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Understanding insomnia in older adults.

AbstractOBJECTIVE:
The aims of this study were to determine the true frequency of primary insomnia (PI), sleep disorder related to another mental disorder (SDMD) and sleep disorder due to a general medical condition (SDMC) in older adults and to establish their differentiating characteristics.
METHODS:
This is a cross-sectional study. Participants were randomly selected samples of 951 subjects who are 65 years or older. Main measures were as follows: presence (according to DSM-IV-TR diagnostic criteria) of PI, SDMD, SDMC or other sleep disorders, co-morbidity and psychotropic consumption.
RESULTS:
Of the subjects, 36.1% reported having sleep problems (95% CI: 33.0-39.2) and 37.0% reported regularly consuming a psychotropic drug. The prevalence of PI was 8.9% (95% CI: 7.1-11.0), and according to the criteria for differential diagnosis, the prevalence of SDMD was 9.3% (95% CI: 7.5-11.4) and that of SDMC was 7.0% (95%CI: 5.4-8.9). A higher percentage of PI subjects had problems in falling asleep on most days (52.5%), had frequent night-time awakenings (66.3%) and early awakenings (51.3%). In subjects with any type of insomnia, the variables that showed a statistically significant association were female gender (OR: 2.21), consumption of psychotropic drugs (OR: 1.83), presence of four or more health problems (OR: 1.88) and being single, widowed or divorced (OR: 1.43).
CONCLUSIONS:
Our results provide a true picture of the prevalence of insomnia in older adults on the basis of diagnostic criteria and indicate that it is a widespread, significant health problem. The peculiarities of PI, SDMD and SDMC need to be appropriately differentiated in clinical practice, and each needs a different approach to obtain the best outcome.
AuthorsJesús López-Torres Hidalgo, Beatriz Navarro Bravo, Ignacio Párraga Martínez, Fernando Andrés Pretel, Juan Téllez Lapeira, Clotilde Boix Gras
JournalInternational journal of geriatric psychiatry (Int J Geriatr Psychiatry) Vol. 27 Issue 10 Pg. 1086-93 (Oct 2012) ISSN: 1099-1166 [Electronic] England
PMID22213513 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2011 John Wiley & Sons, Ltd.
Chemical References
  • Psychotropic Drugs
Topics
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Humans
  • Logistic Models
  • Male
  • Prevalence
  • Psychotropic Drugs (therapeutic use)
  • Risk Factors
  • Sleep Initiation and Maintenance Disorders (epidemiology, etiology, psychology)
  • Spain (epidemiology)

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