ABSTRACT
INTRODUCTION Significant changes in both sleep and circadian regulation occur with aging. A recent National Sleep Foundation survey found that 36% of respondents over the age of 65 experienced sleep disturbances (1). Commonly reported complaints include habitually earlier bedtimes and wake times, inability to maintain sleep through the night, undesired early morning awakening, and frequent daytime sleepiness (2-5). A combination of age-related changes in sleep and circadian rhythm regulation, paired with decreased levels of light exposure and activity, contributes to the development of the circadian rhythm-based sleep disorders in older adults. Thus, the prevalence of circadian rhythm sleep disorders (CRSDs), such as advanced sleep phase disorder and irregular sleep-wake rhythm, are increasingly more common among older adults (6). This chapter reviews our current understanding of the pathophysiology, evaluation, and treatment of the more common age-related CRSDs.
