-Borreguero D, Williams AM. An update on restless legs syndrome (Willis-Ekbom disease): Clinical features, pathogenesis and treatment. Curr Opin Neurol 2014; 27 (04) 493-501
    CrossrefPubMedGoogle Scholar
  • 27 Pizza F, Antelmi E, Vandi S. et al. The distinguishing motor features of cataplexy: a study from video recorded attacks. Sleep 2018; 41 DOI: 10.1093/sleep/zsy026.
    CrossrefPubMedGoogle Scholar
  • 28 Mander BA, Marks SM, Vogel JW. et al. β-amyloid disrupts human NREM slow waves and related hippocampus-dependent memory consolidation. Nature Neurosci 2015; 18 (07) 1051-1057
    CrossrefPubMedGoogle Scholar
  • 29 Spira AP, Gamaldo AA, An Y. et al. Self-reported sleep and beta-amyloid deposition in community-dwelling older adults. JAMA Neurol 2013; 70 (12) 1537-1543
    PubMedGoogle Scholar
  • 30 Gehrman P, Marler M, Martin JL. et al. The relationship between dementia severity and rest/activity circadian rhythms. Neuropsychiat Dis Treat 2005; 1 (02) 155-163
    CrossrefPubMedGoogle Scholar
  • 31 Gronewold J, Haensel R, Kleinschnitz C. et al Sleep-disordered breathing in hospitalized geriatric patients with mild dementia and its association with cognition, emotion and mobility. Int J Environ Res Public Health 2019; 16 (05)
    PubMedGoogle Scholar
  • 32 Vitiello MV, Borson S. Sleep disturbances in patients with Alzheimerʼs disease: epidemiology, pathophysiology and treatment. CNS Drugs 2001; 15 (10) 777-796
    CrossrefPubMedGoogle Scholar
  • 33 Martin JL, Webber AP, Alam T. et al. Daytime sleeping, sleep disturbance, and circadian rhythms in the nursing home. Am J Geriat Psychiat 2006; 14 (02) 121-129
    CrossrefPubMedGoogle Scholar
  • 34 Gallagher-Thompson D, Brooks JO, Bliwise D. et al. The relations among caregiver stress, “sundowning” symptoms, and cognitive decline in Alzheimerʼs disease. J Am Geriat Soc 1992; 40 (08) 807-810
    CrossrefPubMedGoogle Scholar
  • 35 Ancoli-Israel S, Klauber MR, Jones DW. et al. Variations in circadian rhythms of activity, sleep, and light exposure related to dementia in nursing-home patients. Sleep 1997; 20 (01) 18-23
    PubMedGoogle Scholar
  • 36 Guarnieri B, Adorni F, Musicco M. et al. Prevalence of sleep disturbances in mild cognitive impairment and dementing disorders: a multicenter Italian clinical cross-sectional study on 431 patients. Dement Geriat Cognit Disorders 2012; 33 (01) 50-58
    CrossrefPubMedGoogle Scholar
  • 37 Frohnhofen H, Mayer G, Gronewold J. Schlaf und Schlafstörungen bei Demenzerkrankungen. Dtsch Med Wochenschr 2021; 146 (11) 719-722
    Artikel in Thieme ConnectPubMedGoogle Scholar