® Insomnia and anxiety in older people Sleeping pills are usually not the best solution lmost one-third of older people in the people who take one of United States take sleeping pills. These these medicines sleep medicines are also sometimes called only a little longer and A“sedative-hypnotics” or “tranquilizers.” They better than those who affect the brain and spinal cord. don’t take a medicine. Doctors prescribe some of these medicines Sleeping pills can for sleep problems. Some of these medicines have serious side effects. also can be used to treat other conditions, such All sedative-hypnotic medicines have special as anxiety or alcohol withdrawal. Sometimes, risks for older adults. Seniors are likely to be doctors also prescribe certain anti-depressants more sensitive to the medicines’ effects than for sleep, even though that’s not what they’re younger adults. And these medicines may designed to treat. stay in older people’s bodies longer. These Most older adults should first try to treat their medicines can cause confusion and memory insomnia without medicines. According to the problems that: American Geriatrics Society, there are safer and • Increase the risk of falls and hip fractures. better ways to improve sleep or reduce anxiety. These are common causes of hospital stays Here’s why: and death in older people. Sleeping pills may not help much. • Increase the risk of car accidents. Many ads say that sleeping pills help people get a full, restful night’s sleep. But studies show that this is not exactly true in real life. On average, The new “Z” medicines also have risks. Over-the-counter medicines may not be a Most ads are for these new medicines. At first, good choice. they were thought to be safer. But recent studies Side effects of some medicines can be suggest they have as much or more risk than the especially bothersome for seniors: next-day older sleep medicines. drowsiness, confusion, constipation, dry mouth, and difficulty urinating. Avoid these Try treating without medicines first. over-the-counter sleep medicines: Get a thorough medical exam. Sleep problems • Diphenhydramine (Benadryl Allergy, Nytol, can be caused by depression or anxiety, Sominex, and generic) pain, restless leg syndrome, and many other • Doxylamine (Unisom and generic) conditions. Even if an exam does not find a cause, you should try other solutions before you • Advil PM (combination of ibuprofen and try medicines. diphenhydramine) • Tylenol PM (combination of acetaminophen Kinds of sleeping pills and diphenhydramine) All of these pills have risks, especially for older adults: When to try sleeping pills. Consider these medicines if the sleep problems Barbiturates are affecting your quality of life and nothing • Secobarbital (Seconal and generic) else has helped. But your healthcare provider • Phenobarbital (Luminal and generic) should watch you carefully to make sure that the medicine is helping and not causing bad Benzodiazepines side effects. For anxiety: • Alprazolam (Xanax and generic) • Diazepam (Valium and generic) • Lorazepam (Ativan and generic) For insomnia: • Estazolam (generic only) • Flurazepam (Dalmane and generic) • Quazepam (Doral) • Temazepam (Restoril and generic) • Triazolam (Halcion and generic) ”Z” medicines This report is for you to use when talking with your • Zolpidem (Ambien and generic) healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk. • Eszopiclone (Lunesta and generic) © 2017 Consumer Reports. Developed in cooperation with • Zaleplon (Sonata and generic) the American Geriatric Society. To learn more about the sources used in this report and terms and conditions of use, visit www.choosingwisely.org/patient-resources.