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- 저자 : ( Su Shian Lee ) (검색결과 1 건)
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( Su Shian Lee ),( Stephanie Ward ),( Madan G Saha ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Elderly people experience a high prevalence of insomnia and poor sleep quality. Though the risks of hypnosedatives are well documented in this population, its use is highly prevalent. This paper provides an overview of non-pharmacological strategies available, and their evidence of effectiveness for the treatment of insomnia in the elderly. Methods: A literature search was performed using electronic searches on Medline, PsychINFO, EMBASE, Pubmed and the Cochrane library databases from 1995 till 2014. Relevant publications were also sought from citations and through manual searches of review articles. Search limiters were age above 60 years and English language. Key meta-analyses, systematic reviews, interventional and observational studies were identifi ed, reviewed, and available evidences summarized. Results: To improve symptoms of insomnia, there is evidence to suggest that in cognitively intact people, cognitive behavioural therapy (CBT) is effective. This review revealed confi icting evidence in regards to the effectiveness of physical exercises, bright light therapy and thermal manipulations for the treatment of insomnia. In residential care facilities, noise reduction strategy as a stand-alone therapy for insomnia was not effective but minimizing nocturnal interventions such as incontinence and pressure care, reduced night-time sleep disruptions. Conclusion: With the exception of CBT, there is currently limited evidence to suggest that bright light therapy, physical exercises and thermal manipulation are effective for treatment of insomnia in the elderly. This is due to small number of studies, small sample sizes, short follow-up, and strict patient selection criteria in reviewed studies. However, given its lack of adverse effects in contrast to hypnosedatives, non-pharmacological interventions may be considered as the fi rst line intervention for insomnia in the elderly.
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