Clinical Practice Guideline: Sleep Disorders

Sleep problems are extremely common among residents of long-term care facilities. Sleep disturbance and its behavioral consequences in patients with dementia are a common reason for admission to long-term care. Data suggests that age-related sleep changes, medical conditions common among older people, medications that affect sleep, substance use, and factors related to the long-term care facility environment all contribute to the prevalence of sleep difficulties in the long-term care population. Most patients with sleep disorders in the long-term care setting can be appropriately assessed and treated without specialist referral using a stepwise approach that emphasizes nonpharmacologic techniques and that uses a combination of pharmacologic and nonpharmacologic therapies if the latter alone are unsuccessful. The sleep disorders clinical practice guideline focuses on the evaluation and management of sleep disorders that are secondary to chronic medical conditions or environmental issues. Most sleep disorders in the long-term care setting fall into this category. Outcomes that may be expected from the implementation of this guideline include better awareness and understanding of sleep disorders among patients and caregivers, proper utilization of pharmacologic sleep agents, greater acceptance of individualized scheduling (i.e., enabling patients to get up, go to bed, and eat meals at times of their choosing rather than at institutionally established times), reduction in the frequency of daytime drowsiness, increased levels of participation in activities, enhanced quality of life, improved physical and cognitive function and fewer falls, reduction in nighttime disruptive behavior caused by sleep problems, reduction in distressed daytime behavior in patients with dementia, decline in geriatric psychiatry referrals for evaluation of behavioral problems related to sleep disorders, increased participation in rehabilitation programs and better rehabilitation outcomes and increased job satisfaction among caregivers.

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Product Code: CPG21
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Published 2006