Hur inverkar sömnmedel i form av bensodiazepiner och bensodiazepinbesläktade medel på dagtrötthet och frakturrisk hos äldre?

Sammanfattning: Insomnia is getting more prevalent with age, both because of natural changes in the sleep pattern and because of increased morbidity. It can cause dysfunctioning and sedation during the day. Therefore it is often treated with hypnotics. It is possible though that hypnotics can cause daytime sleepiness as well, not to mention increased risk of falling and fractures because of sedation and prolonged reaction time. Benzodiazepines and benzodiazepine related drugs, the subjects of this study, are commonly used as hypnotics. They are meant for short term treatment, however long term insomnia is common in the elderly. This study examines to which extent these hypnotics cause residual sedation during the day and if they increase the risk of falling and occurrence of bone fractures. The prevalence of long term treatment has been of interest as well. 24 elderly residents in a senior housing in Kalmar were interviewed about their daytime alertness, if they felt more alert or more tired when using hypnotics, and how many times they had fallen in the last year. They were asked about how long they had been using hypnotics and what other drugs they used. If they were unsure, their prescriptions was checked for this information. Twelve out of the 24 individuals who were interviewed used some kind of benzodiazepine or benzodiazepine related drug. The majority used the sedative zopiclone but also zolpidem and oxazepam were used. A statistically significant difference in daytime sleepiness was found between users and non-users of hypnotics, but no statistically significant difference in the number of falling incidents could be found. Those who were treated with hypnotics used them every night, nine individuals had been treated longer than three months and two persons had been treated over several years. This study is too small to draw reliable inferences from, but it suggests that long term treatment of the elderly with hypnotics is common and maybe the effects of such a treatment should be investigated further. 2008:F9