Tolerability of Hypnosedatives in Older Patients

  title={Tolerability of Hypnosedatives in Older Patients},
  author={Udo Wortelboer and Stefan Cohrs and Andrea Rodenbeck and Eckart Rüther},
  journal={Drugs \& Aging},
Sleep disturbances are common and prevalence rates increase with age. Especially in the elderly, somatic diseases and medications with adverse effects relating to sleep are frequent reasons for disturbed and nonrefreshing sleep. It should be emphasised that these reasons must be excluded before symptomatic therapy is started. In some cases the use of hypnosedatives may be included as part of the treatment of a somatic disease and may cause sleep disturbances. Pharmacotherapy is one of the main… 

Use of Non-Benzodiazepine Hypnotics in the Elderly

In conclusion, based on relatively limited data, zopiclone, zolpidem, zaleplon, eszopicl one, and ramelteon represent modestly effective and generally well tolerated treatments for insomnia in older adults.

Sleep in the Elderly: Burden, Diagnosis, and Treatment.

  • W. McCall
  • Medicine, Psychology
    Primary care companion to the Journal of clinical psychiatry
  • 2004
Clinical studies, survey results, and guidelines retrieved from peer-reviewed journals in the PubMed database using the search terms elderly, temazepam, trazodone, zolpidem, zaleplon, insomnia, and prevalence and the dates 1980 to 2003 are presented.

Sleep in the Elderly: Burden, Diagnosis, and Treatment.

  • M. Wv
  • Medicine, Psychology
  • 2004
Clinical studies, survey results, and guidelines retrieved from peer-reviewed journals in the PubMed database using the search terms elderly, temazepam, trazodone, zolpidem, zaleplon, insomnia, and prevalence and the dates 1980 to 2003 are presented.

Insomnia in General Practice

Current views on the diagnosis and management of insomnia from the perspective of the GP are described and recognition of the following principles are presented.

Hipnoindutores e insônia

The profile, clinical use and indication of some of the most used sedative and hypnotic compounds are described, and the rational use of sedative antipsychotics for chronic insomnia, particularly in psychiatric patients is discussed.

Cognitive and balance dysfunctions due to the use of zolpidem in the elderly: a systematic review

Zolpidem, even in usual doses (5 mg and 10 mg), has shown to increase the risk for balance dysfunctions, however, this does not occur in relation to cognitive changes.

Medication sleuth: an important role for pharmacists in determining the etiology of delirium.

  • R. Collins
  • Medicine, Psychology
    The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists
  • 2006
A 65-year-old patient with a history of chronic pain, insomnia, and multiple medical problems, who presented with altered mental status and aggressive behavior, is described, and medication reconciliation of this patient's medication profile helped to reveal a medication cause for this patients' delirium.

Therapeutic approaches for the management of sleep disorders in geriatric population.

Comorbidity between sleep disturbances and aging-related health issues will represent a public health challenge to be address in the near future and will suggest an area that require further drug investigation and design of new pharmacological and pharmaceutical strategies to treat sleep disorders in elderly population.

Use of Sleep-Promoting Medications in Nursing Home Residents

Clinicians are advised to avoid long-acting benzodiazepines and to use hypnotics for as brief a period as possible, in most cases not exceeding 2–3 weeks of treatment, although some longer extension trials have recently been carried out.



Insomnia in the elderly: a review for the primary care practitioner.

Zaleplon, the newest benzodiazepine receptor agonist, has the shortest half-life of available agents and does not appear to cause rebound insomnia, residual sedation, or adversely affect psychomotor function.

Insomnia in the elderly.

  • M. Woodward
  • Medicine, Psychology
    Australian family physician
  • 1999
With appropriate management, most older people with insomnia will experience improved sleep and non pharmacological approaches include sleep hygiene measures, increasing sunlight exposure and acupuncture.

Benzodiazepines for insomnia in community-dwelling elderly: a review of benefit and risk.

  • R. Grad
  • Medicine, Psychology
    The Journal of family practice
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Clinicians should discontinue their prescribing of long-acting benzodiazepines for elderly patients with insomnia, and more research is needed on the effects of nondrug interventions as well as on short- and intermediate-acting Benzodiazepine to treat insomnia in community-dwelling elderly.

Sleep Disorders in the Elderly

Attempts to improve sleep should first and foremost be focused on elimination of somatic and psychiatric symptoms as far as possible, and on modification of lifestyle factors that may affect sleep quality.

Zaleplon shortens subjective sleep latency and improves subjective sleep quality in elderly patients with insomnia

Zaleplon is an effective and safe hypnotic for the treatment of insomnia in the elderly and its pharmacology and pharmacokinetics suggest a safety profile that is improved over other hypnotics.

Perspectives on the management of insomnia in patients with chronic respiratory disorders.

Control trials with short-acting benzodiazepine receptor antagonists, including triazolam, zolpidem, and zaleplon, suggest that these agents may be safely used in selected patients who have mild to moderate COPD without daytime hypercapnia.

Rational Use of Benzodiazepines in the Elderly

It is essential that the practitioner develop a treatment plan when utilising these agents to treat older patients, as the acute administration of benzodiazepines is associated with impairments in cognition, memory, coordination and balance, and long term use has been associated with symptoms of withdrawal upon abrupt discontinuation.

[Recommendations for the diagnosis and therapy of insomnia. German Society of Sleep Research and Sleep Medicine DGSM].

The German Sleep Society now publishes its own view to help physicians to cope with different recommendations, some of which are contradictory, regarding treatment with hypnotics.

Subjective quality of sleep and use of hypnotics in an elderly urban population

In multivariate regression analyses, insomnia and habitual use of hypnotics were associated with poor health, but only the latter with age and gender, and aging itself did not seem to have an effect on the quality of sleep.

The Effects of Estazolam on Sleep, Performance, and Memory: A Long‐Term Sleep Laboratory Study of Elderly Insomniacs

A 1‐mg dose of estazolam appears to be a safe and effective hypnotic for elderly patients with insomnia, as well as its side effects, which are not associated with marked rebound insomnia and anterograde memory loss.