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Light Treatment for Sleep Disorders: Consensus Report

V. Age-Related Disturbances

Laboratory of Human Chronobiology, New York Hospital, Cornell University Medical College, 21 Bloomingdale Road, White Plains, NY 10605

Michael Terman

Department of Psychiatry, Columbia University and New York State Psychiatric Institute, 722 West 168th Street, New York, NY 10032

Alfred J. Lewy

Department of Psychiatry, Oregon Health Sciences University, 3181 S.W. Sam Jackson Park Road, Portland, OR 97201

Derk-Jan Dijk

Institute of Pharmacology, University of Zürich, Winterthurerstrasse 190, CH-8057, Zürich, Switzerland

Charmane I. Eastman

Biological Rhythms Research Laboratory, Rush-Presbyterian-St. Luke's Medical Center, 1653 West Congress Parkway, Chicago, IL 60612

Ziad Boulos

Institute for Circadian Physiology, 1 Alewife Center, Cambridge, MA 02140

Sleep maintenance insomnia is a major complaint among the elderly. As a result, an inordinate proportion of sleeping pill prescriptions go to individuals over 65 y of age. Because of the substantial problems associated with use of hypnotics in older populations, efforts have been made to develop nondrug treatments for age-related sleep disturbance, including timed exposure to bright light. Such bright light treatments are based on the assumption that age-related sleep disturbance is the consequence of alterations in the usual temporal relationship between body temperature and sleep. Although studies are limited, results strongly suggest that evening bright light exposure is beneficial in alleviating sleep maintenance insomnia in healthy elderly subjects. Less consistent, but generally positive, findings have been reported with regard to bright light treatment of sleep and behavioral disturbance in demented patients. For both groups, it is likely that homeostatic factors also contribute to sleep disturbance, and these may be less influenced by bright light interventions.

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