Sleeping Pills May Be Dangerous for Senior Citizens

April 6, 2006 – Getting a good night sleep is a common problem for older Americans but they should not, however, reach for the sleep medication, says a specialist – these drugs are twice as likely to cause harm to a senior patient as they are to help them sleep better.

“Probably about 50 percent of older adults complain of sleep related problems,” says Jill Studley, M.D., gerontologist on the medical staff at Baylor University Medical Center at Dallas.

(See information on aging and sleep from Baylor Med Center below news report.)

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David Lazarus reported in his column of the San Francisco Chronicle - one in a multipart look at the business of sleep - a record 43 million sleeping-pill prescriptions were written by U.S. doctors last year, according to market researcher IMS Health.

"By 2010, according to estimates, the pharmaceutical industry will be reaping at least $5 billion from annual sales of so-called hypnotics," writes Lazarus.

"Americans are an increasingly sleepless people. The National Institutes of Health says more than 70 million people nationwide may be affected by sleep troubles -- and the total is expected to grow every year as Baby Boomers advance in age." Click to Lazarus March 3 column.

Millions of seniors ask their physicians for sedatives or sleeping pills or even get them over-the-counter, but new studies demonstrate how dangerous taking these medications can be for older adults, says Studley.

According to recent research, these drugs are twice as likely to cause an accident than they are to help you sleep, according to Studley.

“You won’t function as well in the morning, you may be at a higher risk for falling, having a car crash, or display problems with cognitive dysfunction so it’s very important to ask yourself: ‘Do I really want to take the risks for taking this medication,’” explains Dr. Studley.

So what’s a possible better solution? Studies have found that doing simple things like cutting out caffeine, exercising and going to sleep and waking at the same time each day can really help.

“Don’t go for the medication first. Look into why you’re having the sleep problems, have your doctor do a good review of medications and have your doctor talk to you about good sleep hygiene as well because we’ve found in some studies that good sleep hygiene is as efficacious as using a medication to sleep,” adds Dr. Studley.

Over the counter sleep medications may be safer than prescription drugs, but even they can cause problems sometimes. Be sure and tell your doctor about all the medications that you take—both prescription and non-prescription.

About Sleep and Aging by Baylor University Medical Center at Dalls

Aging changes in sleep

http://www.baylorhealth.com/healthinformation/1/004018.htm

Information

Sleep occurs in multiple stages. The sleep cycle includes dreamless periods of light and deep sleep, with occasional periods of active dreaming (REM sleep). The sleep cycle is repeated several times during the night.

AGING CHANGES

With aging, sleep patterns tend to change. Most people find that aging causes them to have a harder time falling asleep, and that they awaken more often.

Total sleep time remains the same or is slightly decreased (6.5 to 7 hours per night). It may be harder to fall asleep. The transition between being asleep and awake is often abrupt, giving older people the feeling of being more of a "light sleeper" than when they were younger.

Less time is spent in deep, dreamless sleep. Older people average 3 or 4 awakenings each night, with increased recall of being awake.

Awakenings are related to less time spent in deep sleep, and to factors such as need to get up to urinate (nocturia), anxiety, and discomfort or pain associated with chronic illnesses.

EFFECT OF CHANGES

Sleeping difficulty is an annoying problem, but it is seldom dangerous. Because sleep is lighter and awakenings more frequent, older people may feel deprived of sleep even when total sleep time has not changed.

Sleep deprivation can eventually cause confusion and other mental changes. It is treatable, and symptoms should lessen when adequate sleep is obtained. Sleep problems are also a common symptom of depression, so you should be evaluated and treated for depression if it is causing the problem.

COMMON PROBLEMS

● Insomnia is one of the more common sleep problems for the elderly.
● Other sleep disorders, such as narcolepsy or hypersomnia, can also occur.
● Sleep apnea, where the breathing stops for a time during sleep, can cause severe problems.

PREVENTION

The elderly respond differently to medications than younger adults, so it is VERY important to consult with a health care provider before taking medications for sleep. Avoid sleep medications if at all possible. Medications for depression, on the other hand, can be very helpful if depression contributes to the cause of the sleep problem. Most antidepressants do not produce the problems associated with sleeping medications.

Sometimes a mild antihistamine is more effective than an actual sleeping pill for relieving short-term insomnia.

Sleeping medications (such as benzodiazepines) should be used only as recommended, and only for a short time. Some can lead to dependence (needing to take the drug to function) or addiction (compulsive use despite adverse consequences) in some cases. Some build up in your body, and toxic effects can develop if you take them for a long time. Confusion, delirium, falls, and other side effects can develop.

You can take measures to promote sleep:

● Exercise (moderately) in the afternoon.
● Avoid stimulants such as caffeine (found in coffee, tea, cola drinks and so on) for at least 3 or 4 hours before bed.
● A light bedtime snack may be helpful. Many people find that warm milk increases sleepiness, because it contains a natural sedative-like amino acid.
● Try to go to bed at the same time every night and wake at the same time each morning.
● Do not take naps during the day.
● Use the bed only for sleep or sexual activity.

If you can't fall asleep after 20 minutes, get out of bed and do a quiet activity such as reading or listening to music.

When you feel sleepy, get back in bed and try again. If not successful in 20 minutes, repeat.

Drinking alcohol at bedtime may make you sleepy, but it is best to avoid it, because alcohol increases awakenings later in the night.