Each week we will aim to bring out a concise email that provides 4-5 key pieces of information addressing a specific issue in clinical therapeutics.
This week: Insomnia (Part 1)
Andrew Wood, Regional Pharmacist Manager, Ward MM
Insomnia is an inability to fall asleep or remain asleep that leads to reduced functioning because of the amount of quality of sleep obtained. It is a common complaint in the elderly, and may be exacerbated by the challenges of adapting to life in residential care.
- It is actually normal for older people to have a shorter sleep-period at night than they had earlier in life, particularly if they now have daytime naps. A discussion of realistic expectations, and clearing up misperceptions of how much sleep they are obtaining, are useful first steps.
- Good sleep hygiene should be first line: ensuring a comfortable sleep environment; retiring at a set time each night; avoiding excessive daytime naps; avoiding caffeine, nicotine and alcohol in the evening; emptying the bladder before retiring.
- Underlying problems may need to be addressed, especially anxiety/depression, pain, GORD and restless leg syndrome.
- A range of medications may trigger or exacerbate insomnia; common culprits in aged care include: certain antidepressants, beta blockers, statins, and cholinesterase inhibitors (used to treat dementia). Adjustment of timing or dose reduction may help, otherwise alternative medications may need to be sought.
Please consider these issues when preparing or interpreting RMMR reports or education sessions. Contributions of content or suggested topics are welcome and should be sent directly to email@example.com.