Prescription sleep medications put older adults at risk

One in three older than 65 take sleep aids

More than a third of adults older than 65 take something to help them sleep, with 1 in 12 taking prescription sleep aids, according to the National Poll on Healthy Aging. The poll, conducted by the Michigan Institute for Healthcare Policy and Innovation at the University of Michigan, suggests that many older Americans have been taking prescription sleep aids for years even though these medications are meant for short-term use.

Such prescriptions are usually not in the best interests of patients, said Antoinette B. Coe, PharmD, PhD, research assistant professor in the department of clinical pharmacy at the University of Michigan College of Pharmacy, who was not involved in the research. Coe noted that clinical guidelines often caution against prescription sleep medications in older populations because of the risks they present.

“Prescription sleep medications put older patients at higher risk for falls, confusion, delirium, and daytime sleepiness while not really improving how much they sleep or the quality of their sleep,” Coe said.

Kari A. Mergenhagen, PharmD, BCPS, AQ-ID, infectious disease clinical pharmacy specialist at the US Department of Veterans Affairs in Buffalo, NY, said the pressure for speed in the U.S. health system is partly to blame. “People age 65 or older are often given prescriptions before trying other approaches. Providers go with what’s fast to get patients through and out of the office.”

In the poll, which included 1,065 people ages 65 through 80, 46% of respondents reported having trouble falling asleep at least 1 night a week, with 15% saying they ran into difficulty getting shut-eye on 3 or more nights per week. A whopping 40% of those who couldn’t sleep considered their health to be fair or poor.

That’s a sign that providers may be overlooking the conditions that can cause insomnia and may need to invest more time in finding the culprit, said Jennifer Schroeck, PharmD, BCPS, CGP, inpatient clinical pharmacist and Mergenhagen’s colleague at the Buffalo VA.

“Sleeplessness is often more a symptom than the main condition. If you get to the root of the issue, you could be opening a Pandora’s box of what is causing sleeplessness—things like restless leg syndrome, pain, etc. But that’s a good thing, because you want to know what’s causing it so you can treat it,” Schroeck said.