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Elderly Sleep Issues — Handle with Care

Many elderly patients have prescriptions for sedating agents to help them sleep. The University of Michigan and AARP conducted the National Poll on Healthy Aging, which found that 8% of older adults take a prescription sleep drug every night. About 23% who report trouble sleeping most nights of the week take prescription sleep aids regularly. 

This cause for concern as elderly patients are often more susceptible to the sedating effects of these medications.

  • Since many of these patients wake and get out of bed during the night, there is an increased risk of falls.  Because 1 in 10 falls may result in serious injury (including major head injury and fractures requiring hospitalization), it is important to reduce this risk whenever possible in this population. 
  • Additionally, hypnotic medications (including zolpidem) have also been associated with dementia and possibly increased risk of cancer or death. 

The 2019 American Geriatrics Society (AGS) Beers Criteria® strongly recommends limited the use of zolpidem, benzodiazepines, and other hypnotics for the treatment of insomnia in older adults.  

More effective and less risky interventions should be used for elderly patients.  These include sleep hygiene, Cognitive Behavioral Therapy (CBT), relaxation/mindfulness techniques, sleep restriction therapy, exercise training, etc. 


Source: Management of Insomnia Disorder, Comparative Effectiveness Reviews, No.159.  Agency for Healthcare Research and Quality (US); AHRQ Publication No. 15(16)-EHC027-EF, 2015 Dec.
An individual holding medication at the pharmacy

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