Sleep Disorders in the Long-Term Care Setting (AMDA Clinical Guideline)
-Sleep disorders are syndromes characterized by difficulty in initiating or maintaining sleep at night, difficulty in maintaining wakefulness during the day, or abnormal behavior associated with sleep, all of which are subjectively or objectively distressing to the patient. Sleep disorders are extremely common among residents of LTC facilities. Age-related sleep changes, medical conditions common among older people, medications that interfere with sleep, substance use or abuse, and factors related to the LTC facility environment all contribute to the prevalence of sleep difficulties in the LTC population.
This guideline focuses on the evaluation and management of sleep disorders that are secondary to chronic medical conditions or to environment issues as most sleep disorders in the LTC setting fall into this category. The guideline includes a systematic approach to recognizing, assessing, treating, and monitoring patients with sleep disorders, and it proposes a stepwise approach that facilitates appropriate management of LTC patients with sleep disorders, using a combination of nonpharmacologic and pharmacologic therapies.