Insomnia Is Not a Normal Part of Aging: The Challenges of Safely and Effectively Managing Insomnia in Older People

Almost everyone has sleep problems from time to time, and often, simple nonpharmacologic interventions can improve sleep hygiene. When nonpharmacologic interventions fail, patients often request and may even require treatment with hypnotics. Insomnia is a heterogeneous disorder. Patients with insomnia may have trouble falling asleep, staying asleep, or waking too early. Sleep disturbances are especially common in older people because of changes in sleep architecture. Though this population may benefit from hypnotics to improve sleep, these drugs increase the risk of polypharmacy, drug interactions, and adverse drug effects, such as falls and cognitive impairment. Pharmacists must consider patient-specific factors to ensure older patients who require hypnotics receive an appropriate drug for an appropriate duration.