Prevalence, frequency and duration of hypnotic drug use among elderly living at home

Department of Health Care of the Elderly, University of Nottingham Medical School, Queen's Medical Centre.
British medical journal (Clinical research ed.) 03/1988; 296(6622):601-2. DOI: 10.1136/bmj.296.6622.601
Source: PubMed


Details of consumption of hypnotic drugs derived from a nationally representative sample of elderly people were analysed in terms of the prevalence, duration, and likely frequency of use. Of 1020 randomly selected subjects aged 65 and over 16% (166) reported using (mainly benzodiazepine) hypnotic drugs, and of these 89% reported having taken such a drug the night before the interview. Most of these users (73%) had been taking hypnotic drugs for more than one year, with 25% reporting drug use for more than 10 years. These results suggest that for most elderly users of hypnotic drugs, patterns of consumption encourage the development of cumulative effects and benzodiazepine dependence.

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    • "Comparing this to other reports, the prevalence of sleep medication use in the community setting was about 6.5–19% [11] [12] [13], in the psychogeriatric outpatient setting was 37.3% [14], and in the residential care centers it varied from 2.3 to 56.5% [15]. The results of use in this study were quite high as the study setting was a tertiary care hospital; subjects were likely to have multiple medical illnesses of more severity than in the general or community setting. "
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    ABSTRACT: Objective: To demonstrate patients’ strategies for insomnia, prevalence of sleep medication usage, and to determine factors associated with daytime function. Methods: Subjects who were aged > 60 years and who attended the internal medicine outpatient clinic of Srinagarind Hospital, Thailand were randomly interviewed from March 2012 to August 2013. Information on baseline characteristics and sleep variables were collected. Descriptive statistics were used to analyze baseline data, univariate and multiple logistic regression were used to analyze associated factors on poorly perceived impacts on daily life. Results: One hundred participants were recruited. The majority of them were female (74%). Self-help technique was used by 45%. The prevalence of sleep medication use was 45% without gender differences (P = 0.66). Using multiple logistic analysis, only 3 factors: diabetes with an adjusted odds ratio (OR) 5.40, being female (adjusted OR 0.28), and non-pharmacological management (adjusted OR 0.23) were independent factors of poorly perceived impacts on daily life. Conclusion: Frequent use of sleep medication and self-help strategy among older adults with chronic medical illnesses with insomnia was high. Diabetes and male sex were risk factors of poorly perceived impacts on daily life while self-help strategy with non-pharmacological use was a protective factor.
    European geriatric medicine 12/2013; 5(2). DOI:10.1016/j.eurger.2013.11.014 · 0.73 Impact Factor
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    • "For example, future studies could (a) include measures that allow for a wider range of scores on an individual PM test (i.e., those with more items to be remembered); (b) include multiple measures of PM rather than the single measure used here; and (c) consider whether diazepam differentially affects different types of PM tasks, such as time-based versus event-based and naturalistic versus laboratory-based. Research is also needed in older adults who predominantly show age-related decrements in PM (Einstein et al., 1995; Maylor, 1990) and are most frequently prescribed benzodiazepines (Morgan et al., 1988; Stewart et al., 1994). Importantly , these factors may interact to further impede successful independent living in aging. "
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    ABSTRACT: The amnestic effects of benzodiazepines are well documented on a variety of memory tasks. However, prospective memory (PM), or remembering to execute an action at a future time, has not been studied previously. This study examined the effect of diazepam on word list recall, PM, sustained attention, and subjective ratings of arousal. Forty-eight healthy participants, aged 19-35, received an average of 0.19 mg/kg oral diazepam or placebo in a double-blind manner. Retrospective memory and PM were assessed by free recall of unrelated word lists and by instructing participants to request a hidden belonging at the end of the session, respectively. Sustained attention was measured by multiple trials of a digit cancellation task, and subjective arousal was assessed by self-ratings of drowsiness. Diazepam impaired performance on all measures, including PM. Reduced PM performance was associated with decreased subjective arousal in the diazepam group but was unrelated to sustained attention. This is the first report of the effects of benzodiazepines on prospective remembering, and further supports the view that the arousal/attentional system is composed of partially independent subsystems that have differential relationships to memory.
    Human Psychopharmacology Clinical and Experimental 03/2006; 21(2):101-8. DOI:10.1002/hup.747 · 2.19 Impact Factor
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    • "One method to improve sleep is to take medication. Hypnotics are taken regularly by 15–19% of older adults (Clapin-French 1986, Morgan et al. 1988, Englert & Linden 1998), but can cause daytime residual effects, tolerance, dependence, altered sleep stages and rebound insomnia (Morin & Kwentus 1988, Gillin & Byerley 1990). Their safety and efficacy for sleep problems in older people has not been established (National Institute of Health 1991). "
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    ABSTRACT: Aim. The aim of this paper is to report an investigation of the effects of soft music on sleep quality in older community-dwelling men and women in Taiwan. Background. Sleep is a complex rhythmic state that may be affected by the ageing process. Few studies have focused on the effects of music, a non-pharmacological method of improving the quality of sleep in older adults. Method. A randomized controlled trial was used with a two-group repeated measures design. Sixty people aged 60–83 years with difficulty in sleeping were recruited through community leaders and screened using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale. Those reporting depression, cognitive impairment, medical or environmental problems that might interfere with sleep; and those who used sleeping medications, meditation, or caffeine at bedtime were excluded. Participants listened to their choice among six 45-minute sedative music tapes at bedtime for 3 weeks. There were five types of Western and one of Chinese music. Sleep quality was measured with the PSQI before the study and at three weekly post-tests. Groups were comparable on demographic variables, anxiety, depressive symptoms, physical activity, bedtime routine, herbal tea use, napping, pain, and pretest overall sleep quality. Results. Music resulted in significantly better sleep quality in the experimental group, as well as significantly better components of sleep quality: better perceived sleep quality, longer sleep duration, greater sleep efficiency, shorter sleep latency, less sleep disturbance and less daytime dysfunction (P = 0·04–0·001). Sleep improved weekly, indicating a cumulative dose effect. Conclusion. The findings provide evidence for the use of soothing music as an empirically-based intervention for sleep in older people.
    Journal of Advanced Nursing 02/2006; 53(1):134-44; discussion 144-6. DOI:10.1111/j.1365-2648.2006.03693.x · 1.74 Impact Factor
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