Considerations for integrated cognitive behavioural treatment for older adults with coexisting nocturia and insomnia
| Autor: | Camille P Vaughan, Alayne D Markland, Alison J Huang, Cathy A Alessi, Andrew Guzman, Jennifer L Martin, Donald L Bliwise, Theodore M Johnson II, Kathryn L Burgio, Constance H Fung |
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| Rok vydání: | 2022 |
| Předmět: |
behavioural therapy
Aging Cognitive Behavioral Therapy insomnia Clinical Sciences General Medicine older people aged Treatment Outcome Cognition Geriatrics Sleep Initiation and Maintenance Disorders Behavioral and Social Science Commentary Public Health and Health Services Humans Psychology Nocturia Mental health sleep Geriatrics and Gerontology Sleep Sleep Research Aged |
| Zdroj: | Age and ageing, vol 51, iss 2 Age Ageing |
| ISSN: | 1468-2834 0002-0729 |
| Popis: | Nocturia and chronic insomnia disorder are common conditions that frequently coexist in older adults. Existing medication treatments for each condition have risks, particularly in older adults. While treatment guidelines recommend starting with behavioural therapy for each condition, no existing program simultaneously addresses nocturia and insomnia. Existing behavioural interventions for nocturia or insomnia contain concordant and discordant components. An expert panel (including geriatricians with sleep or nocturia research expertise, sleep psychologists and a behavioural psychologist) was convened to combine and reconcile elements of behavioural treatment for each condition. Concordant treatment recommendations involve using situational self-management strategies such as urge suppression or techniques to influence homeostatic drive for sleep. Fluid modification such as avoiding alcohol and evening caffeine and regular self-monitoring through a daily diary is also appropriate for both conditions. The expert panel resolved discordant recommendations by eliminating overnight completion of voiding diaries (which can interfere with sleep) and discouraging routine overnight voiding (a stimulus control strategy). The final product is an integrated cognitive behavioural treatment that is delivered by advanced practice providers weekly over 5 weeks. This integrated program addresses the common scenario of coexisting nocturia and chronic insomnia disorder. |
| Databáze: | OpenAIRE |
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