SLEEP DISORDERS IN THE ELDERLY: THERAPEUTIC STRATEGIES AND CLINICAL CHALLENGES

Abstract

Sleep disorders are highly prevalent in older adults, negatively impacting quality of life and overall health. Aging leads to physiological changes in sleep architecture, which are often exacerbated by comorbidities, polypharmacy, and neurodegenerative diseases. This narrative review, based on a PubMed database search, summarizes the therapeutic strategies and clinical challenges in managing these disorders. The recommended initial approach is non-pharmacological, with Cognitive Behavioral Therapy for Insomnia (CBT-I) being the first-line treatment for chronic insomnia. Pharmacotherapy requires caution, prioritizing medications with favorable safety profiles. For Rapid Respiratory Sleep Behavior Disorder (REMSD), melatonin is preferable to clonazepam due to its comparable efficacy and better tolerability. Accurate diagnosis, often requiring polysomnography, is essential to direct appropriate treatment and avoid the risks associated with inappropriate medication use. It is concluded that effective management of sleep disorders in older adults requires an individualized and multidisciplinary approach, prioritizing safe and evidence-based interventions.