Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_41_библиотеки_им_акад_М_И_Перельмана

efciency (<70%), as determined by wrist actigraphy, were more likely to suffer from falls in the subsequent year compared to women with normal sleep duration and sleep efciency [107]. Additionally, sleep deprivation has also been associated with impaired immune function in healthy humans as well as animals, which most certainly has implications for hospitalized older adults [108]. Scientists have also noted genes in Drosophila ies– which promote increased sleep– in turn promote survival following infection [109, 110]. Sleep disturbances in hospitalized elderly patients are associated with increased mortality at 2years [63]. As previously noted, the AGS has recommended against certain medications to aid in sleep initiation and maintenance in the hospitalized elderly due to increased risk of falls and cognitive impairment, specically benzodiazepines and non-benzodiazepines. Melatonin remains the sleep aid of choice in this patient population. The Assessing Care of Vulnerable Elders-3 (ACOVE-3) program utilizes quality metrics to assess and pro­mote best practices of elder care [111]. Medications such as anticholinergics (including antihistamines) should be avoided [75]. Other medications frequently utilized to aid in sleep, but not recommended, in the elderly population such as antihistamines, oral decongestants (pseudoephedrine and ephedrine), and stimu­lants (amphetamine and methylphenidate) make insomnia worse, are associated with anticholinergic side effects, and are not recommended in the elder population [75, 103].