LOS ANGELES – Most older adults have sleep-related complaints, and most use some form of sleep aid, according to findings from the Successful Aging Evaluation study.
A large number of subjects reported using sleep aids that could have deleterious effects, such as alcohol and over-the-counter remedies.
Of 1,300 subjects included in the Successful Aging Evaluation (SAGE) study, 92.4% had sleep complaints, including waking feeling unrefreshed, early awakening, difficulty falling asleep, and middle of the night awakening. Each of these complaints was reported by between 75% and 79% of subjects, Dr. Nicolas Badre reported in a poster at the annual meeting of the American Association for Geriatric Psychiatry.
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More than half of older adults with insomnia use one or more forms of treatment for sleep disturbance, including prescription drugs.
More than half (55.5%) of the subjects reported using one or more forms of treatment for sleep disturbance: 8.1% reported using complementary or alternative treatments, 10% reported using alcohol, 14.8% reported using prescription medications, 21.3% reported using over-the-counter remedies, and 39% reported using behavioral techniques, according to Dr. Badre of the University of California, San Diego.
The use of any treatment for sleep was significantly associated with a higher number of doctor visits in the past year, lower Satisfaction With Life Scale scores, a lower average number of hours of sleep per night, depression as measured by the nine-item Patient Health Questionnaire, and reduced physical functioning as measured using the 36-Item Short Form Health Survey.
Clinical depression was associated with a significantly increased odds of any use of treatment for sleep (odds ratio, 2.4), and use of prescription treatment for sleep (OR, 3.3), Dr. Badre noted.
No significant association was seen between the use of any treatment for sleep and cognitive impairment.
The SAGE study was a structured, multicohort population-based study designed to assess successful aging. The survey included a 25-minute phone interview followed by a self-report survey of various domains of functioning. Respondents had a mean age of 77.3 years.
"Results from the SAGE investigation confirm the high prevalence of insomnia and its treatment in older adults," Dr. Badre wrote, noting that decreased activity of the suprachiasmatic nucleus and prescriptions often given to older adults – including stimulants, antihypertensives, respiratory medications, chemotherapy, and decongestants – are among the causes of sleep disturbance in older adults.
The high correlation between the use of any treatment for sleep and depression appears to be a significant risk factor for patients being prescribed medication for sleep, and the high rates of alcohol use and over-the-counter remedies as sleep aids are of concern, he said.
Dr. Badre reported having no relevant financial disclosures.