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Somnologie
Erschienen in: Somnologie 1/2017

08.03.2017 | Schlafapnoe | CME

Schlaf und Schlafstörungen beim alten Menschen

verfasst von: Priv.-Doz. Dr. H. Frohnhofen, J. Schlitzer, N. Netzer

Erschienen in: Somnologie | Ausgabe 1/2017

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Zusammenfassung

Schlafstörungen nehmen mit dem Lebensalter zu. Sie sollen behandelt werden, wenn sie zu einer belastenden Symptomatik führen, die als beeinträchtigte Lebensqualität, funktionelle Probleme im Alltag oder beeinträchtigte Selbstversorgungsfähigkeit auftritt. Therapeutische Grundlage bei jeder Form einer Schlafstörung ist die Schlafhygiene. Schlaflosigkeit (Insomnie) wird auch im höheren Lebensalter wirksam durch eine Verhaltenstherapie behandelt, wobei Stimuluskontrolle und Schlafrestriktion die effektivsten Verfahren sind. Pharmakotherapie ist langfristig deutlich weniger wirksam und gerade im höheren Lebensalter mit unerwünschten Effekten assoziiert. Schlafbezogene Atmungsstörungen sind auch im höheren Alter eine häufige Ursache für eine Hypersomnie und werden durch eine nächtliche Überdruckatmung am effektivsten behandelt. Nach einem Restless-Legs-Syndrom muss immer aktiv gefragt werden, da diese Erkrankung im Alter ebenfalls häufig ist und gut therapiert werden kann.
Literatur
1.
Ungar A, Rafanelli M, Iacomelli I et al (2013) Fall prevention in the elderly. Clin Cases Miner Bone Metab 10:91–95PubMedPubMedCentral
2.
Price SD, Holman CDJ, Sanfilippo FM, Emery JD (2014) Association between potentially inappropriate medications from the Beers criteria and the risk of unplanned hospitalization in elderly patients. Ann Pharmacother 48:6–16CrossRefPubMed
3.
4.
Milisen K, Coussement J, Arnout H et al (2013) Feasibility of implementing a practice guideline for fall prevention on geriatric wards: a multicentre study. Int J Nurs Stud 50:495–507CrossRefPubMed
5.
Jones SE, Tyrrell J, Wood AR et al (2016) Genome-Wide Association analyses in 128,266 individuals identifies new morningness and sleep duration loci. PLOS Genetics 12(8):e1006125. doi:10.137/journal.pgen.1006125
6.
Zhang XJ, Li QY, Wang Y, Xu HJ, Lin YN (2014) The effect of non-benzodiazepine hypnotics on sleep quality and severity in patients with OSA: a meta-analysis. Sleep Breath. doi:10.​1007/​s11325-014-0943-7
7.
Li Y, Li Z, Lei F, Du L, Tang X (2013) Persistent insomnia despite long-term nightly use of sleeping pills. J Clin Sleep Med 9:834–836PubMedPubMedCentral
8.
Spira A (2012) Reliability and validation of the Pittsburgh Sleep Quality Index an the Epworth Sleepiness Scale in older men. J Gerontol A Biol Sci Med Sci 67A(4):433–439CrossRef
9.
Beauderau S (2012) Validation of the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale in older black and white women. Sleep Med 13:36–42CrossRef
10.
Dhillon S (2013) Duloxetine: a review of its use in the management of major depressive disorder in older adults. Drugs Aging 30:59–79CrossRefPubMed
11.
Brovold T, Skelton DA, Sylliaas H, Mowe M, Bergland A (2014) Association between health-related quality of life, physical fitness, and physical activity in older adults recently discharged from hospital. J Aging Phys Act 22:405–413CrossRefPubMed
12.
Schröder J (2013) Pharmakotherapie von Schlafstörungen bei älteren Menschen. Dtsch Med Wochenschr 138:2550–2553CrossRefPubMed
13.
Wu C, Gau SS, Lai M (2014) Long-term antidepressant use and the risk of type 2 diabetes mellitus: a population-based, nested case-control study in Taiwan. J Clin Psychiatry 75:31–38CrossRefPubMed
14.
Rios Romenets S, Creti L, Fichten C et al (2013) Doxepin and cognitive behavioural therapy for insomnia in patients with Parkinson’s disease – a randomized study. Park Relat Disord 19:670–675CrossRef
15.
Richelson E (1994) Pharmacology of antidepressants – characteristics of the ideal drug. Mayo Clin Proc 69:1069–1081CrossRefPubMed
16.
Giron MS, Forsell Y, Bernsten C, Thorslund M, Winblad B, Fastbom J (2001) Psychotropic drug use in elderly people with and without dementia. Int J Geriatr Psychiatry 16:900–906CrossRefPubMed
17.
Morgan K (1984) Effects of two benzodiazepines on the speed and accuracy of perceptual-motor performance in the elderly. Psychopharmacology Suppl 1:79–83CrossRefPubMed
18.
Foley D, Ancoli-Israel S, Britz P, Walsh J (2004) Sleep disturbances and chronic disease in older adults: results of the 2003 National Sleep Foundation Sleep in America Survey. J Psychosom Res 56:497–502CrossRefPubMed
19.
Kuhn-Thiel AM, Weiß C, Wehling M (2014) Consensus validation of the FORTA (Fit fOR The Aged) List: a clinical tool for increasing the appropriateness of pharmacotherapy in the elderly. Drugs Aging 31:131–140CrossRefPubMed
20.
Hajak G, Rodenbeck A, Voderholzer U et al (2001) Doxepin in the treatment of primary insomnia: a placebo-controlled, double-blind, polysomnographic study. J Clin Psychiatry 62:453–463CrossRefPubMed
21.
Gallo JJ, Morales KH, Bogner HR et al (2013) Long term effect of depression care management on mortality in older adults: follow-up of cluster randomized clinical trial in primary care. BMJ 346:f2570CrossRefPubMedPubMedCentral
22.
Heun R, Ahokas A, Boyer P, Giménez-Montesinos N, Pontes-Soares F, Olivier V (2013) The efficacy of agomelatine in elderly patients with recurrent major depressive disorder: a placebo-controlled study. J Clin Psychiatry 74:587–594CrossRefPubMed
23.
Riemann D, Voderholzer U, Cohrs S et al (2002) Trimipramine in primary insomnia: results of a polysomnographic double-blind controlled study. Pharmacopsychiatry 35:165–174CrossRefPubMed
24.
Quach L, Yang FM, Berry SD et al (2013) Depression, antidepressants, and falls among community-dwelling elderly people: the MOBILIZE Boston study. J Gerontol A Biol Sci Med Sci 68:1575–1581CrossRefPubMedPubMedCentral
25.
Riemann D, Voderholzer U, Cohrs S et al (2002) Trimipramine in primary insomnia: results of a polysomnographic double-blind controlled study. Pharmacopsychiatry 35:165–174CrossRefPubMed
26.
Bloom HG, Ahmed I, Alessi CA et al (2009) Evidence-based recommendations for the assessment and management of sleep disorders in older persons. J Am Geriatr Soc 57:761–789CrossRefPubMedPubMedCentral
27.
Cumbler E, Guerrasio J, Kim J, Glasheen J (2008) Use of medications for insomnia in the hospitalized geriatric population. J Am Geriatr Soc 56:579–581CrossRefPubMed
28.
Walsh JK (2004) Drugs used to treat insomnia in 2002: regulatory-based rather than evidence-based medicine. Sleep 27:1441–1442PubMed
29.
Giron MST, Forsell Y, Bernsten C, Thorslund M, Winblad B, Fastbom J (2002) Sleep problems in a very old population: drug use and clinical correlates. J Gerontol A Biol Sci Med Sci 57:M236–40CrossRefPubMed
30.
Roberts RE, Shema SJ, Kaplan GA, Strawbridge WJ (2000) Sleep complaints and depression in an aging cohort: a prospective perspective. Am J Psychiatry 157:81–88CrossRefPubMed
31.
Jarema M, Dudek D, Landowski J, Heitzman J, Rabe-Jabłońska J, Rybakowski J (2011) Trazodon – lek przeciwdepresyjny: mechanizm działania i miejsce w leczeniu depresji. Psychiatr Pol 45:611–625PubMed
32.
Berry SD, Zhang Y, Lipsitz LA, Mittleman MA, Solomon DH, Kiel DP (2011) Antidepressant prescriptions: an acute window for falls in the nursing home. J Gerontol A Biol Sci Med Sci 66:1124–1130CrossRefPubMed
33.
Clark MS, Smith PO, Jamieson B (2011) FPIN’s clinical inquiries: antidepressants for the treatment of insomnia in patients with depression. Am Fam Physician 84:1–2PubMed
34.
Kamel NS, Gammack JK (2006) Insomnia in the elderly: cause, approach, and treatment. Am J Med 119:463–469CrossRefPubMed
35.
National Institutes of Health (2005) National Institutes of Health State of the Science Conference statement on Manifestations and Management of Chronic Insomnia in Adults. Sleep 28:1049–1057
36.
Obayashi K, Saeki K, Iwamoto J et al (2014) Effect of exposure to evening light on sleep initiation in the elderly: a longitudinal analysis for repeated measurements in home settings. Chronobiol Int 31:461–467CrossRefPubMed
37.
Lyseng-Williamson KA (2012) Melatonin prolonged release: in the treatment of insomnia in patients aged ≥55 years. Drugs Aging 29:911–923CrossRefPubMed
38.
Frohnhofen H, Hoeltmann B, Orth G (2009) Acceptance of NCPAP in a sample of patients admitted for geriatric rehabilitation. Eur J Med Res 14(Suppl 4):82–85CrossRefPubMedPubMedCentral
39.
40.
41.
Cooke JR, Ancoli-Israel S, Liu L et al (2009) Continuous positive airway pressure deepens sleep in patients with Alzheimer’s disease and obstructive sleep apnea. Sleep Med 10:1101–1106CrossRefPubMedPubMedCentral
42.
Frohnhofen H, Heuer HC, Kanzia A, Firat A (2009) Influence of type of treatment for sleep apnea on activities of daily living in a sample of elderly patients with severe sleep apnea. J Physiol Pharmacol 60(Suppl 5):51–55PubMed
43.
44.
Kuhn-Thiel AM (2014) Consensus validation of the FORTA list: a clinical tool for increasing the appropriateness of pharmacotherapy in the elderly. Drugs Aging 31(2):131–140CrossRefPubMed
45.
Basu R (2003) Sedative-hypnotic use of diphenhyramine in a rural, older adult community-based cohort: effect on cognition. Am J Geriatr Psychiatry 11(2):205–213CrossRefPubMed
46.
Bent S (2004) Valerian for sleep: a systematic review and metaanalysis. Am J Med 119(12):1005–1012CrossRef
47.
Jeste D (2008) ACNP White Paper: update on use of antipsychotic drugs in elderly persons with dementia. Neuropsychopharmacology 33(5):957–970CrossRefPubMed
48.
Lichstein KMC (2000) Treatment of late-life insomnia. Sage Publications, Thousand OaksCrossRef
49.
50.
Engle-Friedman M, Bootzin RR, Hazlewood L, Tsao C (1992) An evaluation of behavioral treatments for insomnia in the older adult. J Clin Psychol 48:77–90CrossRefPubMed
51.
Bliwise DL, Friedman L, Nekich JC, Yesavage JA (1995) Prediction of outcome in behaviorally based insomnia treatments. J Behav Ther Exp Psychiatry 26:17–23CrossRefPubMed
52.
Epstein DR, Sidani S, Bootzin RR, Belyea MJ (2012) Dismantling multicomponent behavioral treatment for insomnia in older adults: a randomized controlled trial. Sleep 35:797–805CrossRefPubMedPubMedCentral
53.
Frohnhofen H, Mahl N (2007) Maskenakzeptanz-Test (MAT) bei älteren Patienten mit obstruktiver Schlafapnoe. Laryngorhinootologie 86:6–7CrossRefPubMed
54.
Davies R, Lacks P, Storandt M, Bertelson AD (1986) Countercontrol treatment of sleep-maintenance insomnia in relation to age. Psychol Aging 1:233–238CrossRefPubMed
55.
Edinger JD, Stout AL, Hoelscher TJ (1988) Cluster analysis of insomniacs’ MMPI profiles: relation of subtypes to sleep history and treatment outcome. Psychosom Med 50:77–87CrossRefPubMed
56.
Riedel BW, Lichstein KL, Dwyer WO (1995) Sleep compression and sleep education for older insomniacs: self-help versus therapist guidance. Psychol Aging 10:54–63CrossRefPubMed
57.
Morin CM, Vallières A, Guay B et al (2009) Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia: a randomized controlled trial. JAMA 301:2005–2015CrossRefPubMedPubMedCentral
58.
Spira AP, Beaudreau SA, Stone KL et al (2012) Reliability and validity of the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale in older men. J Gerontol A Biol Sci Med Sci 67:433–439CrossRefPubMed
59.
Otmani S, Metzger D, Guichard N et al (2012) Effects of prolonged-release melatonin and zolpidem on postural stability in older adults. Hum Psychopharmacol 27:270–276CrossRefPubMed
60.
Obayashi K, Saeki K, Iwamoto J et al (2014) Effect of exposure to evening light on sleep initiation in the elderly: a longitudinal analysis for repeated measurements in home settings. Chronobiol Int 31:461–467CrossRefPubMed
61.
62.
Ancoli-Israel S, Palmer BW, Cooke JR et al (2008) Cognitive effects of treating obstructive sleep apnea in Alzheimer’s disease: a randomized controlled study. J Am Geriatr Soc 56:2076–2081CrossRefPubMedPubMedCentral
63.
Chong MS, Ayalon L, Marler M et al (2006) Continuous positive airway pressure reduces subjective daytime sleepiness in patients with mild to moderate Alzheimer’s disease with sleep disordered breathing. J Am Geriatr Soc 54:777–781CrossRefPubMed
64.
Netzer N (2016) Principal 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 Respir J. doi:10.​1183/​13993003.​01975-2015
65.
Deutsche Gesellschaft für Schlafforschung und Schlafmedizin (DGSM) (2017) S3-Leitlinie: Nicht erholsamer Schlaf/Schlafstörungen. Kapitel „Schlafbezogene Atmungsstörungen“. Somnologie 20 (Suppl s2). doi:10.​1007/​s11818-016-0093-1
66.
Lin F, Chen P, Liao CH, Hsieh Y, Sung F (2014) Retrospective population cohort study on hip fracture risk associated with zolpidem medication. Sleep 37:673–679PubMedPubMedCentral
67.
Wu T, Chie W, Yang R, Kuo K, Wong W, Liaw C (2013) Risk factors for single and recurrent falls: a prospective study of falls in community dwelling seniors without cognitive impairment. Prev Med 57:511–517CrossRefPubMed
68.
Foley DJ, Vitiello MV, Bliwise DL, Ancoli-Israel S, Monjan AA, Walsh JK (2007) Frequent napping is associated with excessive daytime sleepiness, depression, pain, and nocturia in older adults: findings from the National Sleep Foundation ’2003 Sleep in America’ Poll. Am J Geriatr Psychiatry 15:344–350CrossRefPubMed
69.
Bélanger L, Vallières A, Ivers H, Moreau V, Lavigne G, Morin CM (2007) Meta-analysis of sleep changes in control groups of insomnia treatment trials. J Sleep Res 16:77–84CrossRefPubMed
70.
Garcia-Borreguero D (2016) Guidelines for the first line treatment of restless legs syndrome/Willis ekbom disease, prevention and teatment of dopaminergic augmentation: a combined task force of the IRLSSG, EURLSSG, and the RLS-foundation. Sleep Med 21:1–11CrossRefPubMed
71.
Kim ES (2016) Gabapentin Enacabril: a review in restless legs syndrome. Drugs 76(8):879–887CrossRefPubMed
72.
Ford DE, Kamerow DB (1989) Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? JAMA 262:1479–1484CrossRefPubMed
73.
Moreh E, Jacobs JM, Stessman J (2009) Feeling tired predicts functional status, physical activity, and mortality in elderly people. J Am Geriatr Soc 57:742–743CrossRefPubMed
74.
Rongen-van Dartel SAA, Repping-Wuts H, van Hoogmoed D et al (2014) Relationship between objectively assessed physical activity and fatigue in patients with rheumatoid arthritis: inverse correlation of activity and fatigue. Arthritis Care Res (Hoboken) 66:852–860CrossRef
75.
de Rekeneire N, Leo-Summers L, Han L, Gill TM (2014) Epidemiology of restricting fatigue in older adults: the precipitating events project. J Am Geriatr Soc 62:476–481CrossRefPubMedPubMedCentral
76.
de Vries NM, Staal JB, Teerenstra S, Adang EMM, Rikkert MGMO, Nijhuis-van der Sanden MWG (2013) Physiotherapy to improve physical activity in community-dwelling older adults with mobility problems (Coach2Move): study protocol for a randomized controlled trial. Trials 14:434CrossRefPubMedPubMedCentral
77.
Schnelle JF, Buchowski MS, Ikizler TA, Durkin DW, Beuscher L, Simmons SF (2012) Evaluation of two fatigability severity measures in elderly adults. J Am Geriatr Soc 60:1527–1533CrossRefPubMedPubMedCentral
Metadaten
Titel
Schlaf und Schlafstörungen beim alten Menschen
verfasst von
Priv.-Doz. Dr. H. Frohnhofen
J. Schlitzer
N. Netzer
Publikationsdatum
08.03.2017
Verlag
Springer Medizin
Erschienen in
Somnologie / Ausgabe 1/2017
Print ISSN: 1432-9123
Elektronische ISSN: 1439-054X
DOI
https://doi.org/10.1007/s11818-017-0102-z

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