Insomnia in the Elderly - Part 2 |
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: May 15, 2009 |
Expiration
Date: May 15, 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.
- Identify appropriate medications for treatment of insomnia in the elderly a well as their associated risks.
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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 May 15, 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: |
This is the second in a two-part series focusing on insomnia in the elderly. The first module in the series highlighted the following points:
- Insomnia is very common in the geriatric population.
- 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.
- Insomnia affects women more often than men.
- Many 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.
- Patients with sleep disorders are at higher risk of medical and psychiatric illness, as well as falls and accidents.
- Risk of placement into a long-term care facility is increased among patients with sleep disorders.
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CASE 3: |
Mrs. E is an 89-year-old woman who lives independently in an apartment in a retirement community. She has mild cognitive impairment, but is still able to care for herself. She also has diagnoses of hypertension and insomnia. Her medications include HCTZ and triazolam 0.125 mg at bedtime. You receive a call from the nursing staff at the retirement center, stating that Mrs. E has seemed confused lately. She has been noted to wander the facility very early in the morning, once dressed only in her undergarments. Mrs. E does not remember this event. Mrs. E's daughter confirms that she seems more confused lately and is now unable to balance her checkbook, which she was doing several months previously. Her physical exam is unchanged and she appears well. |
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