More than half of older adults have sleep problems and a third of them take sleep medication despite potential health risks, according to the latest National Poll on Healthy Aging conducted by the University of Michigan.
A majority of respondents said they hadn’t talked with their primary care provider about the problem because they incorrectly believe that sleep issues are just part of aging. Many are putting themselves at risk of physical or mental harm without realizing it, according to experts at the UM’s Institute for Healthcare Policy and Innovation.
The nationally representative sample of people ages 65 to 80 found that more than a third of older adults (36 percent) reported regularly or occasionally using a prescription or over-the-counter sleep aid, pain medication or herbal supplement to help with sleep.
Those who turn to medications may not realize that these remedies carry health risks, either alone or in combination with other substances, according to Preeti Malani, M.D., a UM physician trained in geriatric medicine. Older adults who use sleep aids risk serious side effects, including drug-drug interactions, falls, memory issues, confusion, and constipation, even if the medication they took was sold without a prescription.
The most recent Beers Criteria from the American Geriatrics Society, which guides medication use among older people, strongly warns against use of prescription sleep drugs such as Ambien, Lunesta and Sonata.
In a typical week, nearly half of older adults (46 percent) reported that they regularly have trouble falling asleep one or more nights a week. Those with occasional sleep issues tended to use OTC medications. Among those with chronic sleep problems who took something regularly to try to sleep, prescription sleep medications were the most common option, with 17 percent reporting use.
Most who use drugs to help them sleep had been taking them for years. However, manufacturers and the U.S. Food and Drug Administration say sleep medications should only be taken short-term.
Medication: not the only option
“Although sleep problems can happen at any age and for many reasons, they can’t be cured by taking a pill, either prescription, over-the-counter or herbal, no matter what the ads on TV say,” said Malani.
While many sleep aids can be purchased without a doctor’s guidance or prescription, they still carry health risks for older people, Malani noted. Most contain diphenhydramine, an antihistamine that can cause side effects such as confusion, urinary retention and constipation.
She encouraged people regularly having difficulty sleeping to consult with their doctor. Among older adults who did this, 62 percent said the doctor provided helpful advice. But many poll respondents admitted that they simply never brought it up. Malani noted that a change in non-medication-based sleep habits are the first choice for improving sleep in older people.
Sleep and health
Other health conditions can contribute to sleep difficulties. Twenty-three percent of poll respondents who had trouble sleeping said it was because of pain. Moreover, 40 percent of those with frequent sleep problems said their overall health was fair or poor. Other reasons for sleep troubles included having to get up to use the bathroom at night (50 percent), and worry or stress (25 percent).
Insomnia and other irregular sleep patterns can interfere with daytime functioning and are associated with memory issues, depression and an increased risk of falls and accidents.
For more about sleep problems and older adults, check out these AHCJ articles: