Trouble sleeping? That’s just a natural outcome of accumulating lots of birthdays, right?
Actually, insomnia is not a normal result of aging. According to the National Poll on Healthy Aging, however, half of senior citizens are convinced that sleep problems “come naturally with age.”
The pollsters discovered that more than one-third of those over 65 “reported using some type of medication to help with sleep, including prescription sleep medications, over-the-counter medications promoted as nighttime formulations, herbal/natural sleep aids (like melatonin) or prescription pain medications.”
Not surprisingly, people who reported that they frequently have trouble getting to sleep were even more likely to take such medication. Almost one-third use their medicine regularly, with another third using it occasionally. A majority of those taking prescription sleeping pills had been taking them for years.
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Why is this important? Regular use of sleeping medications can have serious consequences for older adults.
People over 45 account for three-fourths of the emergency-department visits due to adverse effects of the sleeping pill zolpidem (The CBHSQ Report, May 2013). Side effects of such medications may include dementia and serious injury due to falls (Clinical Therapeutics, November 2016).
One popular prescription sleeping pill for older people is trazodone. Even though the Food and Drug Administration has never approved this old-fashioned antidepressant for insomnia, many primary-care providers prescribe it off-label for people who have a hard time falling asleep.
Trazodone is not innocuous, however. It may cause morning hangover. Dizziness, constipation, blurred vision and dry mouth also are fairly common. Liver injury, high blood pressure, glaucoma and abnormal heart rhythms are among its serious complications.
One reader reported her spouse’s experience: “My husband had difficulty sleeping and was prescribed trazodone. For most of the next day, he was like a zombie – brain fog, confusion, foot shuffling and disorientation. When he stopped taking the trazodone, we realized that all these nasty after-effects were due to the drug.”
People who are aware of the hazards of relying on prescription sleeping pills may turn to over-the-counter sleep aids. Unfortunately, a number of OTC medicines for sleeping contain diphenhydramine, a sedating antihistamine; it is the “PM” in Advil PM or Tylenol PM.
Diphenhydramine also has serious drawbacks for older individuals. This drug has strong anticholinergic activity and can lead to confusion, grogginess and memory loss.
People with chronic sleep disturbances should discuss this problem with their primary-care provider. Cognitive behavioral therapy for insomnia can be very helpful without causing adverse effects.
Some people find melatonin helpful. Others like a glass of tart cherry juice before bedtime. People who have to get up several times for bathroom visits report that eating a handful of raisins in the evening can help.
Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated radio show can be heard on public radio. In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: www.PeoplesPharmacy.com.