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Sleep Disorders In Older Adults Harrison G. Bloom, M.D.

I N T E R N A T I O N A L L O N G E V I T Y C E N T E R - U S A. Sleep Disorders In Older Adults Harrison G. Bloom, M.D. Director, International Geriatrics Clinical Education and Consultation Service International Longevity Center-USA New York, NY 翻译 : 唐莉. 老年人睡眠障碍. 哈里森 . 布鲁姆医学博士

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Sleep Disorders In Older Adults Harrison G. Bloom, M.D.

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  1. I N T E R N A T I O N A L L O N G E V I T Y C E N T E R - U S A Sleep Disorders In Older Adults Harrison G. Bloom, M.D. Director, International Geriatrics Clinical Education and Consultation Service International Longevity Center-USA New York, NY 翻译:唐莉

  2. 老年人睡眠障碍 • 哈里森.布鲁姆医学博士 • 国际老年医学临床教育中心主任 • 国际长寿中心，纽约

  3. I N T E R N A T I O N A L L O N G E V I T Y C E N T E R - U S A Consensus Conference to Develop Guidelines for the Assessment and Treatment of Sleep Disorders in Older Adults ILC-USA December 6 & 7, 2007 Made possible by an unrestricted grant from Takeda Pharmaceuticals North America

  4. 老年睡眠障碍评估和治疗的共识和指南 • 2007年12月6~7日

  5. “If sleep doesn’t serve an absolutely vital function it is the biggest mistake that evolution has ever made.”

  6. 如果睡眠不能完全恢复人体的活力和机能将是极大的错误，而这种错误在不断发生。如果睡眠不能完全恢复人体的活力和机能将是极大的错误，而这种错误在不断发生。

  7. Goal Develop consensus guidelines that are practical and relevant to the primary care practitioner in an ambulatory setting.

  8. 目标 形成和初级保健医生共识的医疗开发的实用性与基础护理相关的治疗背景

  9. Guidelines Evidence Based Best Practices

  10. 指导思想 以实践为依据

  11. Gallup Survey on Sleep and Healthy Aging October, 2005

  12. 睡眠和健康的民意调查 2005年10月

  13. Gallup Survey Objective Document older adults’ awareness and attitudes on a range of issues: • Knowledge of the importance of sleep • Sleep behaviors and coping mechanisms • Attitudes toward sleep and aging

  14. 民意调查目的 老年人对睡眠问题的意识和态度： • 睡眠的重要性 • 睡眠行为和应对机制 • 对于睡眠和衰老的态度

  15. Survey Goal Use survey results to help encourage discussion among healthcare professionals about sleep problems within the aging population.

  16. 调查目的 通过调查结果鼓励医疗保健专家关注讨论老年人睡眠障碍

  17. Methodology The Gallup Organization interviewed 1,003 Americans 50 years of age and older via random telephone surveys. Results are nationally representative of all adults age 50 and older.

  18. 方法学 盖洛普通过电话随机调查了1003位50岁以上的美国老年人 调查结果能够代表美国50岁以上人群的意见

  19. Summary of Findings: Older adults recognize the importance of sleep…

  20. 研究结果摘要： 中老年人意识到睡眠的重要性

  21. 睡眠的重要性 大部分老年人相信睡眠对健康非常重要

  22. Sleep Patterns One in two (47%) report they are getting less then seven hours a sleep a night One in three (34%) feel they need more sleep than they are currently getting

  23. 睡眠模式 二分之一(47%)的老年人一夜睡眠不足7小时 三分之一(34%)的老年人认为他们需要比现在睡眠时间更长的睡眠

  24. Attitudes Toward Sleep 45%feel they need more sleep today than when they were younger 24%agree that getting more than 9 hours of sleep a night is a sign of laziness

  25. 睡眠的态度 45%的人感觉需要比他们年轻时更多的睡眠 24%的人认为睡眠时间超过9个小时是懒惰的表现

  26. Reported use of “sleep aids” One in three (33%)report using at least one “sleep aid” in the past month 18% reported using the respective “sleep aid” every night

  27. 辅助睡眠方法的应用 三分之一（33%）的人在过去一个月内至少一次使用过辅助睡眠方法 18%的人每晚使用各种辅助睡眠方法

  28. OTC antihistamines or cold meds OTC sleep aids Melatonin Herbal remedies Alcohol Audio tapes Rx meds not prescribed to help with sleep problems Respondents reported usage of seven

  29. 老年人七种常用的辅助睡眠方法 • 非处方抗组织胺或感冒药 • 非处方辅助睡眠 • 褪黑素 • 草药 • 酒精 • 录音带 • 治疗睡眠障碍的处方和非处方药

  30. Treatment of Sleep Problems One in four (25%) believes she/he has a sleep problem 72% who feel they have a sleep problem have spoken to their healthcare providers More than half (53%) who have spoken with their healthcare providers are not receiving treatment 25%of people who feel they have a sleep problem report taking Rx sleep medication

  31. 睡眠障碍的治疗 四分之一（25%）的人认为自己有睡眠障碍 72%感觉自己有睡眠障碍的人已经报告了医生 一半以上（53%）报告过医生的人未得到治疗 25%认为自己有睡眠障碍的人正在服用处方睡眠药

  32. 处方睡眠药安全吗?

  33. Most Frequently Cited Safety Concerns • Not knowing long-term effects of drug (73%) • Becoming addicted (68%) • Next-day grogginess (67%) • Interactions with other medications (63%) • Next-day “hangover” feeling (63%)

  34. 最常见的安全隐患 • 长期药效不详(73%) • 成瘾性(68% • 次日感觉头昏(67%) • 对其他药物的影响(63%) • 次日“宿醉”感(63% )

  35. “It ain’t so much what we don’t know that gets us into trouble as what we do know that ain’t so.”

  36. 我们遇到的困难不是我们所能预料的

  37. Sleep: A marker of Physical and Mental Health in the ElderlyKathryn J. Reid, et al Objective: The objective of this study was to determine the occurrence and recognition of common sleep-related problems and their relationship to health-related quality-of-life measures in the elderly. Am J Geriatr Psychiatry 14:10,October 2006

  38. 睡眠：老年人身心健康的标志 目的：这项研究的目的是确定常见睡眠相关问题的发生和鉴别，以及睡眠与健康生活质量的关系。

  39. TABLE 2. Five-Item Sleep Questionnairea 1. Do you feel excessively sleepy during the day? Yes No 2. Do you find yourself falling asleep when you do not want to? Yes No 3. Do you snore frequently and loudly or stop breathing? Yes No 4. If yes to 3, do you feel unrefreshed on awakening? Yes No 5. Do you have difficulty falling asleep, staying asleep, or being able to sleep? Yes No -------------------- aData collection for educational data was initiated after enrollment had begun at the first several project sites (N1,323). For other demographic variables, the full sample size is 1,503. Am J Geriatr Psychiatry 14:10,October 2006

  40. 表2.睡眠问卷中的五个问题 1.你感觉白天嗜睡吗？ 2.当你不想睡的时候你会睡着吗？ 3.你频繁和大声打鼾或有呼吸中断吗？ 4.如果第三题你选择是，那么你在醒来的时候会觉得睡眠不解乏吗？ 5.你有入睡困难、易醒吗？

  41. Discussion A positive response to the question about excessive daytime sleepiness best predicted both poor physical and mental health. The results of this study also demonstrates a significant relationship between sleep disturbances with both physical and mental health-related quality-of-life status. Am J Geriatr Psychiatry 14:10,October 2006

  42. 讨论 白天过度嗜睡预示体力和精力的减弱 这项研究的结果也证实睡眠与身心健康相关的生活质量有密切关系

  43. Discussion Although the results of the current study indicate that sleep complaints are prevalent in the elderly and are often accompanied by higher rates of mental and physical health problems, primary care professionals are not identifying sleep problems in their patients’ charts. Am J Geriatr Psychiatry 14:10,October 2006

  44. 讨论 虽然当前研究结果表明老年人普遍存在睡眠主诉并常伴随身心健康问题，但初级保健专业人员尚不能鉴别患者的睡眠障碍。

  45. Discussion Although only speculation, the low detection rate of sleep disorders in this sample maybe the result of a common belief that sleep problems are part of normal aging and the perception among both patients and physicians that little can be done to improve sleep quantity and quality in the elderly. Am J Geriatr Psychiatry 14:10,October 2006

  46. 讨论 虽然只是推测，这个样本中睡眠障碍检出率低可能是由于人们通常认为睡眠障碍是正常衰老的一种表现，患者和医生很少去改善老年人的睡眠时间和质量

  47. Discussion Furthermore, even when recognized, the increasing demands and time constraints in primary care practices require efficient tools to screen for sleep disorders. Results from this study indicate that asking just one question about sleep can be reasonably predictive of poor mental and poor physical health-related quality of life. Am J Geriatr Psychiatry 14:10,October 2006

  48. 讨论 此外，甚至公认由于在初级保健实践中需求量的增加和时间所限，需要有效的工具来筛查睡眠障碍。这项研究表明，只要询问一个关于睡眠的问题就能合理的预测出和生活质量相关的身心健康。

  49. Discussion This study indicates that although there has been more than a decade of discussion about the prevalence and low detection rates of sleep problems, little has changed in primary care practice in recognition of sleep problems in the elderly. Am J Geriatr Psychiatry 14:10,October 2006

  50. 讨论 这个研究表明虽然睡眠障碍的患病率和低检出率已经讨论了十余年，但在老年人睡眠障碍的初级保健中仍没有改善。

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