November 11, 2005

Sleep pills may do more harm than good in elderly

NEW YORK (Reuters Health) - While sedative drugs, such as
Restoril and Ambien, may improve sleep in older people with
insomnia, the risks of such therapy may outweigh the benefits,
according to investigators in Canada.

The findings are based on a review of 24 trials that
included 2417 subjects aged 60 or older who were treated with
so-called sedative hypnotic pills or inactive placebo pills for
insomnia. The subjects received the assigned pills for at least
five consecutive nights.

Compared with placebo, sedative use was associated with
statistically significant improvements in sleep quality, total
sleep time, and the number of nighttime awakenings, Dr. Usoa
Busto, from the Center for Addiction and Mental Health in
Toronto, and colleagues note. However, the actual improvements
were modest in scope.

Several adverse effects were more common with sedative
hypnotics than with placebo, Busto's group reports in the
British Medical Journal. Sedative use greatly increased the
odds of thinking difficulties and daytime fatigue.

The likelihood of an untoward event was even greater in
subjects who were at high risk for falls or mental impairments,
the report indicates.

"Although the improvements in sleep variables obtained from
prescription hypnotics are statistically significant ... the
clinical benefits may be modest at best," the authors conclude.
Behavioral therapies may be a better option for older people
with insomnia, they add.

SOURCE: British Medical Journal, online November 11, 2005.