Published online by Cambridge University Press: 02 January 2018
Sleep disorders are common among elderly people, affecting about 50% compared with about 26% of younger adults. About two-thirds of residents in long-term care have sleep disturbance (Karacan & Williams, 1983; Becker & Jamieson, 1992). This high prevalence of sleep disorders results in excessive daytime napping, fatigue, cognitive impairment, increased psychiatric morbidity and increased prescribing of hypnotics, with an associated increase in mortality (Kripke et al, 1979). Karacan & Williams (1983) quote figures varying from 26 to 100% for the prescribing of hypnotics to residents in institutional care. This has major implications. There is a risk of both accidental and deliberate overdose. There may be interactions with other drugs and a hangover effect can impair daytime functioning. Excessive sedation can make the patient difficult to rouse in an emergency. Dependence may occur and the drugs may further disrupt sleep. They also increase the likelihood of sleep apnoea.