Cited by 464Sleep and related disordersObstructive Sleep Apnea ResearchCircadian rhythm and melatonin

Evidence‐Based Recommendations for the Assessment and Management of Sleep Disorders in Older Persons

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Bloom, Harrison G., Ahmed, Imran, Alessi, Cathy A., Ancoli‐Israel, Sonia, Buysse, Daniel J., Kryger, Meir H., Phillips, Barbara A., Thorpy, Michael J. +2 more·2009·Journal of the American Geriatrics Society

Abstract

Sleep‐related disorders are most prevalent in the older adult population. A high prevalence of medical and psychosocial comorbidities and the frequent use of multiple medications, rather than aging per se, are major reasons for this. A major concern, often underappreciated and underaddressed by clinicians, is the strong bidirectional relationship between sleep disorders and serious medical problems in older adults. Hypertension, depression, cardiovascular disease, and cerebrovascular disease are examples of diseases that are more likely to develop in individuals with sleep disorders. Conversely, individuals with any of these diseases are at a higher risk of developing sleep disorders. The goals of this article are to help guide clinicians in their general understanding of sleep problems in older persons, examine specific sleep disorders that occur in older persons, and suggest evidence‐ and expert‐based recommendations for the assessment and treatment of sleep disorders in older persons. No such recommendations are available to help clinicians in their daily patient care practices. The four sections in the beginning of the article are titled, Background and Significance, General Review of Sleep, Recommendations Development, and General Approach to Detecting Sleep Disorders in an Ambulatory Setting. These are followed by overviews of specific sleep disorders: Insomnia, Sleep Apnea, Restless Legs Syndrome, Circadian Rhythm Sleep Disorders, Parasomnias, Hypersomnias, and Sleep Disorders in Long‐Term Care Settings. Evidence‐ and expert‐based recommendations, developed by a group of sleep and clinical experts, are presented after each sleep disorder.

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Crossref · 10.1111/j.1532-5415.2009.02220.x

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  • Reinforcing sleep hygiene behaviors (consistent sleep-wake schedules, limiting caffeine or stimulating activities before bed) enhances treatment efficacy and supports long-term sleep-wake regulation.

    “Meta-analyses support that reinforcing sleep hygiene behaviors, including maintaining consistent sleep-wake schedules and limiting caffeine or stimulating activities before bed, enhances treatment efficacy and supports long-term sleep-wake regulation [105,106].”

    From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [105]

    The insomnia sections recommend stable bed and rising times and avoiding caffeine and stimulating activities; they also say sleep hygiene can be useful alongside other treatments. The reported sustained benefit, however, is for multicomponent CBT-I, not specifically for reinforcing sleep hygiene, and the paper does not establish that those behaviors independently enhance treatment efficacy or provide long-term sleep-wake regulation. Page numbers were not available in our copy. (LLM, conf=0.85)

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10 of the 339 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. [33]Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Institute of Medicine of the National Academy of Sciences 2006 National Academies Press Washington, DC 20669438
  2. [46]Stone KL Ancoli-Israel S Blackwell T Poor sleep is associated with increased risk of falls in older women Arch Intern Med 2007 in press 18779464

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Authors
Bloom, H. G., Ahmed, I., Alessi, C. A., Ancoli‐Israel, S., Buysse, D. J., Kryger, M. H., Phillips, B. A., Thorpy, M. J., Vitiello, M. V., & Zee, P. C.
Affiliations
  • International Longevity Centre (US)
  • Albert Einstein College of Medicine (US)
  • University of California, Los Angeles (US)
  • University of California San Diego (US)
  • University of Pittsburgh (US)
  • University of Connecticut (US)
  • University of Kentucky (US)
  • University of Washington (US)
  • Northwestern University (US)
Venue
Journal of the American Geriatrics Society
Publisher
Wiley
Published
2009-04-28
Volume
57
Issue
5
Pages
761-789
ISSN
  • 0002-8614 (ISSN-L)
  • 1532-5415
OpenAlex
W1740055240
Cited by
464
References
339
Citations by year
2026: 14 · 2025: 13 · 2024: 23 · 2023: 21 · 2022: 35 · 2021: 33 · 2020: 21 · 2019: 33 · 2018: 32 · 2017: 26 · 2016: 25 · 2015: 32 · 2014: 36 · 2013: 23 · 2012: 37
FWCI
4.73
Type
journal article
Language
en
Open access
Locations
  • Journal of the American Geriatrics Society (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Aging (R01AG008415)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Keywords
sleep disorders, older adults, insomnia, sleep apnea, restless legs syndrome, circadian rhythm sleep disorders, parasomnias, hypersomnia, long-term care, comorbidities, hypertension, depression, cardiovascular disease, cerebrovascular disease, sleep disorder treatment, clinical guidelines
MeSH terms
Aged, Humans, Risk Factors, Sleep Wake Disorders, Geriatric Assessment, Practice Guidelines as Topic, Evidence-Based Medicine

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