ABSTRACT
This chapter focuses upon the role of hypnotic drugs in the treatment of sleep problems in old age and, in particular, consider both the effects and side-effects of these widely used medicines. In clinical pharmacology a drug is described as a hypnotic if it promotes sleep. In general hypnotic drugs reduce sleep onset latency, decrease the amount of wakefulness intervening during sleep, and consequently increase total sleep time. Women are more likely to experience disturbed sleep through bereavement and chronic illness, while men are more likely to use alcohol as a remedy for problem sleep. Doctors also show a greater willingness to prescribe mood altering drugs for their women patients. Among elderly people in hospitals, nursing homes, and in residential care, levels of hypnotic drug usage are particularly high. Most benzodiazepine hypnotics reduce sleep onset latency and intervening wakefulness, increase total sleep time, and improve personal satisfaction with sleep. However, all hypnotics become less effective with regular use.
