Awake at 4 AM: treatment of insomnia with early morning awakenings among older adults

J Clin Psychol. 2010 Nov;66(11):1161-74. doi: 10.1002/jclp.20734.

Abstract

Insomnia is a common problem among older adults. In particular, older adults experience insomnia coupled with early morning awakenings due to an interaction between age-related changes in circadian rhythm timing coupled with behavior changes that contribute to sustained poor sleep. Cognitive-behavioral therapy for insomnia (CBT-I), at times coupled with circadian interventions (e.g., timed light exposure), are likely to be most successful in optimizing sleep quality. In delivering CBT-I to older adults, modifications are sometimes necessary to accommodate for medical problems, lifestyle, social factors, and patient preferences. Addition of circadian interventions can ameliorate the negative effects of inappropriately timed sleep as well. These treatment methods can be highly effective and benefits can be long-standing. A case example is used to illustrate these points.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging / psychology
  • Chronic Disease
  • Cognitive Behavioral Therapy / methods*
  • Geriatric Assessment*
  • Humans
  • Male
  • Phototherapy / methods*
  • Sleep Disorders, Circadian Rhythm / diagnosis
  • Sleep Disorders, Circadian Rhythm / therapy
  • Sleep Initiation and Maintenance Disorders / diagnosis*
  • Sleep Initiation and Maintenance Disorders / therapy*