ABSTRACT
Many clinical sleep researchers now agree that, irrespective of age, the most appropriate use of hypnotic drugs is in the treatment of 'transient situational insomnia'. This chapter is concerned with alternative strategies for responding to, and coping with sleep problems in old age. Medical treatment can be provided for those conditions in which sleep loss and tiredness may be the principal, and sometimes the only complaint. Where sleeping drugs have been taken continuously for long periods of time a systematic and supervised withdrawal can help to minimise some of the unpleasant rebound effects. Dementia has a particularly disruptive effect upon sleep, with prolonged daytime napping, frequent night-time awakenings and the added risk of confused nocturnal wandering. Clinical psychology has developed a variety of techniques and procedures which have proved extremely useful in the management of insomnia. Psychological treatments have proved useful in the treatment of insomnia and may provide a positive alternative to the use of hypnotics.
