Recent Developments in the Management of Insomnia in Later Life.
Recent Developments in the Management of Insomnia in Later Life.
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晚年失眠管理的最新进展。
DOI：
10.1007/s40501-018-0145-1
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发表时间：
2018
影响因子：
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通讯作者：
Bramoweth,AdamD
中科院分区：
文献类型：
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作者：
Tighe,CaitlanA;Bramoweth,AdamD
研究目的：睡眠对很大比例的老年人有影响，但它不是衰老的必然结果，可以干预。这篇叙述性综述的目的是概述最近关于老年人失眠管理的建议和实证研究结果。最近的发现用认知行为疗法治疗失眠症（CBT-I）继续得到经验支持，并被推荐为成人的一线干预措施。越来越多的证据表明，其他治疗失眠的非药物疗法，如正念疗法、光疗法、体育活动干预，以及由非临床医生“睡眠教练”提供的治疗，也对失眠症状有积极影响。最后，最近的系统综述为失眠的药理学治疗提供了指导和建议。总结：cbt - i仍然是成人失眠的首选治疗方法。对于老年失眠症患者，仍然需要增加cbt - 1和其他治疗方法的可用性，并对其进行优化，以最大限度地提高治疗效果。也有证据表明药物治疗失眠是有益的；然而，这些并非没有风险，特别是在老年人群中。
Purpose of reviewInsomnia impacts a significant proportion of older adults yet is not an inevitable consequence of aging and is amenable to intervention. The aim of this narrative review is to provide an overview of recent recommendations and empirical findings regarding the management of insomnia in older adults.Recent findingsThe treatment of insomnia with cognitive behavioral therapy for insomnia (CBT-I) continues to be empirically supported and the recommended first-line intervention for adults. Accumulating evidence indicates that other non-pharmacological therapies for insomnia, such as mindfulness-based therapies, light therapy, and physical activity interventions, as well as treatment delivered by non-clinician “sleep coaches” also positively impact insomnia symptoms. Finally, recent systematic reviews offer guidelines and recommendations for pharmacological management of insomnia.SummaryCBT-I remains the recommended first-line treatment for insomnia across adult ages. There is a continued need to increase the availability and optimize the delivery of CBT-I and other therapies for older adults with insomnia to maximize treatment benefits. There is also evidence for some benefit of pharmacological agents to treat insomnia; however, these are not without risks, particularly in the geriatric population.