Hypnotic Use in the Elderly

1995 ◽  
Vol 8 (5) ◽  
pp. 208-216
Author(s):  
Judith L. Beizer
Keyword(s):  
Sleep Disturbances ◽  
The Elderly ◽  
Initial Therapy ◽  
Geriatric Population ◽  
Sleep Complaints ◽  
Psychiatric Illnesses ◽  
Short Course ◽  
Underlying Causes ◽  
Nocturnal Myoclonus ◽  
Systemic Side Effects

Sleep disturbances are a common complaint in the geriatric population. Studies have shown that older people have a different sleep architecture as compared with that of younger people. Older patients with sleep complaints should be evaluated for underlying causes of sleep disturbances such as medication use, medical or psychiatric illnesses. Common sleep disorders in the elderly include sleep apnea, nocturnal myoclonus, restless leg syndrome, and insomnia. To treat insomnia, initial therapy should be nonpharmacological measures such as good sleep hygiene. If pharmacological treatment is necessary, a short course with a low dose of a short or intermediate-acting benzodiazepine or Zolpidem can be attempted. Because of pharmacokinetic and pharmacodynamic alterations, elderly patients are particularly susceptible to the central nervous systemic side effects of hypnotic agents and should be closely monitored.

Fatigue and asthenia

2015 ◽  
Author(s):  
Sriram Yennurajalingam ◽  
Eduardo Bruera
Keyword(s):  
Sleep Disturbances ◽  
Symptomatic Treatment ◽  
Future Research ◽  
Optimal Management ◽  
Pharmacological Agents ◽  
Factors Associated ◽  
Short Course ◽  
Underlying Causes ◽  
Individualized Management ◽  
Anxiety Depression

Fatigue is the most frequent, complex, multidimensional, and debilitating symptom in patients with advanced medical conditions. In the majority of palliative care patients, the aetiology of fatigue is multifactorial and the most common factors associated with fatigue include anorexia/cachexia, anxiety, depression, shortness of breath, sleep disturbances, anaemia, and inflammation. Routine screening for fatigue is essential for optimal assessment of fatigue and history and investigations should always be individualized. Management should initially aim towards identification and treatment of the reversible/underlying causes; however, if there are no reversible causes identified or if the fatigue is not responsive to specific treatments, symptomatic treatment should be considered. For optimal management the multidimensional components of fatigue should be assessed and future research is needed on the use of non-pharmacological treatment such as physical activity, counselling, and/or pharmacological agents such as a trial of psychostimulants or short course of corticosteroids.

scholarly journals Therapeutic Approaches for the Management of Sleep Disorders in Geriatric Population

2019 ◽  
Vol 26 (25) ◽  
pp. 4775-4785 ◽  
Author(s):  
Mireille Salas-Crisóstomo ◽  
Pablo Torterolo ◽  
André Barciela Veras ◽  
Nuno Barbosa Rocha ◽  
Sérgio Machado ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Sleep Disturbances ◽  
Current Knowledge ◽  
The Elderly ◽  
Health Condition ◽  
Human Beings ◽  
Geriatric Population ◽  
Medical Issues ◽  
Obstructive Sleep ◽  
New Treatments

Objective:Aging is a natural biological phenomenon that occurs in human beings. With increasing of age, there is an appearance of deleterious changes related to progression onto pathological conditions, including hypertension, heart disease, diabetes, hearing and vision impairments, as well as sleep disorders. It is important to recognize that some sleep disturbances reported by aged subjects include insomnia, obstructive sleep apnea, restless legs syndrome, among others. Moreover, accumulating evidence indicates that coexistence of medical issues with sleep disorders constitutes clinical challenges for treatment of comorbidities in elderly. Here, we have attempted to review and summarize the available literature that assesses the sleep disturbances in aging. In addition, we highlight the management of sleep disorders associated with aging. Due to the particular health condition of aged adults, the development of effective pharmacological interventions for sleep disorders treatment in aging is warranted.Methods:Review of studies retrieved from the PubMed.Results:The sleep-wake cycle includes abnormalities classified as sleep disorders. Comorbidity between sleep disturbances and aging-related health issues will represent a public health challenge to be addressed in the near future. Moreover, this scenario will suggest an area that requires further drug investigation and design of new pharmacological and pharmaceutical strategies to treat sleep disorders in the elderly population.Conclusion:The review highlights the sleep disturbances in aging. We focus on current knowledge in medicinal chemistry and further design of new treatments tools for managing sleep disturbances in the aged population.

scholarly journals AN EPIDEMIOLOGICAL SURVEY STUDY TO KNOW THE SLEEPING AND WAKE UP TIME OF ELDERLY AND ITS RELATION TO HEALTH

2020 ◽  
pp. 63-66
Author(s):  
Ankita ◽  
Mukta ◽  
Shivakumar S. Harti ◽  
Medha Kulkarni
Keyword(s):  
Chronic Pain ◽  
Sleep Disturbances ◽  
Epidemiological Survey ◽  
Survey Study ◽  
Older Individuals ◽  
Medical Problems ◽  
Geriatric Population ◽  
Sleep Complaints ◽  
Falling Asleep ◽  
Waking Up

Vridh Awsatha compared with Geriatric Population is the state of “Vata Vridhi” related with various Vatavridhi disorders. The older individuals often suffer from multiple medical problems. Like, osteoarthritis, shortness of breath, congestive heart failure, all can lead to difficulty with sleep initiation and maintenance. Trouble with sleep is strongly correlated with complaints about health and depression. Studies examining the prevalence of sleep disturbances in patients with chronic medical diseases have reported that 31% of arthritis and 66% of chronic pain patients report difficulty falling asleep, while 81% of arthritis, 85% of chronic pain, and 33% of diabetes patients report difficulty staying asleep. In a recent National Sleep Foundation survey of adults aged 65 years and over, those with more medical conditions, including cardiac and pulmonary disease and depression, reported significantly more sleep complaints. Objective: This study has been conducted to evaluate the sleeping and waking time of elderly and Diseases pattern with sleep status. Methodology: Interview based Questionnaire was prepared to know the sleep timings, waking up timings of elderly. 96 subjects of both sex was selected from OPD of AIIA, and nearby place and collected data was analyzed by using odd’s. Conclusion: According to the study the health status is directly affected by the timings of sleeping and waking up i.e. people who wake up early tends to be healthier. So, to add the quality in the end years of life, sleep will be main domain to work upon.

352 Feasibility of Hypnosis as Adjunctive Treatment for Subjective Sleep Disturbance: A Pilot Study and Proof of Concept

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A140-A141
Author(s):  
Emma Zhao ◽  
Afik Faerman ◽  
David Spiegel
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbances ◽  
Positive Impact ◽  
Self Report ◽  
Adjunctive Treatment ◽  
Current Evidence ◽  
Data Set ◽  
Sleep Complaints ◽  
Subjective Sleep ◽  
Before And After

Abstract Introduction Hypnosis-based interventions have been shown to have a positive impact on several dimensions of sleep health. However, current evidence is limited as only a paucity of studies included populations with sleep complaints. Here we present a pilot data set to demonstrate the feasibility of developing a hypnosis-based adjunctive treatment for subjective sleep complaints. Methods Eleven adults (42% female; mean age 45±16.87 years) who sought treatment at the Stanford Sleep Medicine Center or Center for Integrative Medicine for subjective sleep complaints received hypnosis as adjunctive treatment. Self-report questionnaires were used to assess the weekly frequency of subjective sleep disturbances experienced before and after treatment, as well as 5-point Likert scale ratings of perceived qualitative improvement in symptom severity and overall sleep quality. Results Five participants (45%) reported a reduction in symptom frequency and severity after hypnosis treatment. All five participants attributed at least some of the improvement to hypnosis treatment. Most participants (63%) observed post-treatment improvements in their overall sleep quality. No participants reported adverse effects of hypnosis. Conclusion Results suggest hypnosis-based adjunctive treatment may be effective for alleviating subjective sleep disturbances. The findings serve as preliminary support for further randomly controlled trials in larger samples. Support (if any):

Effectiveness of the Complete Health Improvement Program in a Geriatric Population

2021 ◽  
pp. 155982762110493
Author(s):  
Emily Scriven ◽  
Bhakti Chavan ◽  
David Drozek
Keyword(s):  
Risk Factors ◽  
Lifestyle Modification ◽  
Density Lipoprotein ◽  
The Elderly ◽  
Lipoprotein Cholesterol ◽  
Health Improvement ◽  
Cvd Risk ◽  
Improvement Program ◽  
Geriatric Population ◽  
Complete Health

The Complete Health Improvement Program (CHIP) is an intensive therapeutic lifestyle modification program (ITLMP) with well-documented success in decreasing risk factors for cardiovascular disease (CVD). Plant-based diets and physical activity are components of the program that contribute to these improvements. Yet, there are few studies on how ITLMPs affect risk factors specifically for the geriatric population. The goal of this study was to examine results of CHIP participants with a focus on the older (greater than 65 years) population in Athens, Ohio. Retrospective data from 2011 to 2017 were analyzed for 26 CHIP classes. Recorded variables included body mass index (BMI), blood pressure (BP), total cholesterol (TC), triglycerides, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), blood glucose (BG), and exercise level. Among geriatric participants, significant changes were found in BMI, BP, TC, LDL, HDL, BG, and exercise level ( P < .001). As compared to the younger population, changes in variables were equivalent in the geriatric population in all variables ( P > .05). These improvements in CVD risk factors among the elderly support the hypothesis that CHIP should be considered for CVD prevention and treatment in the geriatric population.

scholarly journals Geriatric oral health concerns, a dental public health narrative

2019 ◽  
Vol 6 (2) ◽  
pp. 883
Author(s):  
Ramprasad Vasthare ◽  
Anil V. Ankola ◽  
Arron Lim Yan Ran ◽  
Prateek Mansingh
Keyword(s):  
Public Health ◽  
Oral Health ◽  
Healthy Aging ◽  
Dental Health ◽  
The Elderly ◽  
Dental Public Health ◽  
Cognitive Changes ◽  
Geriatric Population ◽  
Health Concerns ◽  
Treatment Services

Across the world, the segment of the elderly in populations is seen to be increasing at a rapid rate. There also exists a trend in which more teeth are retained as age increases due to effective dental public health measures like fluoridation. This inevitably places an increased need for dental healthcare among the geriatric populations. Since oral health greatly affects the systemic health of aged individuals, it is imperative for dentists and physicians to work together as a team to impart treatment to the best of one’s abilities for geriatric patients. It is therefore, necessary to first assess the oral health concerns surrounding the geriatric population from the perspective of public health dentistry. Relationship of the elderly with periodontal disease, dental caries, salivary hyposalivation and xerostomia, cognitive changes, and simultaneous usage of diverse medications was discussed. This paper reviewed the literature and then examined and discussed the various problems mentioned in depth and suggested recommendations for a plan of action. Knowledge about the specific oral health concerns and issues will help to better position us in developing strategies for providing better oral healthcare to the geriatric population in addition to the existing systemic healthcare. In the future, the elderly will make up a huge portion of the demographic visiting dentist regularly for a myriad of oral health problems. Dental health professionals therefore, must have adequate training and competency to deal with the predicament of this geriatric population. Preventive and treatment services can ensure healthy aging which will improve the quality of life.

scholarly journals OLD AGE HOMES: ARE THEY ACCEPTABLE TO PAKISTANI GERIATRIC POPULATION? RESULTS OF A SURVEY OF ELDERLY OUTPATIENTS VISITING TEACHING HOSPITALS IN KARACHI, PAKISTAN

2018 ◽  
Vol 8 (2) ◽  
pp. 107-111 ◽  
Author(s):  
Waris Qidwai ◽  
Imdad Ali Khushk ◽  
Fizzah Farooq ◽  
Muhammad Yusuf Hafiz ◽  
Kashmira Nanji
Keyword(s):  
Old Age ◽  
The Elderly ◽  
Developed Countries ◽  
Cross Sectional Study ◽  
Teaching Hospitals ◽  
Chi Square ◽  
Geriatric Population ◽  
Cross Sectional ◽  
Term Care ◽  
Old Age Homes

Background: Worldwide, some one million people pass the sixty year old threshold every month (Ageing, WHO). Between 2010 and 2050, the number of older people in less developed countries is projected to increase. Methods: Cross-sectional study conducted in Outpatient clinics (OPD) of two hospitals in Karachi from April to May 2013. Elderly (> 60 years of age) visiting the clinics were consecutively recruited. 477 elderly were approached and a pretested, structured questionnaire was used to obtain information. Data was analyzed using SPSS version 19 and Pearson chi-square test was used to identify the factors related to choosing of "Old Age Homes". Results: A total of 400 participants were selected. Fifty-five percent of the elderly were in between 60 to 65 years of age and majority was males 54.8 percent. Elderly were aware of the presence of "Old Age Homes" in Pakistan, however only 7 percent choose to live in there. The main reason was found to be that the elderly did not want to go away from their families and loved ones. Conclusion: In conclusion, majority of the participants felt insecure to live in a home with strangers. However, "Old Age Homes" were preferred choice for those with chronic diseases or those living alone. Media should initiate public education programs to reduce social stigmas in seeking alternate long-term care services outside of the family.

Case Series of Skull Base Meningioma Resection in the Octogenarian Population

2021 ◽  
Author(s):  
Dorian M. Kusyk ◽  
Gordon Mao ◽  
Rocco Dabecco ◽  
Alexander K. Yu
Keyword(s):  
Skull Base ◽  
Case Series ◽  
The Elderly ◽  
Outcome Data ◽  
Skull Base Tumor ◽  
Geriatric Population ◽  
Perioperative Morbidity ◽  
Wide Range ◽  
Potential Risk Factors ◽  
Skull Base Meningiomas

Abstract Introduction The geriatric population is the fastest growing segment of the American population, and octogenarians are increasingly seen by neurosurgeons for relatively common lesions such as meningiomas. Unfortunately, providers do not have clear data to guide decision-making regarding these lesions, particularly if they involve the skull base. Current research in outcomes among the elderly looks at a wide range of ages, often anyone older than 65. Previous studies in octogenarians report a wide-range of mortality rates and do not focus on skull base lesions. This paper strives to clarify the experiences and outcomes of octogenarians. Patients and Methods This retrospective series reviews skull base tumor surgeries performed at a single academic institution over the past 15 years in octogenarian patients. Primary endpoint was 30-day mortality; however, potential risk factors, perioperative morbidity, postdischarge disposition, and longer term follow-up were also captured. Multivariate logistic regression was performed to identify relevant perioperative and medical characteristics that increases the risk of adverse events. Results Fourteen patients underwent craniotomies for skull base procedures with an average age of 84.5, with a 14% 30-day mortality rate. One patient required a tracheostomy on discharge and approximately half were able to either go home or rehabilitation after their procedure. On statistical analysis, there were no noted characteristics that predisposed any of the patients to a poorer outcome. Conclusion Octogenarian patients were able to tolerate surgery for skull base meningiomas resection. This outcome data may be used to inform surgical decision and guide conversation with patients and their families.

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