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Sleeplessness Not What Nature Intended for Elderly, Panel Says

March 28, 1990

WASHINGTON (AP) _ Sleep problems may be common among the elderly, but that’s not the way nature intended it to be.

Sleeplessness among those over 65 generally is caused by health problems, emotional distress or poor sleep habits, a National Institutes of Health panel of experts said in a report released Wednesday.

Attempts to treat troubled sleep among the elderly often lead to an overuse of drugs or over-the-counter medications that are ineffective or even make the condition worse, the report said.

″The (common belief) that you don’t need as much sleep as you age is not true,″ said Dr. Robert J. Joynt, vice president of health affairs at the University of Rochester and chairman of the NIH panel that studied sleep problems among the elderly.

″In healthy, older people without an accompanying medical disease, there are very few complaints of sleep disorders,″ Joynt said at a news conference. ″Sleep problems are not because of the aging process alone, but because of other diseases.″

The 14-member panel said more than half of those over 65 who live at home complain of sleep problems. In long-term care facilities, such as rest homes, about two-thirds of the patients say they have sleep disorders.

And yet, Joynt said, many in medical science know little about normal sleep or how to treat sleep problems.

″Knowledge about sleep and its disorders is lacking and education is needed at all levels,″ including by physicians, he said.

In desperate attempts to treat themselves, the panel said, elderly patients often resort to the habitual use of over-the-counter sleep medication.

″They (over-the-counter drugs) are used to deal with the symptoms of sleeplessness,″ said Israel Hanin, a Loyola University professor and the pharmacology expert on the panel. ″These drugs may help to make the patient sleepy, but they have side effects and don’t treat the basic cause of sleeplessness.″

Hanin said over-the-counter sleeping pills can cause problems with vision and urination, along with a dry mouth and some heart conditions. And, he said, the pills become ineffective after long use.

Powerful prescription sleeping pills are even more dangerous because they can lead to more serious health problems and addiction, the panel said.

″Our report is quite clear in condemnation in the use of sedatives for sleep disorders,″ said Dr. Morton C. Creditor of the University of Kansas Medical Center in Kansas City. ″A major problem we have to deal with is over medication among the elderly.″

Joynt said that people tend with age to develop a different sleep pattern, but will generally sleep just as much as the young.

″For the elderly, sleep at night may be fragmented and not as deep,″ Joynt said. ″But the elderly often sleep some during the day so that their sleep is about equal″ to that of younger people.

Studies, he said, show that many who complain that they can’t sleep at night are actually sleeping more than they believed.

Sleep problems often are caused by poor sleep habits such as drinking caffeine at night or drinking fluids that cause people to awaken at night to go to the bathroom, Joynt said.

The report said exercise, going to bed the same time each night and ″the use of the bedroom primarily for sleeping and sexual activity″ may help.

Emotional and social developments may also disrupt sleep. Events such as retirement, depression or changes in natural sleep-rest cycles can lead to sleep disorders.

Many sleep problems, the panel said, are caused by medical conditions that must be treated before the sleeplessness will go away. Some of the common physical problems that can interrupt slumber include obesity, alcoholism, breathing difficulty, arthritis and cardiovascular disease.

The report called for more research on normal sleep patterns of the elderly. It also said that sleep disorders should be treated by specialists using advanced diagnostic tools, and that there should be controlled clinical trials to evaluate new treatments for sleeplessness.

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