Geriatric Quick Consult      Patient Can't Sleep      Table #1

Differential Diagnosis - Insomnia in Hospitalized Older People

Acute Insomnia Chronic Insomnia
  • Psychiatric disorders

    • Anxiety
    • Grief
    • Depression


  • New drugs*


  • Drug withdrawal*


  • Related to acute illness:

    • Pain
    • Limited mobility
    • Dyspnea
    • Polyuria
    • Urinary incontinence
    • Delirium
    • Infection
    • Metabolic disorder


  • Environment-related transient insomnia

    • Unfamiliar sleep environment
    • Nonconductive sleep environment (noise, light, temperature)
  • Primary insomnia


  • Associated with primary sleep disorders
    • Sleep apnea
    • Restless legs syndrome
    • Periodic limb movement disorder
    • Circadian rhythm disorder


  • Secondary to other conditions
    • Psychiatric disorders
    • Medical disorders
    • Neurologic disorders (dementia, Parkinson's)
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