Insomnia, alcohol and drug use in community-residing elderly persons

Abstract

This paper describes and discusses the concurrent use of alcohol and medications in a retrospective sample of community-residing elderly persons with sleep complaints who reported daily alcohol consumption in a geriatric assessment clinic. Insomnia is a common complaint of older persons and frequently alcohol and over-the-counter and/or prescription medications are used as sedatives. The potential for adverse drug/alcohol interactions is a serious threat to health and functional status. The sample consisted of 19 persons ranging in age from 65 to 88 years. The most commonly voiced reason for seeking care related to problems of the central nervous system, including depression, anxiety and memory loss/forgetfulness. Other problems included urinary incontinence/retention, unexplained falls, bruises, trauma and pain. Eighteen of the 19 persons (95%) were using medications that adversely interact with alcohol. Sixteen of the 19 (84%) reported sleep problems, with sleep maintenance as the most common complaint. We recommend that all patients aged 65 years and older who report insomnia be asked about their use of alcohol, over-the-counter and prescription drug use, and be carefully assessed for drug/alcohol interactions during the initial health history and at least annually thereafter. We also recommend that consideration be given to non-pharmacological techniques to improve sleep.