Sleep Aids for Seniors

A recent study found that poor sleep is not a normal part of aging, and blamed the epidemic of untreated insomnia on doctors, who sometimes assume insomnia is normal in older people. If your doctor understands you have trouble getting to sleep, he or she may recommend medication.

The most common insomnia drugs are fall into the classifications of sedatives, minor tranquilizers, and antianxiety drugs. These drugs are risky for older people and for people with breathing problems because they suppress the areas of the brain that control breathing. Prescription insomnia medications are often habit-forming. Their addictivity varies from person to person, so it pays to err of the safe side and watch yourself.

One common prescription sleep aid type is the benzodiazepines, which are sold under the names librium, valium, and dalmane, among others. Doctors are sometimes reluctant to prescribe these to seniors as older people cannot metabolize and breakdown drugs as efficiently as younger people. The drugs may work fine, but they might not wear off the next day. The medical literature says these drugs are not “well tolerated” by the elderly.

Most hypnotics are respiratory depressants and given that seniors often have sleep-related problems like apnea and nocturnal myoclonus, medical authorities advise doctors take caution in prescribing hypnotics for older patients with sleep complaints.

Non-benzodiazepine sleeping pills like Ambien and Lunesta are better tolerated and shorter-acting. These have become very popular in the past few years and are the most commonly prescribed sleep aids for older people.

Decades ago barbiturates were used, but these are now considered obsolete, as safer alternatives have been developed. There are also over-the-counter drugs which contain sleep-inducing anti-histamines (such as diphenhydramine and dimenhydrinate). These can relieve occasional or mild sleeping problems.

Nursing home staff unfortunately relies on sleep pills too often. This is understandable as they have to manage a large group of people, and its easier if most of the people in the building sleep and wake at the same time. Nursing homes are also tailor-made to produce insomnia as they have the lights on all night and are frequently noisy and because residents don’t get enough exercise. Many nursing homes turn to long-acting benzodiazepine hypnotics.

The chronic use of the older sleeping pills in the elderly, however, can produce undesirable side effects, such as impaired memory and alertness, incontinence, daytime sleepiness, and imbalance, which are already problems for many old people. The short acting benzodiazepines and the hypnotic non-benzodiazepines might be better as far as side effects, but studies are needed to confirm this. Zolpidem (Ambien) may be especially safe and effective in this group. In the meantime, behavioral therapy is proving to be useful even in older adults and, as in younger people, should be tried first. Light therapy may be particularly beneficial for nursing home residents.

Whatever medication you take, be sure to employ good sleep hygiene practices. Curiously, a scientific study found that listening to soft music at bedtime help older people sleep better.

Some people, with or without the approval of doctors, use melatonin to get over temporary insomnia. This is a hormone that naturally occurs in the body and is also found in plants, from which dietary supplements are derived. Older people’s bodies don’t produce as much of the hormone, and many seniors buy supplements at the health store or drug store. Because it is unregulated, you never really know what you’re getting when you buy melatonin. More here.

Related: valerian

Tiagabine is also promising in treatment of sleeping problems in older people.

Antihistimes

Benzodiazepines

Non-Benzodiazepine Sleeping Aids

Barbituates

journal abstracts

Pramipexole for Restless Legs Syndrome

Americans taking more sleep medicing than ever

Melatonin and sleep in an aging population

news

Study Links Children's Sleep Problems to School Problem

Scientists working on sleep/wake equation

Average sunrise time predicts depression prevalence

Study says therapy better than pills in treating sleep-onset insomnia

"Sleep hath seized me wholly"

(William Shakespeare – Cymebline)