Insomnia elderly people

Insomnia is, by far, the most common sleep disorder it is estimated that approximately half of adults experience some form of insomnia at least once in their lives. Insomnia is less common in children and teenagers than in adults, but it is particularly prevalent in elderly people, as their sleep becomes fragmented with age. Insomnia is slightly more common in females than males. 

Elderly people who are living fuU lives with relatively unimpaired daytime wakefulness may complain of insomnia because they are not sleeping as long as they did when they were younger. Injudicious use of hypnotics in these individuals can produce daytime cognitive impairment and so impair overall quality of life. 

Benzodiazepines are most commonly prescribed for women and elderly patients. This may be partially due to the fact that women, in general, seem to be more willing to seek psychological help than men. In addition, four out of five people who experience panic attacks are women. Elderly patients are commonly afflicted with other conditions, such as insomnia and depression, which respond well to treatment with benzodiazepines. 

Insomnia is a common complaint in the elderly. As people age they require less sleep, and a variety of physical ailments to which the elderly are subject can cause a change in the sleep pattern (e.g. cerebral atherosclerosis, heart disease, decreased pulmonary function), as can depression. Providing sedative hypnotics are warranted, the judicious use of short half-life benzodiazepines such as temazepam, triazolam, oxazepam and alprazolam for a period not exceeding 1-2 months may be appropriate. Because of their side effects, there would appear to be little merit in using chloral hydrate or related drugs in the treatment of insomnia in the elderly. It should be noted that even benzodiazepines which have a relatively short half-life are likely to cause excessive day-time sedation. The side effects and dependence potential of the anxiolytics and sedative hypnotics have been covered elsewhere in this volume (Chapter 9). 

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