A Review of Symptom, Pathogenesis and Treatment Characteristics of the Elderly with Chronic Insomnia

Overview

Journal Medicine (Baltimore)

Date 2025 Jan 31

PMID 39889161

Authors

Libo Xia

Haiyan Liu

Jixiang Ren

Affiliations

Soon will be listed here.

Abstract

One third of a person's life is in a state of sleep, and good sleep quality is one of the indicators of health. Long-term insomnia has a great impact on patients' quality of life, physical and mental state. Especially in the elderly, long-term insomnia will induce a variety of chronic diseases, seriously affecting the quality of life. Because of the characteristics of the physiological structure of the elderly, insomnia in the elderly has its unique characteristics different from that of the young. This article reviews the characteristics of chronic insomnia in the elderly in terms of symptom, pathogenesis and treatment. By elaborating the characteristics of senile chronic insomnia, we hope to provide ideas for clinical treatment of senile chronic insomnia.

References

Mander B, Rao V, Lu B, Saletin J, Lindquist J, Ancoli-Israel S . Prefrontal atrophy, disrupted NREM slow waves and impaired hippocampal-dependent memory in aging. Nat Neurosci. 2013; 16(3):357-64. PMC: 4286370. DOI: 10.1038/nn.3324. View

Nakamura T, Takasu N, Nakamura W . The suprachiasmatic nucleus: age-related decline in biological rhythms. J Physiol Sci. 2016; 66(5):367-74. PMC: 10717791. DOI: 10.1007/s12576-016-0439-2. View

Ishunina T, Van Heerikhuize J, Ravid R, Swaab D . Estrogen receptors and metabolic activity in the human tuberomamillary nucleus: changes in relation to sex, aging and Alzheimer's disease. Brain Res. 2003; 988(1-2):84-96. DOI: 10.1016/s0006-8993(03)03347-x. View

Roenneberg T, Kuehnle T, Juda M, Kantermann T, Allebrandt K, Gordijn M . Epidemiology of the human circadian clock. Sleep Med Rev. 2007; 11(6):429-38. DOI: 10.1016/j.smrv.2007.07.005. View

Koh K, Evans J, Hendricks J, Sehgal A . A Drosophila model for age-associated changes in sleep:wake cycles. Proc Natl Acad Sci U S A. 2006; 103(37):13843-7. PMC: 1564207. DOI: 10.1073/pnas.0605903103. View

van Galen K, Ter Horst K, Serlie M . Serotonin, food intake, and obesity. Obes Rev. 2021; 22(7):e13210. PMC: 8243944. DOI: 10.1111/obr.13210. View

Morin C, LeBlanc M, Belanger L, Ivers H, Merette C, Savard J . Prevalence of insomnia and its treatment in Canada. Can J Psychiatry. 2011; 56(9):540-8. DOI: 10.1177/070674371105600905. View

Nakamura T, Nakamura W, Yamazaki S, Kudo T, Cutler T, Colwell C . Age-related decline in circadian output. J Neurosci. 2011; 31(28):10201-5. PMC: 3155746. DOI: 10.1523/JNEUROSCI.0451-11.2011. View

Mackiewicz M, Nikonova E, Zimmermann J, Romer M, Cater J, Galante R . Age-related changes in adenosine metabolic enzymes in sleep/wake regulatory areas of the brain. Neurobiol Aging. 2006; 27(2):351-60. DOI: 10.1016/j.neurobiolaging.2005.01.015. View

10.

Liu C, Dai X, Li Y, Li H . Lifestyle Adjustment: Influential Risk Factors in Cognitive Aging. Adv Exp Med Biol. 2023; 1419:185-194. DOI: 10.1007/978-981-99-1627-6_14. View

11.

Sun H, Ye E, Paixao L, Ganglberger W, Chu C, Zhang C . The sleep and wake electroencephalogram over the lifespan. Neurobiol Aging. 2023; 124:60-70. PMC: 9957961. DOI: 10.1016/j.neurobiolaging.2023.01.006. View

12.

Broms U, Pitkaniemi J, Backmand H, Heikkila K, Koskenvuo M, Peltonen M . Long-term consistency of diurnal-type preferences among men. Chronobiol Int. 2013; 31(2):182-8. DOI: 10.3109/07420528.2013.836534. View

13.

Verreault M, Granger E, Neveu X, Delage J, Bastien C, Vallieres A . The effectiveness of stimulus control in cognitive behavioural therapy for insomnia in adults: A systematic review and network meta-analysis. J Sleep Res. 2023; 33(3):e14008. DOI: 10.1111/jsr.14008. View

14.

Natraj N, Richards A . Sleep spindles, stress and PTSD: The state of the science and future directions. Neurobiol Stress. 2023; 23:100516. PMC: 9969071. DOI: 10.1016/j.ynstr.2023.100516. View

15.

Krystal A, Lankford A, Heith Durrence H, Ludington E, Jochelson P, Rogowski R . Efficacy and safety of doxepin 3 and 6 mg in a 35-day sleep laboratory trial in adults with chronic primary insomnia. Sleep. 2011; 34(10):1433-42. PMC: 3174845. DOI: 10.5665/SLEEP.1294. View

16.

Naylor E, Buxton O, Bergmann B, Easton A, Zee P, Turek F . Effects of aging on sleep in the golden hamster. Sleep. 2001; 21(7):687-93. DOI: 10.1093/sleep/21.7.687. View

17.

Duffy J, Dijk D, Klerman E, Czeisler C . Later endogenous circadian temperature nadir relative to an earlier wake time in older people. Am J Physiol. 1998; 275(5 Pt 2):R1478-87. DOI: 10.1152/ajpregu.1998.275.5.r1478. View

18.

Riemann D, Perlis M . The treatments of chronic insomnia: a review of benzodiazepine receptor agonists and psychological and behavioral therapies. Sleep Med Rev. 2009; 13(3):205-14. DOI: 10.1016/j.smrv.2008.06.001. View

19.

Duffy J, Zeitzer J, Rimmer D, Klerman E, Dijk D, Czeisler C . Peak of circadian melatonin rhythm occurs later within the sleep of older subjects. Am J Physiol Endocrinol Metab. 2002; 282(2):E297-303. DOI: 10.1152/ajpendo.00268.2001. View

20.

McCrae C, Lichstein K . Secondary insomnia: diagnostic challenges and intervention opportunities. Sleep Med Rev. 2003; 5(1):47-61. DOI: 10.1053/smrv.2000.0146. View