Insomnia in the Elderly - Part 1 |
Certified
for 1 AMA PRA Category 1 Credit™
Co-Sponsored
by
the
University of Alabama
School
of Medicine
Division of Continuing Medical Education,
Division of Gerontology, Geriatrics, and
Palliative Care, and
The Center for Aging
| Release
Date: April 27, 2009 |
Expiration
Date: April 27, 2012 |
| TARGET
AUDIENCE: |
| Primary
care physicians |
| OBJECTIVES: |
| Upon
completion of this CME activity,
participants
should be able to: |
- Discuss typical sleep changes in the elderly.
- Describe how to take an appropriate history to identify sleep problems in the elderly.
- Recognize medical conditions and medications that contribute to sleep disorders in the elderly.
- List appropriate recommendations for nonpharmacologic therapies for insomnia.
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| FACULTY: |
| EDITOR
AND CONTRIBUTING AUTHORS: |
Angela
R. Curtis, PhD
Managing Editor
Assistant Professor, Geriatric Education
Manager
Division
of Gerontology, Geriatrics and
Palliative Care
University of Alabama at Birmingham
Kathleen N. Fix, MD
Assistant Professor of Medicine, Division of Gerontology, Geriatrics and Palliative Care
University of Alabama at Birmingham
Medical Director, Senior Care Center at Fairhaven
Birmingham VA Medical Center
Birmingham, Alabama |
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| |
| DISCLOSURE: |
Dr. Fix has no commercial affiliations
to disclose.
Because of the nature of preliminary
studies, some products mentioned are
unlabeled and investigational. Dosages,
indications, and methods of use of
drugs mentioned in this publication
may reflect the experience of the authors,
clinical literature, or other resources.
Therefore, please see the full prescribing
information before using any licensed
product mentioned. |
| CME
PARTICIPATION: |
| To
participate in this online course
for CME credit, please review the
objectives before beginning the program.
Complete the course and the self-assessment
test before April 27, 2012 to receive
CME credit. Your certificate will
then be available online. This process
should take approximately 1 hour. |
| ACCREDITATION: |
The
University of Alabama School of
Medicine is accredited by the Accreditation
Council for Continuing Medical
Education to provide continuing
medical education for physicians.
The
University of Alabama School of
Medicine designates this educational
activity for a maximum of 1 AMA
PRA Category 1 Credit™.
Physicians should only claim credit
commensurate with the extent of
their participation in the activity.
The
boards of nursing in many states,
including Alabama, recognize Category
1 continuing medical education
courses as acceptable activities
for the renewal of license to practice
nursing. |
| DISCLAIMER: |
| Dosages,
indications, and methods of use of
any drug referred to in this publication
may reflect the clinical experience
of the authors, clinical literature,
or other clinical resources. Therefore,
please see the full prescribing information
before using any product mentioned.
UAB is an equal opportunity/affirmative
action institution. |
| INTRODUCTION: |
Insomnia is very common in the geriatric population. It affects up to 50% of community dwelling elders[1] and may be higher in patients living in long-term care (LTC). Insomnia can be primary, occurring in the absence of a causative factor, or secondary, as a result of an underlying medical condition or medication side effect. It affects women more often than men.[2] In 2006, $2 billion were spent on sleep remedies in the United States.[3] Nearly 40% of hypnotics are prescribed to patients over the age of 60.[4] Many of these sleep remedies are associated with high risks for the elderly population. Sleep disorders often go unrecognized in the elderly because sleep difficulties are thought to be part of normal aging. In addition, patients with sleep disorders are at higher risk of medical and psychiatric illness, as well as falls and accidents. The risk of placement into a long-term care facility is increased among patients with sleep disorders. |
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CASE 1: |
Mr. H is an 84-year-old man who comes to your clinic asking for a sleeping pill. He states that he is very distressed about his inability to sleep. He has a history of hypertension and peripheral vascular disease, with amputation of the left leg above the knee. He naps frequently during the day and feels sleepy, and sometimes feels that his thinking is clouded. He falls occasionally, without serious injury. His medications include benazepril, aspirin and clopidogrel. He has lived in an assisted living unit (ALU) since his leg was amputated. He uses a power wheelchair and does not have a prosthesis. |
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