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Sharp Health News

Treating insomnia in older adults

May 11, 2017

Treating insomnia in older adults

Long bouts of sleepless nights may leave you searching for the latest and greatest in sleep medications. However, sleeping pills — also known as sedative-hypnotic drugs — affect the brain and spinal cord, and should be used with caution, according to Dr. David Hall, a double board-certified internal medicine and pediatrics doctor with Sharp Rees-Stealy Medical Group.

“All sedative-hypnotic medications have specific risks for adults who are 65 years of age or older because they are more sensitive to the drugs’ effects than are younger adults,” says Dr. Hall. “This is also true for newer drugs such as zolpidem (Ambien®) and eszopiclone (Lunesta®) that were initially thought to be safer. Recent studies show that they have as much or more risk than the well-established sleep medications.”

Dr. Hall adds that sleeping pills can cause side effects such as confusion and memory problems that more than double the risk of falls and hip fractures — common causes of hospitalizations and death in older adults.

If you are 65 years of age or older, Dr. Hall recommends nondrug approaches first, which are safer than medications for improving sleep or reducing anxiety. “It’s important to first get a thorough medical exam by your doctor, as sleep problems can be caused by depression, anxiety, pain, restless leg syndrome and many other conditions,” he says. “Nondrug options, such as improving sleep hygiene and cognitive behavioral sleep therapy, should be considered before medications.”

When to consider sedative-hypnotic drugs
“If sleep problems are affecting your quality of life, and you’ve tried nondrug treatments that don’t help, then you may want to consider these types of medications,” says Dr. Hall. “However, be sure your doctor monitors you closely to make sure the medication is helping and not causing harmful side effects.”

Tips for better sleep
Dr. Hall offers the following tips to help you get a good night’s sleep:

  • Exercise – However, avoid vigorous activity right before bedtime.
  • Establish a routine – Keep a consistent schedule when you go to bed and wake up in the morning, even on weekends.
  • Avoid meals right before bedtime – Eat three hours or more before going to bed.
  • Stay away from caffeine after 3 pm – If caffeine has a strong effect on you, you may want to avoid it even earlier in the day.
  • Limit alcohol consumption – Alcohol causes initial sleepiness, but overall it can disrupt your sleep.
  • Create the right environment – Keep the bedroom dark, quiet and cool, and clear your mind before bedtime.
  • Eliminate bright lights – Lights from your TV or mobile device can keep you awake.
  • Control pets – Pets jumping on and off your bed can disrupt your sleep.

Lastly, Dr. Hall suggests getting out of bed if you end up tossing and turning. “Find an activity, such as reading, that will make you sleepy and then return to bed after you start to feel drowsy.”

At Sharp Rees-Stealy, we want to empower you to make well-informed choices about your treatment options. That’s why we’ve made it our priority to support our doctors in helping you make smart and effective decisions by participating in Choosing Wisely®.

Choosing Wisely, an initiative of the ABIM Foundation, educates patients and doctors on selecting the most effective treatment available and avoiding unproductive, costly procedures. Sharp Rees-Stealy is the only medical group in Southern California to participate in this national campaign.

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