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31.07.2014

Drugs for insomnia in elderly, sleep study results - .

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DOCTORS have been accused of the "inappropriate and extended" prescribing of powerful sleeping pills to vulnerable elderly insomniacs who risk becoming addicted. Panel member Dr Alan Wade said: "People living with insomnia in later life need to be managed with care, especially when it comes to the use of sleeping pills, such as benzodiazepines and Z-drugs, which can often lead to poor quality sleep and reduced functioning the next day. Patient information: See related handout on insomnia, written by the authors of this article.
Physicians may initiate treatment of insomnia at an initial visit; for patients with a clear acute stressor such as grief, no further evaluation may be indicated.
An approach to the evaluation and treatment of the patient with insomnia is shown in Figure 1.


However, if insomnia is severe or long-lasting, a thorough evaluation to uncover coexisting medical, neurologic, or psychiatric illness is warranted.
A more comprehensive evaluation should be pursued with nonresponders or if a comorbid condition is present or suspected.The evaluation of chronic insomnia should involve a detailed history and examination to detect any coexisting medical or psychiatric illness and may include an interview with a partner or caregiver. Food and Drug Administration (FDA) to treat circadian rhythm sleep disorder in blind children and adults, but it is unregulated and preparations vary greatly in strength.
Exercise improves sleep as effectively as benzodiazepines in some studies and, given its other health benefits, is recommended for patients with insomnia. Hypnotics generally should be prescribed for short periods only, with the frequency and duration of use customized to each patient's circumstances.


Benzodiazepines are most useful for short-term treatment; however, long-term use may lead to adverse effects and withdrawal phenomena.



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