Difficulty sleeping is a common complaint by older people which leads to medication use to help attain sleep.
This study provides a population-based description of medication, specifically taken to help with sleep, by Canadians over the age of 60. The proportion of this sleep medication that is prescribed, and the determinants of prescribed versus over the-counter (OTC) sleep medication use will also be presented.
The Canadian Community Health Survey, 2002, provided the study population of 9,393 respondents over the age of 60.
Almost 16% of Canadians over 60 reported taking sleep medication over the past year, of which 85% was prescribed by physicians. Sleep medication is higher for women, increases with age, poor health, chronic illness and poor quality sleep,and was especially high for people with a recent major depressive episode. Prescribed sleep medication increased with age, low income, low education, poor health, chronic illness and residence in the province of Quebec. Adjusting for health status or insurance covering medication costs made little difference.
This study provides important new information on the use of sleep medication by older Canadians. Overall sleep medication use and proportion of sleep medication prescribed are separate parameters with potentially different distributions, e.g., Quebec showed the same amount of sleep medication use as elsewhere, but a much higher proportion of it was prescribed.
"Women report sleep disturbances to a greater extent , and sleep disturbances seem to increase with old age  as does the use of sleep medication . Investigation of active ageing in the elderly showed that women are more often widowed, have a lower level of education, and are homemakers. "
[Show abstract][Hide abstract] ABSTRACT: It has been suggested that physical or social activity is associated with fewer sleep disturbances among elderly people. Women report more sleep disturbances than men, which could indicate a variation in activity patterns between the genders. The aim of this study was to investigate associations between sleep disturbances and leisure activities in men and women (
) aged ≥60 years in a Swedish population. Sleep disturbances were measured using eight dichotomous questions and seventeen variables, covering a wide range of leisure activities. Few leisure activities were found to be associated with sleep disturbances and their importance decreased when the models were adjusted for confounders and gender interactions. After clustering the leisure activities and investigating individual activities, sociointellectual activities were shown to be significant for sleep. However, following adjustment for confounders and gender interactions, home maintenance was the only activity significant for sleep. Being a female increased the effect of home maintenance. Besides those leisure activities, poor/fair self-rated health (OR 7.50, CI: 4.27–11.81) and being female (OR 4.86, CI: 2.75–8.61) were found to have the highest association with poor sleep. Leisure activities pursued by elderly people should focus on activities of a sociointellectual nature, especially among women, to promote sleep.
"In general, hypnotics is the most frequently used treatment for insomniacs in general (Lieberman 2007, Neutel & Patten 2009) but there are side effects such as daytime sleepiness, dependency and drug–drug interactions (Barbera & Shapiro 2005). Non-pharmacological treatment such as sleep hygiene interventions (Morin et al. 1999), daytime sleep restrictions and bright light therapy (Fetveit & Bjorvatn 2004) has been evaluated in a nursing home population with successful improvements of sleep onset. "
[Show abstract][Hide abstract] ABSTRACT: This study aimed to evaluate effects of a non-pharmacological intervention on sleep, activity and fatigue in patients receiving peritoneal dialysis by the use of both actigraphy registration and self-assessed questionnaires.
Insomnia is estimated to affect up to 60% of haemo- and peritoneal dialysis patients. It is associated with two common uremic symptoms, pruritus and restless legs syndrome. To our knowledge, no interventions have been evaluated by actigraphy.
A prospective multiple baseline single-case experimental design.
Two women and seven men with sleep problems, 48-77 years, treated with PD participated in a 17-week study from January 2009 to February 2011. Two interventions were separately implemented. First, a pressure-relieving mattress and second, a four week individual sleep hygiene and sleep scheduling intervention. The two interventions were evaluated both objectively by actigraphy and subjectively by questionnaires.
A total of 315 sleep-wake cycles from nine individuals were evaluated. Three patients improved clinically significantly in five or more of the nine outcomes, i.e. sleep onset latency, nocturnal sleep duration, numbers and duration of napping, movement and fragmentation index, number of steps, metabolic equivalent unit, sleep efficiency and fatigue. The other six patients also showed improvements but to a lesser degree. Physical activity advice was the intervention that yielded most sleep improvements.
This study illuminates the need for regular assessment of sleep and tiredness. It also demonstrates how a non-pharmacological treatment and self-management can be applied with renal supportive care to improve sleep quality.
This study is a clinical example of a non-pharmacological intervention with supportive care and self-management. This model can improve health and reduce the pharmacological burden because hypnotics can be replaced by sleep hygiene self-care activities.
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