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INSOMNIA
Characterized as a condition in which a person has trouble falling asleep, staying asleep or getting enough sleep. It includes daytime
disturbance in functioning or distress due to problems in sleep pattern, affecting day to day living. This can happen due to a number of reasons: - Medical conditions (pain, neurologic, Gastrointestinal (GI), cardiovascular or psychiatric conditions) - Everyday stress in life - Medications such as Prozac, Zoloft, prednisone, theophylline/caffeine, Stimulants (e.g., Ritalin), clonidine, bupropion, Anticonvulsants
Sleep Hygiene
Bed Uses:
Bedtimes and awakenings should be scheduled What to Avoid Before Going to Bed or Attempting to Sleep: What to Do Before Going to Bed or Attempting to Sleep: Avoid consuming caffeine, alcohol, and nicotine Avoid large meals and spicy foods 3 hours prior to bedtime Do yoga or tai chi or other non strenuous stretching/exercise Avoid doing stimulating tasks 30-60 minutes before bed Practice relaxation techniques like meditation, prayer, and Do not take stimulating medications at night Go to bed late (applies pressure to sleeping) Know your sleep signs (heavy eyelids, yawning, etc.) (if this occurs get up and do a relaxing activity)
Over-The-Counter and Natural Products:
Medication
Side Effect
Confusion, depression, drowsiness, HA. Not recommended in elderly patients.
Melatonin secretion in the elderly decreases with age, hence not as effective.
Not recommended in the elderly due to withdrawal
Urinary retention, constipation, dry mouth, perspiration, fast heart rate. Not recommended in the elderly

Prescription Medications:
Medication
Side Effect
Nightmares, agitation, HA, GI disturbance, dizziness, daytime drowsiness,
Similar to Ambien for side effects but works differently. Can be taken if only 4-5 Short-term Insomnia. Reduces Sleep latency Hallucinations, Nausea and Vomiting, headache, dry mouth, strong desire to sleep Watch for falls, hangover effect, amnesia and dependence on the medication
Confusion, hypotension, strong desire to sleep for long hours Increased appetite. Weight gain, constipation, dry mouth, strong desire to sleep for High sedation and dizziness, confusion, dry mouth and constipation. Dry mouth, dizziness, headache, constipation, agitation, high cholesterol and Using Medications Safely and Responsibly in Golden Adults (April 16, 2012)
BLOOD PRESSURE

Normal blood pressure: 120/80
“Acceptable” blood pressure (80+ years old): ≤ 150/90 Things to keep in mind: many can cause low blood pressure especially when standing (dizziness, headache, weakness, falling), NSAIDS (ibuprofen, aspirin, naproxen) can increase blood pressure so let your doctor know if you’re taking these frequently
Common Medications:
Some decrease potassium (signs: muscle cramping and weakness) Take in the morning to avoid needing to get up during the night to use the bathroom Can cause fatigue and decreased ability to exercise Check your heart rate (don’t want to use if it is <55) Diabetics may have a harder time telling when they are experiencing hypoglycemia Don’t abruptly discontinue, needs to be slowly weaned Can cause increased potassium so avoid salt substitutes and K supplements Can cause allergic swelling around the mouth and face Can cause swelling in the limbs (particularly in the legs)
STATINS

Goal of Therapy: prevent a heart attack or stroke in people with additional risk factors for cardiovascular diseases
Primary Prevention: prevent a “first” heart attack or stroke Secondary Prevention: prevent a “second” heart attack or stroke Clear benefit for Secondary Prevention “Less clear” and questionable benefit in Primary Prevention; and in other populations (e.g., women and older adults)  muscle pain (or myalgia) of varying severity  ranges from mild confusion / memory loss to Potential Risk of Diabetes (controversial): relationship yet to be determined
Cholesterol-Lowering Therapy ALWAYS includes (not replaces) lifestyle changes!
Compiled By:
Elder Services, Washington State University Using Medications Safely and Responsibly in Golden Adults (April 16, 2012)

Source: http://www.worklife.wsu.edu/File/Using%20Medications%20Safely%20and%20Responsibly%20in%20Golden%20Adults.pdf