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Lazy GPs keep on doling out powerful sleeping pills to the elderly when they should only be used as short term treatmentOne in five elderly insomnia sufferers have never had drugs reviewed by GPFour out of five of those surveyed have trouble sleeping despite taking pills
00:34 GMT, 3 April 2013
00:35 GMT, 3 April 2013
One in five elderly insomnia sufferers told a survey they have never had their drugs reviewed by a GP – which breaches official guidelines (file picture)
Doctors are still prescribing powerful sleeping pills for months at a time to older people who risk becoming addicted, warn experts.
One in five elderly insomnia sufferers told a survey they have never had their drugs reviewed by a GP – which breaches official guidelines.
Around two-thirds of patients aged 65 and over have never been advised about alternative approaches such as sleep education, relaxation techniques, and psychological therapy.
But four out of five said they struggled with the effects of lack of sleep despite taking drugs.
Around 10 million NHS prescriptions for sleeping pills are issued each year, including the so-called Z-drugs.
These drugs, which commonly have names beginning with Z, are non-benzodiazepine hypnotics that have been widely prescribed since the 1990s.
But NHS guidelines say they should be only for short-term use, usually for two weeks and up to a maximum of four weeks at a time.
They have been criticised as having too many side effects such as loss of memory, extreme tiredness and balance problems compared with their benefits.
In a new report Insomnia, A Wake Up Call, a panel of six experts says hypnotics such as benzodiazepines and Z-drugs are not considered the best insomnia treatments for older patients.
‘However, despite recommendations, there is continued high, inappropriate and extended prescribing of these medications, such that some patients may become involuntarily addicted’ warns the report.
The survey which formed part of the report, included 100 UK patients with insomnia, half of whom were aged 65 and over.
All had been treated with hypnotics in the past six months.
Nearly half of all those questioned said they had never received alternative treatment options, such as practical advice on sleep and relaxation techniques, and cognitive behaviour therapy (CBT).
One in five of all those surveyed said they had never had their hypnotic prescription reviewed by their GP (file picture)
But younger people aged 18 to 64 were much more likely to get additional coping advice, two-thirds versus one third of pensioners.
One in five of all those surveyed said they had never had their hypnotic prescription reviewed by their GP.
A further 18 per cent said their reviews were more than six months apart, and only 10 per cent had been referred to a specialist.
More than 80 per cent rated their sleep quality on hypnotic drugs as ‘fairly bad’ or ‘very bad’ and half reported suffering from tiredness during the day.
Panel member Dr Alan Wade, a GP with a special interest in sleep, said ‘People living with insomnia in later life need to be managed with care, especially when it comes to the use of sleeping pills, such as benzodiazepines and Z-drugs, which can often lead to poor quality sleep and reduced functioning the next day.
‘The number of potentially addictive sleeping pills prescribed in this population is a worry, especially when there are effective and safer alternative treatment options available.
‘Doctors and care home providers need to think more carefully about prescribing these drugs. They should only be used for short term treatment but evidence suggests that up to 30 per cent of patients remain on them for the long term.
‘The elderly are particularly vulnerable, leading to increased traffic accidents, falls and fractures.’
The survey found that 16 per cent of participants had suffered a fall, injury or accident while on sleeping pills, but there was no significant difference in the rate of incidents between age groups.
The report recommends that hypnotics should be a last resort treatment for elderly patients with insomnia.
Sleeping pills have been criticised as having too many side effects such as loss of memory, extreme tiredness and balance problems compared with their benefits
Non-drug strategies should be tried first, and when medical treatment is necessary melatonin should be used before hypnotics.
Melatonin is a natural hormone that helps regulate the body’s sleep-wake cycle and is often taken to counter the effects of jet lag.
The report was sponsored by Flynn Pharma Ltd which markets the melatonin drug Circadin in the UK and Republic of Ireland.