Sleep in the Elderly
Insomnia may be a significant risk factor for
depression and cognitive impairment, both common
problems in the elderly. Yet despite the fact
that 30 percent of older adults complain of difficulties
with sleep, little is known about insomnia in
this population.
Nalaka Gooneratne, MD, MSc, an assistant professor in the Department of Medicine, is a specialist in sleep disorders in the elderly. He is interested in understanding the biobehavioral basis of insomnia in older adults in order to develop new treatment modalities. His work focuses on neuroendocrine and inflammatory factors that may exacerbate insomnia, as well as on the cognitive beliefs of older adults about sleep and sleep disorders.
Dr. Gooneratne is currently examining the role
of melatonin, a hormone secreted by the pineal
gland, in sleep in the elderly. Prior work done
by Dr. Gooneratne and Dr.
Allan Pack in the Division of Sleep Medicine
has shown that low melatonin levels are present
in some elderly subjects with insomnia.
Building
on this observation, Dr. Gooneratne has obtained
NIH funding to examine whether or not exogenous
melatonin can help to improve sleep patterns
in patients over the age of 65 suffering from
insomnia. His Phase II/III clinical trials examining
the potential of melatonin to treat insomnia
in the elderly are the largest randomized, placebocontrolled
studies to date of melatonin therapy for insomnia
that incorporate both objective and subjective
measures of sleep and daytime function.
A second goal of Dr. Gooneratne's research is to explore the cognitive beliefs of senior citizens towards their sleep problems and to examine how their backgrounds and ethnicity inform their decisions. A better understanding of these factors may identify barriers to treatment. Data from this study, funded by a Hartford Foundation grant, has recently been presented at the Association of Professional Sleep Societies meeting in 2004 and at an NIH State-of-the-Science conference on Chronic Insomnia in 2005.
To compliment these research activities, Dr. Gooneratne also runs a Sleep Disorders Clinic for Seniors. It is one of the few sleep clinics in the country that focuses solely on sleep disorders in the elderly population. This clinic also provides a fertile ground for the generation of additional clinically relevant research projects. These projects will help to establish the foundation for interventions that can improve the quality of life of the millions of elders that suffer from sleep disorders.
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