An alarming percentage of seniors rely on sedatives to make it through the night, risking serious side effects. Public-health efforts to wean them from the drugs have yielded mixed results.
I’m married to a night owl. My Lovely Wife and her active brain typically keep late hours together, waiting patiently for the moment they’ve figured everything out and relaxed sufficiently to climb into bed and slip into slumber. This generally occurs long after I’ve retired for the evening but does not guarantee an uninterrupted snooze. More often than she’d prefer, MLW awakens sometime in the night and doesn’t get back to sleep until the birds begin chirping outside our bedroom window.
At least that’s what she tells me. I’ve been known to snore contentedly through mild earthquakes.
MLW is no outlier here in Geezerville; a good night’s sleep tends to become tougher to secure the older you get. A recent University of Michigan survey found that nearly half of the respondents between the ages of 60 and 80 reported having trouble falling asleep. And while there’s little scientific consensus on the causes, which can include dysfunctional brain signals, anxiety, chronic pain, and uncooperative bladders, elderly insomniacs tend to agree on the solution: sedatives.
Thankfully, MLW is not among the one in three seniors who relies on pharmaceuticals to get to sleep. That makes her less likely to suffer from memory loss, falls, and the other side effects of these drugs. The risks are severe enough, in fact, that public-health officials have revised international guidelines to discourage doctors from prescribing a category of sedatives called benzodiazepines, which include lorazepam, clonazepam, and zopiclone, to anyone over the age of 65. The results have been encouraging — a survey of patients at Veterans Administration hospitals showed a 21 percent drop in prescriptions — but, as University of Michigan researchers suggest, there’s still a long way to go.
“This downward trend is definitely encouraging, in particular the trend in the new starts for these medications, because the easiest solution is to not start people on them at all,” lead study author Donovan Maust, MD, MS, noted in a statement.
In a separate study at the Royal Victoria Hospital in Montreal, an education program helped 64 percent of participants wean themselves from the drugs. Not surprisingly — in my view, at least — 94 percent of those newly drug-free patients reported that they slept as well without the sedatives as they had when they were taking them.
This would suggest that lifestyle changes may be more sleep-inducing than any pharmaceutical options, notwithstanding recent research on the salutary effects of melatonin. The recommendations are so familiar as to be yawners themselves: fresh air and exercise, a consistent bedtime, no screens before bed, easy on the booze, yadda yadda yadda.
This generally works for me, unless for some reason I’m required to rise at an earlier hour than usual. I haven’t used an alarm clock since they went digital, so my brain on these occasions will wake me at regular, inconvenient intervals just to make sure I’m prepared to meet my obligations. This makes me a wreck for the rest of the day. So I have some notion of what MLW goes through during those evenings when she can’t quiet her thoughts enough to sink unhindered into a satisfying repose. And I’m amazed at how well she functions.
That’s not to say she’s satisfied with her erratic sleep schedule. Lately, she’s curtailed her evening screen time, eliminated her post-dinner glass of wine, and begun taking a morning walk. Early results seem to be encouraging. Just the other day she told me she slept through the whole night. I had to take her word for it. I was out like a light as soon as my head hit the pillow.