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Age and Ageing 2003; 32: 19-25
© 2003, British Geriatrics Society

Review

Non-pharmacological management of primary and secondary insomnia among older people: review of assessment tools and treatments

Lyndal Petit, Nahid Azad, Anna Byszewski, Francine F.-A. Sarazan and Barbara Power

The Ottawa Hospital Civic Campus, 1053 Carling Avenue Ottawa, Ontario, Canada

Background: primary and secondary insomnia, especially among older adults, is frequently encountered by family physicians. Pharmacological interventions, although effective in some circumstances, can be detrimental in others. Non-pharmacological management of insomnia may allow the patients to self-administer the treatment.

Objectives: review of published literature of assessment tools and treatments for primary and secondary insomnia.

Results: two frequently used self-reporting methods for obtaining sleep data are sleep diaries and Pittsburg Sleep Quality Index. A large amount of research supports the use of non-pharmacological treatments such as stimulus control, sleep restriction, sleep hygiene education, cognitive therapy, multi-component therapy and paradoxical intention.

Conclusion:  assessing the nature of insomnia by using an effective assessment tool and providing patients with a non-pharmacological treatment should be the first intervention for insomnia. It is shown that non-pharmacological treatments for primary and secondary insomnia are feasible and effective alternatives to the use of benzodiazepines, and that family physicians should consider these when managing older patients with insomnia.

Keywords: insomnia, non-pharmacological treatments, assessment tools, older people, benzodiazepines


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