Albert Steven M, Roth Thomas, Toscani Michael, Vitiello Michael V, Zee Phyllis
Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pennsylvania.
Henry Ford Health Systems, Detroit, Michigan.
Gerontologist. 2017 Apr 1;57(2):163-170. doi: 10.1093/geront/gnv139. Epub 2015 Oct 28.
Getting a good night's sleep can be challenging for older adults with chronic medical conditions, which often interfere with sleep. As a result, many older adults turn to over-the-counter (OTC) sleep aids, that is, products with diphenhydramine or doxylamine. However, these products are indicated only for occasional difficulty with sleep, not for chronic use; and their safety and efficacy has not been well established in general and in older adults specifically. To engage national stakeholders in a discussion of OTC sleep aids in older adults, the Gerontological Society of America (GSA) convened a multidisciplinary workgroup. The Workgroup examined differences between younger and older adults in sleep health and use of OTC sleep aids using data from the National Health and Wellness Survey; assessed the pharmacologic properties and medication effects of OTC sleep aids; and worked with stakeholders to promote strategies for safe and effective use. Older adults are more likely to take diphenhydramine or doxylamine products 15 or more days in a month, an indicator of inappropriate use. The Workgroup recommends research to investigate the ways older people use OTC sleep aids. The goal should be reduction in inappropriate use and associated risks, such as daytime sedation, compromised cognitive function, and falls. In addition, the Workgroup recommends a greater role for community pharmacists in counseling older adults on appropriate use of OTC sleep aids.
对于患有慢性疾病的老年人来说,睡个好觉可能颇具挑战,这些疾病常常会干扰睡眠。因此,许多老年人会求助于非处方(OTC)助眠药物,即含有苯海拉明或多西拉敏的产品。然而,这些产品仅适用于偶尔的睡眠困难,并不适用于长期使用;而且它们的安全性和有效性总体上尚未得到充分证实,在老年人中尤其如此。为了让全国的利益相关者参与关于老年人使用非处方助眠药物的讨论,美国老年学会(GSA)召集了一个多学科工作组。该工作组利用来自国民健康与 Wellness 调查的数据,研究了年轻人和老年人在睡眠健康及使用非处方助眠药物方面的差异;评估了非处方助眠药物的药理特性和药物作用;并与利益相关者合作,推广安全有效使用的策略。老年人更有可能每月服用苯海拉明或多西拉敏产品15天或更长时间,这是不当使用的一个指标。该工作组建议开展研究,以调查老年人使用非处方助眠药物的方式。目标应该是减少不当使用及相关风险,如日间镇静、认知功能受损和跌倒。此外,该工作组建议社区药剂师在指导老年人正确使用非处方助眠药物方面发挥更大作用。