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Bereavement is a ubiquitous part of the human condition. Almost no person makes it through his or her life without having to cope with the loss of a loved one several different times. The loss of a parent, child, or grandparent can be very distressing. For many, the most devastating loss is that of their spouse or partner, which usually occurs during later life. More than 800,000 older Americans are widowed every year. Apart from the severe emotional strain of the loss of a loved one, there are profound changes in lifestyle and status, often accompanied by reductions in financial security, perceived personal safety, and freedom of action. Thus, late-life spousal bereavement (LLSB) comprises one of the major impacts of bereavement on society.
Losses of family members or close friends can also be very traumatic, depending upon the nature of the death and/or the vulnerability of the individual. Most people experiencing grief from bereavement find that there is a lessening of the intensity of the grief as time progresses. For a majority, five emotional and cognitive stages of grief arise, peak, and dissipate within 6 months.1 However, those who continue to show elevated cognitive and affective symptoms 6 months postloss at are at higher risks for poor health outcomes, and require further intervention. For instance, complicated grief (CG), also referred to as prolonged grief disorder or traumatic grief, has recently gained acceptance in individuals for whom the usual time-limited course of emotional recovery from the loss event does not occur, and the associated emotional distress and functional impairments persist. Six-month postloss, a score of > 25 on the Inventory of Complicated Grief (ICG)2 is used to indicate CG.
The literature on sleep and bereavement is limited. This review focuses on two areas for which there are some findings to report, namely LLSB and CG. For LLSB, we will include the loss of a life partner of the same generation, whether or not the two people were formally married. One can regard LLSB and CG as bereavement situations for which sleep disruptions are likely to be maximal.
LATE-LIFE SPOUSAL BEREAVEMENT (LLSB)
As noted above, in addition to the severe emotional strain of the loss of a loved one, in LLSB there are profound changes in lifestyle...