Hypnotic medications in older adults: a call for caution

Introduction The elderly often suffer from insomnia, which can influence quality of life. Some suffer from insomnia because of ongoing medical issues; however, many suffer from primary insomnia. A few elderly adults seek treatment for insomnia by using hypnotic medications that may have more adverse effects than benefits. Several of these adverse events, like falls with subsequent injury or fracture, can be life changing. In this article, we review the various modes of insomnia treatment with a literature search on both pharmacologic and nonpharmacologic treatments. Conclusion Cognitive behavioural therapy may be an effective long-term treatment for insomnia in the elderly and is a nonpharmacologic approach. Pharmacologic treatment may be effective and efficacious in the short term. Many of the commonly used hypnotics have not been studied over a longer term. Providers should review the potential risks and benefits before initiating any type of treatment plan for insomnia in older adults.