Sleep Medicine
Volume 2, Issue 2 , Pages 99-114 , March 2001

Sleep disorders in the elderly

  • Barbara Phillips

      Affiliations

    • Division of Pulmonary and Critical Care Medicine, 800 Rose Street MN 614, University of Kentucky College of Medicine, Sleep Center, Samaritan Hospital, Lexington, KY 40536, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1-859-323-5419; fax: +1-859-323-1020
    • ,
  • Sonia Ancoli-Israel

      Affiliations

    • Department of Psychiatry 116A, University of California San Diego and Veterans’ Affairs San Diego Health Care System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA

Received 14 June 2000 ,Revised 2 October 2000 ,Accepted 5 October 2000.

References 

  1. Bliwise DL. Sleep in normal aging and dementia. Sleep. 1993;16:40–81
  2. Ancoli-Israel S. Sleep problems in older adults: putting myths to bed. Geriatrics. 1997;52:20–30
  3. Miles L, Dement WC. Sleep and aging. Sleep. 1980;3:119–220
  4. Cauter EV, Leproult R, Plat L. Age-related changes in slow wave sleep and REM sleep and relationship with growth hormone and cortisol levels in health men. J Am Med Assoc. 2000;284:861–868
  5. Dijk DJ, Duffy JF, Czeisler CA. Contribution of circadian physiology and sleep homeostasis to age-related changes in human sleep. Chronobiol Int. 2000;17:285–311
  6. Foley DJ, Monjan AA, Brown SL, et al.  Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep. 1995;18:425–432
  7. Rediehs MH, Reis JS, Creason NS. Sleep in old age: focus on gender differences. Sleep. 1990;13:410–424
  8. Foley DJ, Monjan A, Simonsick EM, et al.  Incidence and remission of insomnia among elderly adults: an epidemiologic study of 6,800 persons over 3 years. Sleep. 1999;22(Suppl 2):S366–S372
  9. Roberts RE, Shema SJ, Kaplan GA, et al.  Sleep complaints and depression in an aging cohort: a prospective perspective. Am J Psychiatry. 2000;157:81–88
  10. Ford DE, Kamerow DB. Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? J Am Med Assoc. 1989;1479–1484
  11. Freidman RC, Kornfield DS, Bigger TJ. Psychological problems associated with sleep deprivation in interns. J Med Educ. 1973;48:436–441
  12. Leighton K, Livingston M. Fatigue in doctors. Lancet. 1983;1:1280
  13. Wilkinson R. After affect of sleep deprivation. J Exp Psychol. 1963;66:439
  14. Martin S, Engleman HM, Dreary IJ, Douglas NJ. The effect of sleep fragmentation on daytime function. Am J Respir Crit Care Med. 1996;153:1328–1332
  15. Marcus CL, Loughlin GM. Effect of sleep deprivation on driving safety in housestaff. Sleep. 1996;19:763–766
  16. Roth T, Ancoli-Israel S. Daytime consequences and correlates of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. II. Sleep. 1999;22(Suppl 2):S354–S358
  17. Series F, Roy N, Marc I. Effects of sleep deprivation and sleep fragmentation on upper airway collapsibility in normal subjects. Am J Respir Crit Care Med. 1994;150:481–485
  18. Cooper KR, Phillips BA. The effect of short-term sleep loss on respiration. J Appl Physiol. 1982;53:855–858
  19. Phillips BA, Berry DTR, Schmitt F, Patel R, Cook Y. Sleep quality and pulmonary function in the healthy elderly. Chest. 1989;95:60–64
  20. Phillips BA, Cooper KR, Burke TV. The effect of sleep loss on breathing in patients with COPD. Chest. 1987;9:29–32
  21. Zorick FJ, Walsh JK. Evaluation and management of insomnia: an overview. In:  Kryger MH,  Roth T,  Dement WC editor. Principals and Practice of Sleep Medicine. 3rd ed.. Philadelphia, PA: WB Saunders; 2000;p. 615–624
  22. Ancoli-Israel S, Roth R. Characteristics of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. 1. Sleep. 1999;22:S347–S353
  23. Meissner H, Reimer A, Santiago SM, et al.  Failure of physician documentation of sleep complaints in hospitalized patients. West J Med. 1998;169:146–149
  24. Chenier MC. Review and analysis of caregiver burden and nursing home placement. Geriatr Nurs. 1997;18:121–126
  25. Zarcone VP. Sleep Hygiene. In:  Kryger MH,  Roth T,  Dement WC editor. Principals and Practice of Sleep Medicine. 3rd ed.. Philadelphia, PA: WB Saunders; 2000;p. 657–661
  26. King AC, Oman RF, Brassington GS, et al.  Moderate intensity exercise and self-rated quality of sleep in older adults. J Am Med Assoc. 1997;277:32–37
  27. Butler RN, Davis R, Lewis CB, et al.  Physical fitness: benefits of exercise for the older patient. Geriatrics. 1998;53(46):49–5261–62
  28. Naylor E, Penev PD, Orbeta L, et al.  Daily social and physical activity increases slow-wave sleep and daytime neuropsychological performance in the elderly. Sleep. 2000;23:87–95
  29. Chesson AL, Anderson WM, Littner M, et al.  Practice parameters for the nonpharmacologic treatment of chronic insomnia. An American Academy of Sleep Medicine report. Standards of Practice Committee of the American Academy of Sleep Medicine. Sleep. 1999;22:1128–1133
  30. Tamaki M, Shirota A, Tanaka H, et al.  Effects of a daytime nap in the aged. Psychiatry Clin Neurosci. 1999;53:273–275
  31. Gigli GL, Placidi F, Diomedi M, et al.  Sleep in healthy elderly subjects: a 24-hour ambulatory polysomnographic study. Int J Neurosci. 1996;85:263–271
  32. Asada T, Motonaga T, Yamagata Z, et al.  Associations between retrospectively recalled napping behavior and later development of Alzheimers disease: association with APOE genotypes. Sleep. 2000;23:629–634
  33. Bursztyn M, Ginsberg G, Hammerman-Rozenberg R, Stressman F. The siesta in the elderly: risk factor of mortality. Arch Intern Med. 1999;159:1582–1586
  34. Gyawali P. Is taking a siesta really a health hazard. Arch Intern Med. 2000;160:711–712(letter)
  35. Cheng TO. Afternoon nap is good for the elderly. Arch Intern Med. 2000;160:711–712(letter)
  36. Ancoli-Israel S, Poceta JS, Stepnowsky C, et al.  Identification and treatment of sleep problems in the elderly S M R. 1997;1:2–17
  37. Stepanski EJ. Behavioral therapy for insomnia. In:  Kryger MH,  Roth T,  Dement WC editor. Principals and Practice of Sleep Medicine. 3rd ed. Philadelphia, PA: WB Saunders; 2000;p. 647–656
  38. Morin C, Colecchi C, Stone J, et al.  Behavioral and pharmacologic therapies for late-life insomnia. A randomized controlled trial. J Am Med Assoc. 1999;281:991–999
  39. Morin C, Kowatch R, Barry T, et al.  Cognitive-behavioral therapy for late-life insomnia. J Consult Clin Psychol. 1993;61:137–146
  40. Kohsaka M, Fukuda N, Honma H, et al.  Effects of moderately bright light on subjective evaluations on healthy elderly women. Psychiatry Clin Neurosci. 1999;53:239–241
  41. Kobayashi R, Kohsaka M, Fukuda N, et al.  Effects of morning bright light on sleep in healthy elderly women. Psychiatry Clin Neurosci. 1999;53:237–238
  42. Campbell SS, Terman M, Lewy AJ, et al.  Light treatment for sleep disorders; Consensus Report. V. Age-related disturbances. J Biol Rhythm. 1995;10:151–154
  43. Is melatonin a treatment for insomnia and jet lag?. In:  Goldberg JR editors. A white paper of the National Sleep Foundation. Washington, DC: NSF; 1997;
  44. Youngstedt SD, Kripke DF, Elliott JA. Melatonin excretion is not related to sleep in the elderly. J Pineal Res. 1998;24:142–145
  45. Mishima K, Okawa M, Hozumi S, Hishikawa Y. Supplementary administration of artificial bright light and melatonin as potent treatment for disorganized circadian rest-activity and dysfunctional autonomic and neuroendocrine systems in institutionalized demented elderly persons. Chronobiol Int. 2000;17:419–432
  46. Morgan K. Sleep and aging: a research-based guide to sleep in later life. Baltimore; MD: The Johns Hopkins University Press; 1987;
  47. Whitney CW, Enright PL, Newman AB, et al.  Correlates of daytime sleepiness in 4578 elderly persons: the cardiovascular health study. Sleep. 1998;21(1):27–52
  48. Newman AB, Enright PL, Manolio MA, et al.  Sleep disturbance, psychosocial correlated, and cardiovascular disease in 5201 older adults: the cardiovascular health study. J Am Geriatr Soc. 1997;45:1–7
  49. Johns M. W: Reliability and factor analysis of the Epworth Sleepiness Scale. Sleep. 1992;15:376–381
  50. Walsh JK, Schweitzer PK. Ten-year trends in the pharmacological treatment of insomnia. Sleep. 1999;22:371–375
  51. Nierenberg AA, Peck PE. Management of monoamine oxidase inhibitor-associated insomnia with trazodone. J Clin Psychopharmacol. 1989;9:42–45
  52. Thompson JW, Surname MR, Blashfield RK. Psychotropic medication and priapism: a comprehensive review. J Clin Psychiatry. 1990;51:430–433
  53. Walsh JK, Erman M, Erwin CW, et al.  Subjective hypnotic efficicacy of trazodone and zolpidem in DSM-III-R primary insomnia. Human Psychopharmacol. 1998;13:191–198
  54. Roehrs T, Roth T. Hypnotics: efficacy and adverse effects. In:  Kryger MH,  Roth T,  Dement WC editor. Principals and Practice of Sleep Medicine. 3rd ed.. Philadelphia, PA: WB Saunders; 2000;p. 417
  55. Mendelson WB, Thompson C, Frankdo T. Adverse reactions to sedative/hypnotics: Three years experience. Sleep. 1996;19:702–706
  56. Mendelson W. The use of sedative/hypnotic medication and its correlation with falling down in the hospital. Sleep. 1996;19:698–701
  57. Ray WA, Thapa PB, Gideon P. Benzodiazepines and the risk of falls in nursing homes. J Am Geriatric Soc. 2000;48:682–685
  58. Mendelson WB, Garnett D, Gillin JC. Flurazepam-induced sleep apnea syndrome in a patient with insomnia and mild sleep-related respiratory changes. J Nerv Ment Dis. 1981;169:261–264
  59. Dolly FR, Block AF. Effects of flurazepam on sleep-disordered breathing and nocturnal oxygen desaturation in asymptomatic subjects. Am J Med. 1982;239–243
  60. Camacho ME, Morin CM. The effect of temazepam on respiration in elderly insomniacs with mild sleep apnea. Sleep. 1995;18:644–645
  61. Mendelson WB. Hypnotics: basic mechanisms and pharmacology. In:  Kryger MH,  Roth T,  Dement WC editor. Principals and Practice of Sleep Medicine. 3rd ed.. Philadelphia, PA: WB Saunders; 2000;p. 407–413
  62. Ancoli-Israel S. Insomnia in the elderly: a review for the primary care practitioner. Sleep. 2000;23:S23–S30
  63. Betts TA, Birtle J. Effects of two hypnotic drugs on actual driving performance the next morning. Br Med J. 1982;285:852
  64. Schlich D, L'Heritier C, Coquelin JP, et al.  Long-term treatment of insomnia with zolpidem: a multicenter general practitioner study of 107 patients. J Int Med Res. 1991;19:271–279
  65. George C. Perspectives on the management of insomnia in patients with chronic respiratory disorders. Sleep. 2000;23:S31–S35
  66. Girault C, Muir JF, Mihaltan F, et al.  Effects of repeated administration of zolpidem on sleep, diurnal and nocturnal respiratory function, vigilance, and physical performance in patients with COPD. Chest. 1996;1110:1203–1211
  67. George CF, Series F, Kryger MH, et al.  Safety and efficacy of zaleplon versus zolpidem in outpatients with chronic obstructive pulmonary disease (COPD) in insomnia. Sleep. 1999;22:S320
  68. Hajak G, Bandelow B. Safety and tolerance of zolpidem in the treatment of disturbed sleep: a post-marketing surveillance of 16944 cases. Int Clin Psychopharmacol. 1998;13:157–167
  69. Lavie P, Herer P, Hoffstein V. Obstructive sleep apnoea syndrome as a risk factor for hypertension: population study. Br Med J. 2000;320:479–482
  70. Nieto FJ, Young TB, Lind BK, et al.  Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. J Am Med Assoc. 2000;283:1829–1836
  71. Grote L, Ploch T, Heitmann J, Knacck L, Penzel T, Peter JH. Sleep-related breathing disorder is an independent risk factor for systemic hypertension. Am J Respir Crit Care Med. 1999;160:1875–1882
  72. Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. New Engl J Med. 2000;342:1378–1384
  73. Kripke DF, Ancoli-Israel S, Klauber MR, et al.  Prevalence of sleep-disordered breathing in ages 40–64 years. A population-based survey. Sleep. 1997;20:65–76
  74. Ancoli-Israel S, Kripke DF, Klauber MR, Mason WJ, et al.  Sleep-disordered breathing in community dwelling elderly. Sleep. 1991;14:486–495
  75. Young T, Palta M, Dempsey J, et al.  The occurrence of sleep-disordered breathing among middle-aged adults. New Engl J Med. 1993;328:1230–1235
  76. Keefe DL, Watson R, Naftolin F. Hormone replacement therapy may alleviate sleep apnea in menopausal women: a pilot study. Menopause. 1999;6:196–200
  77. Pickett CK, Regensteiner JG, Woodard WD, et al.  Progestin and estrogen reduce sleep-disordered breathing in postmenopausal women. J Appl Physiol. 1989;66:1656–1661
  78. Cook WR, Benich JJ, Wooten SA. Indices of severity of obstructive sleep apnea syndrome do not change during medroxyprogesterone acetate therapy. Chest. 1989;96:262–266
  79. Rajagopal KR, Abbrecht PH, Jabbari B. Effects of medroxyprogesterone acetate in obstructive sleep apnea. Chest. 1986;90:815–821
  80. Terra SG, Oberg KC. Medroxyprogesterone acetate in the treatment of obstructive sleep apnea. Ann Pharmacother. 1997;31:776–778
  81. Dexter DD, Dovre EJ. Obstructive sleep apnea due to endogenous testosterone production in a woman. Mayo Clin Proc. 1998;73:246–248
  82. Schneider BK, Pickett CK, Zwillich CW, et al.  Influence of testosterone on breathing during sleep. J Appl Physiol. 1986;61:618–623
  83. Pillar G, Lavie P. Assessment of the role of inheritance in sleep apnea syndrome. Am J Resp Crit Care Med. 1995;151:688–691
  84. Redline S. Epidemiology of sleep-disordered breathing. Semin Respir Crit Care Med. 1998;19(2):113–122
  85. Ancoli-Israel S, Klauber MR, Stepnowsky C, et al.  Sleep-disordered breathing in African-American elderly. Am J Resp Crit Care Med. 1995;152:1946–1949
  86. Wetter DW, Young TB, Bidwell A, et al.  Smoking as a risk factor for sleep-disordered breathing Arch Int Med. 1994;154:2219–2224
  87. Moser NJ, Phillips BA, Berry DTR, Harbison GL. What is hypopnea, anyway?. Chest. 1994;105:426–428
  88. American Academy of Sleep Medicine Task Force. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. Sleep. 1999;22:667–689
  89. Hosselet JJ, Norman RG, Ayappa I, Rapoport DM. Detection of flow limitation with a nasal cannula/pressure transducer system. Am J Respir Crit Care Med. 1998;157:1461–1467
  90. Levy P, Pepin JL, Malauzat D, et al.  Is sleep apnea syndrome in the elderly a specific entity?. Sleep. 1996;19:S29–S38
  91. Ancoli-Israel S, Kripke DF, Klauber MR, et al.  Sleep-disordered breathing in the community-dwelling elderly. Sleep. 1991;14:486–495
  92. Ancoli-Israel S. Epidemiology of sleep disorders. Clin Geriatr Med. 1989;5:347–362
  93. Ancoli-Israel S, Kripke DF, Klauber MR, et al.  Natural history of sleep disordered breathing in community-dwelling elderly. Sleep. 1993;16:S25–S29
  94. Hoch CC, Dew MA, Reynolds CF, et al.  Longitudinal changes in diary-and laboratory-based sleep measures in ‘old old’ and ‘young old’ subjects: a three-year follow-up. Sleep. 1997;20:192–202
  95. Bliwise D, Carskadon M, Carey F, Dement W. Longitudinal development of sleep-related respiratory disturbance in adult humans. J Gerontol. 1984;39:290–293
  96. Phoha RL, Dickel MJ, Mosko SS. Preliminary longitudinal assessment of sleep in the elderly. Sleep. 1990;13:425–429
  97. Hoch CC, Reynolds CF, Monk TH, et al.  Comparison of sleep-disordered breathing among healthy elderly in the seventh, eighth and ninth decades of life. Sleep. 1990;13:502–511
  98. Bader GG, Turesson K, Wallin A. Sleep-related breathing and movement disorders in healthy elderly and demented subjects. Dementia. 1996;7:279–287
  99. Bixler EO, Vgontzas AN, Have TT, Tyson K, Kales A. Effect of age on sleep apnea in men. Am J Respir Crit Care Med. 1998;157:144–148
  100. Redline S, Kimp K, Thishler PV, et al.  Gender differences in sleep disordered breathing in a community-based sample. Am J Respir Crit Care Med. 1994;149:722–726
  101. Bliwise DL, Feldman DE, Bliwise NG, et al.  Risk factors for sleep disordered breathing in heterogeneous geriatric populations. J Am Geriatr Soc. 1987;35:132–141
  102. Phillips B, Cook Y, Schmitt F, Berry D. Sleep apnea: prevalence of risk factors in a general population. South Med J. 1989;82:1090–1092
  103. Young T, Zaccarro D, Leder R, et al.  Prevalence and correlates of sleep-disordered breathing in the Wisconsin Sleep Cohort Study. Am Rev Respir Dis. 1991;143:380
  104. White DP. Central sleep apnea. In:  Kryger MH,  Roth T,  Dement WC editor. Principals and Practice of Sleep Medicine. Philadelphia, PA: WB Saunders; 2000;p. 827–839
  105. Javaheri S, Parker TJ, Liming JD, et al.  Sleep apnea in 81 ambulatory male patients with stable heart failure. Types, and their prevalences, consequences and presentations. Circulation. 1998;97:2154–2159
  106. Mant A, Saunders NA, Eyland AE, et al.  Sleep-related respiratory disturbance and dementia in elderly females. J Gerontol. 1988;43:140–144
  107. Hoch CC, Reynolds CF, Kupfer DJ, et al.  Sleep-disordered breathing in normal and pathologic aging. J Clin Psychiatry. 1986;47:499–503
  108. Ancoli-Israel S, Klauber MR, Butters N, et al.  Dementia in institutionalized elderly. relation to sleep apnea. J Am Geriatr Soc. 1991;39:258–263
  109. Ancoli-Israel S, Coy TV. Are breathing disturbances in elderly equivalent to sleep apnea syndrome?. Sleep. 1994;17:77–83
  110. Redline S, Kapur V, Sanders M, et al.  Effects of varying approaches for identifying respiratory disturbances on sleep apnea assessment. Am J Respir Crit Care Med. 2000;161:369–374
  111. Redline S, Sanders M. Hypopnea: a floating metric: implications for prevalence, morbidity estimates, and case finding. Sleep. 1997;20:1209–1217
  112. Berry DTR, Webb WB, Block AJ. Sleep apnea syndrome: a critical review of the apnea index as a diagnostic criterion. Chest. 1984;86:529–531
  113. Ancoli-Israel S, Klauber MR, Fell RL, Parker L, et al.  Morbidity, mortality and sleep-disordered breathing in community dwelling elderly. Sleep. 1996;19:277–282
  114. Ancoli-Israel S, Klauber MR, Fell RL, et al.  Sleep-disordered breathing: preliminary natural history and mortality results. In:  Seifert RA,  Carlson J, et al. editor. International Perspective on Applied Psychophysiology. New York: Plenum Publishing Corp; 1994;p. 103–111
  115. Bliwise DL, Bliwise NG, Partinen M, Pursley AM, Dement WC. Sleep apnea and mortality in an aged cohort. Am J Pub Health. 1988;78:544–547
  116. Hoch CC, Reynolds CF, Houck PR, et al.  Predicting mortality in mixed depression and dementia using EEG sleep variables. J Neuropsychiatry Clin Neurosci. 1989;1:366–371
  117. Mant A, King M, Saunders NA, et al.  Four-year follow-up of mortality and sleep-related respiratory disturbance in non-demented seniors. Sleep. 1995;18:433–438
  118. Phillips BA, Berry DTR, Lipke-Molbe T. Sleep-disordered breathing in healthy aged persons: fifth and final follow-up. Chest. 1996;110:654–658
  119. He J, Kryger MH, Zorick FJ, Conway W, Roth T. Mortality and apnea index in obstructive sleep apnea; experience in 385 male patients. Chest. 1988;94:9–14
  120. Wright J, Johns R, Watt I, Melville A, Sheldon T. The health effects of obstructive sleep apnoea and the effectiveness of treatment with continuous positive airway pressure: a systematic review of the research evidence. Br Med J. 1997;314:851–860
  121. Zhang J, Fraser S, Lindsay J, et al.  Age-specific patterns of factors related to fatal motor vehicle traffic crashes: focus on young and elderly drivers. Public Health. 1998;112:289–295
  122. Rehm C, Ross S. Elderly drivers involved in road crashes: a profile. Am Surg. 1995;61:435–437
  123. Berry DTR, Phillips BA, Cook YR, et al.  Sleep-disordered breathing in healthy aged persons: one-year follow-up of daytime sequelae. Sleep. 1989;12:211–215
  124. Redline S, Strauss ME, Adams N, et al.  Neuropsychological function in mild sleep-disordered breathing. Sleep. 1997;20:160–167
  125. Cheshire K, Engelman H, Dreary I, et al.  Factors impairing daytime performance in patients with sleep apnea/hypopnea syndrome. Arch Intern Med. 1992;152:538–541
  126. Kim H, Young T, Matthews G, et al.  Sleep-disordered breathing and neuropsychological deficits. Am J Respir Crit Care Med. 1997;156:1813–1819
  127. Reynolds CF, Kupfer DJ, Taska L, et al.  Sleep apnea in Alzheimer's dementia: correlation with mental deterioration. J Clin Psychiatry. 1985;46:257–261
  128. Donohue JL, Lowenthal DT. Nocturnal polyuria in the elderly person. Am J Med Sci. 1997;314:232–238
  129. Phillips BA, Berry DTR, Schmitt F, et al.  Sleep-disordered breathing in the healthy elderly. Clinically significant? Chest. 1992;101:345–349
  130. Phillips BA, Berry DTR, Schmitt FA, et al.  Sleep-disordered breathing in healthy aged persons: two and three year follow-up. Sleep. 1994;17:411–415
  131. Kribbs NB, Pack AI, Kline R, et al.  Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis. 1993;147:887–895
  132. Janson C, Noges E, Svedberg-Brandt S, Lindberg E. What characterized patients who are unable to tolerate continuous positive airway pressure (CPAP) treatment?. Respir Med. 2000;94:145–149
  133. Schmidt-Nowara W, Lowe A, Weigand L, et al.  Oral appliances for the treatment of snoring and obstructive sleep apnea: a review. Sleep. 1995;18:501–510
  134. Scher A, Schechtman KB, Piccirillo JF. The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. Sleep. 1996;19:156–177
  135. Walker R, Grigg-Damberger MM, Gopalsami C, et al.  Laser-assisted uvulopalatoplasty for snoring and obstructive sleep apnea: results in 170 patients. Laryngoscope. 1995;105:938–943
  136. Powell NB, Riley RR, Troell RJ, et al.  Radiofrequency volumetric tissue reduction of the palate in subjects with sleep-disordered breathing. Chest. 1998;113:1163–1174
  137. Li KK, Powell NB, Riley RW, et al.  Radiofrequency volumetric reduction of the palate: and extended follow-up study. Otolaryngol Head Neck Surg. 2000;122:410–414
  138. Emery BE, Flexon PB. Radiofrequency volumetric tissue reduction of the soft palate: a new treatment for snoring. Laryngoscope. 2000;1092–1098
  139. Coleman SC, Smith TL. Midline radiofrequency tissue reduction of the palate for bothersome snoring and sleep-disordered breathing: a clinical trial. Otolaryngol Head Neck Surg. 2000;122:387–394
  140. Ancoli-Israel S, Kripke DF, Mason W, et al.  Sleep apnea and periodic movements in an aging sample. J Gerontol. 1985;40:419–425
  141. Ancoli-Israel S, Kripke DF, Klauber MR, Mason WJ, et al.  Periodic limb movements in sleep in community-dwelling elderly. Sleep. 1991;14:496–500
  142. Trenkwalder C, Walters AS, Hening W. Periodic limb movements and restless legs syndrome. Neurol Clin. 1996;14:629–650
  143. Montplaisir J, Michaud M, Denesle R, Gosselin A. Periodic leg movements are not more prevalent in insomnia or hypersomnia but are specifically associated with sleep disorders involving a dopaminergic agent. Sleep Med. 2000;1:163–167
  144. Walters AS. the International Restless Legs Study Group. Toward a better definition of restless legs syndrome. Mov Disord. 1995;10:634–642
  145. Lavigne GJ, Montplaisir J. Restless legs syndrome and sleep bruxism; prevalence and association among Canadians. Sleep. 1994;17:739–743
  146. Rothdach AJ, Trenkwalder C, Haberstock J, Keil U, Berger K. Prevalence and risk factors of RLS in an elderly population: the MEMO study. memory and morbidity in Augsburg elderly. Neurology. 2000;54:1064–1068
  147. Phillips BA, Young T, Finn L, Hening WA, Asher K, Purvis C. Epidemiology of restless legs symptoms in adults. Arch Int Med. 2000;160:2131–2141
  148. Chesson AL, Wise M, Davila D, et al.  Practice parameters for the treatment of restless legs syndrome and periodic limb movement disorder. An American Academy of Sleep Medicine Report. Standards of Practice Committee of the American Academy of Sleep Medicine. Sleep. 1999;22:961–968
  149. Yamashiro Y, Kryger MH. Acute effect of nasal CPAP on periodic limb movements associated with breathing disorders during sleep. Sleep. 1994;17:172–175

PII: S1389-9457(00)00083-6

Sleep Medicine
Volume 2, Issue 2 , Pages 99-114 , March 2001

Article Tools