The use of non-prescription sleep products in the elderly

While sleep disorders are common in the elderly, the use of non-prescriptio n products for sleep in this population has not been fully evaluated. The o bjectives of this project were to assess the use, perceived effectiveness a nd toxicity of non-prescription sleep products in an ambulatory elderly pop ulation. Methods. A self-administered 20-question survey was distributed to seniors, aged 60 years or more, during hospital or pharmacy visits. Results. Of the total respondents (N = 176, mean age 74 +/- 7 years, 59% fe male), 84 (48%) indicated that they had used one or more therapies for slee p within the past year. These included non-prescription products (50% of th erapies), prescription products (17%) and non-drug activities such as walki ng or drinking milk (34%). For those individuals who had used a non-prescri ption product in the past year (N = 47, 27% of total respondents), the most frequently used products were: dimenhydrinate (21%), acetaminophen (19%), diphenhydramine (15%), alcohol (13%) and herbal products (11%). Most took t hem at least 1 day per week (79%) and 32% took them daily. These products s ubjectively improved sleep latency (mean 32 vs 61 minutes, p < 0.001), numb er of nocturnal awakenings (mean 2 vs 3 awakenings, p < 0.001) and total ho urs of sleep (mean 6.6 vs 5.4 hours, p < 0.001). Mild side-effects were rep orted by 35 respondents (75%), the most common being dry mouth (N = 22) and daytime drowsiness (N = 13). Respondents were taking an average of four (S D +/- 3, range 0-10) other medications currently. Conclusions. Non-prescription products are widely used by this population o f ambulatory elderly for sleep disturbances. Most of the products were not marketed for sleep; however, they were perceived to be efficacious with low toxicity. The potential for drug interaction is high. Further research is warranted to evaluate the safety and effectiveness of non-prescription slee p products in the elderly. Copyright (C) 1999 John Wiley & Sons, Ltd.