Sleeping disturbances and pharmacological/nonpharmacological interventions in old people.

Ann Univ Mariae Curie Sklodowska Med

Department of Neurology, Gentofte Hospital, Hellerup, Denmark.

Published: November 2003

Sleeping disturbance constitutes a major problem occurring in 25% of people aged over 65. Among the most frequent reasons of insomnia one can mention the overuse of coffee, alcohol, smoking, using some drugs, stress, depression, neurosis, dementia, chronic diseases. Idiopathic insomnia constitutes less than 5% of cases. Before the treatment of insomnia is started, its cause should be found and it should be determined if it is transient or chronic. The treatment of insomnia can be based on pharmacotherapy and non-pharmacotherapy methods. Behavioural therapy is mentioned among non-pharmacotherapeutic methods. It aims at changing the sleep-related habits. Pharmacotherapeutic treatment (still mostly based on benzodiazepines) should not last longer than 2-3 weeks and drugs of short elimination T 1/2 (below 6 hours) should be used. Side-effects of this group of drugs should always be taken into consideration. It should be remembered that sleep disturbances can be symptoms of other diseases and their treatment cannot consist in prescribing hypnotics only.

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