Promotional Feature - Treating insomnia in the elderly

Insomnia is a condition that disproportionally affects the elderly; one National Institute on Aging survey found that over half (57%) of elderly people reported some form of chronic disruption of sleep, while only 12% that were surveyed reported no sleep complaints.

This is a promotional feature article that has been produced by Lundbeck Limited.

Therefore, if insomnia is not treated and managed effectively, it may put a large burden on both the individual and society.1

Because sleep complaints are fairly common in the elderly population, it is important for the physician to try to understand the true nature of the complaint; GPs must look at a number of aspects in order to determine the patient’s sleep hygiene. If the patient is sleep deprived, GPs may want to advise the following in order for them to achieve good sleep hygiene.2

  • Keep good sleeping habits, such as keeping to a regular bedtime routine and not using the weekend to catch up on sleep.
  • Avoid caffeinated drinks, smoking, alcohol, heavy meals and heavy exercise before bedtime.
  • Ensure that their bedroom environment is made right for sleep; not too hot, cold or noisy, and that it is only used for sleep – not for watching TV or working in bed.
  • Get in the mood for sleep by learning how to relax and wind down before bedtime.

Guidelines on the treatment of insomnia, published in November 2010 by The British Association for Psychopharmacology (BAP), recommend that good sleep habits are explored as the first intervention.3

The role of Circadin in the management of primary insomnia

Circadin is indicated for the short-term treatment of primary insomnia in patients who are aged 55 or over.4 Circadin, prolonged-release melatonin, helps restore the natural rhythm of sleep.5

This is particularly important for elderly patients, as natural melatonin reduces with age.6

The BAP guidelines recommend that prolonged-release melatonin should be used first if a hypnotic is indicated when treating primary insomnia in the elderly.3

Circadin is licensed for use in patients aged 55 and above and can be prescribed alongside sleep hygiene for up to 13 weeks, if required.4

It does not share the same commonly occurring side effects associated with Z-drugs and benzodiazepines, which means Circadin is suitable for consideration before Z-drugs and benzodiazepines in the licensed population.3,4

 


Updated with the latest in diagnosis guidance and insomnia news, the new healthcare professionals’ website, sponsored by Lundbeck Ltd, at www.sleepwelllivewell-hcp.co.uk ensures that you have access to information that aids insomnia patient management.

The above website was developed by Lundbeck Limited. Healthcare professional pages of  the website contain promotional material.

Including information on the sleep cycle, the biological clock and insomnia and risk, the site explains how Circadin may help patients 55 and over who have trouble drifting off to sleep, have restless sleep, wake up during the night and too early in the morning and feel tired and irritable the next day.

Guidance and tools available include: Tool to help assess response to insomnia treatment -  a standardised tool adapted from the Leeds Sleep Evaluation Questionnaire (LSEQ) Parrot and Hindmarch 1978,7 sleep advice for people with insomnia by Dr Alan Wade, guidelines and an algorithm for the management of insomnia and the British Association for Psychopharmacology Guidelines (sleep disorders); outlining, amongst other things, recommendations on prescribing prolonged release melatonin.

References
1. Foley DJ, Monjan AA, and Brown SL. et al. Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep 1995;18: 425–432

2. National Sleep Foundation. Healthy Sleep Tips www.sleepfoundation.org/article/sleep-topics/healthy-sleep-tips (accessed July 2011)

3.Wilson SJ, Nutt DJ, Alford C et al. British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders. Journal of Psychopharmacology. 2010; 24(11):1577-601

4.Circadin Summary of Product Characteristics. Jan 2011. Available at: www.medicines.org.uk (accessed Jul 2011)

5. Lundbeck Ltd, Data on File, CIRC002 May 2008

6.Mahlberg R, Tilmann A, Salewski L et al. Normative data on the daily profile of urinary 6-sulfatoxymelatonin in healthy subjects between the ages of 20 and 84. Psychoneuroendocrinol 2006; 31: 634–641

7. Parrott AC, Hindmarch I. Factor analysis of a sleep evaluation questionnaire. Psychological Medicine 1978; 8: 325-9

This is a promotional feature article that has been produced by Lundbeck Limited.

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