Taking sleep medications to treat insomnia, even when recommended by a doctor, may actually increase the risk of falling for older adults, according to a team of sleep researchers.
The problem may stem from older people continuing to take sleep medications long after they should, said Orfeu Buxton, associate professor of biobehavioral health at Penn State.
“The importance for me — personally and professionally — is that this matches what I’ve heard from gerontologists and physicians treating older patients at assisted-living and nursing homes,” said Buxton. “So many older adults come into the care of a physician late in life with a huge medication burden. They’ve been taking sleeping medications for years, or decades, and it’s the physician’s problem to get them off of medications that are no longer appropriate at that age.”
The medications, which include sleeping pills, often have side effects that cause problems with balance, memory and situational awareness, according to Buxton.
“The more likely a person has difficulty sleeping, the more likely they are going to be up and walking around in the dark at night,” said Buxton. “You might think that if they have a physician-prescribed sleep medication that risk of falling might go down because they would stay in bed, but it doesn’t. It worsens.”
Falls are a major health concern for older adults and a costly strain on the American health system, according to the researchers. More than 30 percent of adults aged 60 who live on their own fall each year. The costs for falls in the older adult population is estimated at $23.3 billion.
Buxton suggests that non-drug-related approaches to treating sleep disorders may be more effective for older adults and not put them at risk for increased falls.
“If you have difficulty sleeping the most effective treatment is cognitive behavioral therapy for insomnia — CBTi — which teaches patients how to learn to sleep well again,” said Buxton. “In contrast, medications have many unintended consequences that worsen with later age and with the duration of taking them. Almost all the sleeping medications are meant only for short-term use and even the long-term use indications are supposed to be on the order of weeks, not decades.”