Institute for Continuing Education

Sleep Disorders in the Elderly

Course Objectives

Upon successful completion of this module, you will be able to:

• Identify and describe the major categories of sleep disorders that affect the elderly population, including chronic insomnia disorder, obstructive sleep apnea, circadian rhythm sleep-wake disorders, REM sleep behavior disorder, and sleep-related movement disorders, with specific attention to prevalence rates, risk factors, and clinical presentations unique to geriatric patients.
• Explain the age-related physiological changes in sleep architecture including alterations in sleep stages (N1, N2, N3, and REM sleep), sleep efficiency, total sleep time, sleep latency, and circadian timing, and distinguish these normal aging changes from pathological sleep disturbances requiring clinical intervention.
• Discuss the current diagnostic criteria, evaluation methods, and assessment tools for sleep disorders in elderly patients, including in-laboratory polysomnography with video recording, home sleep apnea testing, actigraphy for circadian assessment, and validated screening instruments such as the STOP-Bang questionnaire, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Insomnia Severity Index.
• Describe the complex bidirectional relationships between sleep disorders in the elderly and comorbid medical and psychiatric conditions including cardiovascular disease, cognitive decline, dementia, Alzheimer disease, Parkinson disease, depression, anxiety, chronic pain, and metabolic syndrome, with emphasis on recent 2024-2025 research findings.
• Identify and evaluate evidence-based treatment approaches for elderly sleep disorder patients, including cognitive-behavioral therapy for insomnia (CBT-I) as first-line treatment, positive airway pressure therapy, pharmacological management guided by the 2023 American Geriatrics Society Beers Criteria, behavioral interventions, and multimodal treatment strategies.
• Explain the special considerations, challenges, and optimization strategies for implementing positive airway pressure therapy in elderly patients with obstructive sleep apnea, including mask selection, troubleshooting, and understanding of cardiovascular outcomes and the 2024 research findings on reduction of Alzheimer disease risk with CPAP treatment.
• Discuss the comprehensive role of the sleep technologist in the diagnostic evaluation, therapeutic intervention, patient education, and ongoing care management of elderly patients with sleep disorders, including technical adaptations for physical limitations, communication strategies for cognitive impairment, and interdisciplinary collaboration.

Course Information

The increase in the number of people over 65 and the rise in the proportion of older people represent a marked change in the demographic patterns in this country that will have profound social, economic, medical, and personal consequences. Individuals over 65 constituted 4 percent of the American population in 1900 and nearly 10 percent in 1972. Today, there are over 25 million Americans are 65 years of age or older, approximately 12% of the national population.

Within ten years this number will approach 30 million and probably exceed 20% of the population by 2020. One of the major changes that commonly accompanies the aging process is an often profound disruption of an individual’s daily sleep-wake cycle.