According to statistics, more than one million seniors rely on sleeping pills every night to get a good night’s sleep. Nearly 40% of people over the age of 65 have the habit of taking sleeping pills. Sleeping drugs can be roughly divided into two categories: benzodiazepine (Benzodiazepine) and non-benzodiazepine (Non-benzodiazepine). The Food and Drug Administration found that the group with the highest use rate of benzodiazepine sleeping pills among people is women aged 60 to 79, followed by women over 80 years old. The group with the highest proportion of non-benzodiazepine users was women over 80 years old, followed by women aged 60 to 79 years. It can be seen from this that the insomnia problem of the elderly is very serious, and relatively speaking, the risk of using sleeping pills has also become higher.

Effects of side effects of sleeping pills on the elderly

Whether you take benzodiazepines or non-benzodiazepine drugs, there will be side effects, and for the elderly, the risk of taking sleeping pills is greater. Studies have shown that the elderly are more sensitive to benzodiazepines than young people. In addition to the more sensitive effects of sleeping pills, there are also some innate factors:

1. Increased risk of falls in the elderly
   Side effects of sleeping pills include dizziness. Dizziness may not be a disease, but to the elders, “fainting can kill people”! Dizziness makes it easy to fall. In addition, due to physical aging, the muscle fibers of the elderly slowly atrophy, making their movements appear weak and slow. The center of gravity of the elderly caused by dizziness due to the use of sleeping pills is unstable, and their muscles cannot react immediately like young people, so they are more likely to fall.
   
   After adults pass middle age, the calcium in their bones begins to lose about 0.5% per year, so the elderly are prone to stooping. Old people have fragile bones and are more likely to break if they fall than young people. If you just stay in bed, it is very likely that you will not be able to get up after lying down. If an elderly person with nocturia problems gets up at night to go to the toilet after taking sleeping pills, they are more likely to fall and fracture, which will greatly increase the risk of death.
   
2. Reduced attention span in the elderly
   
   As the human body ages, nerve conduction speeds slow down and the response to external stimuli becomes less sensitive. Coupled with the degeneration of the visual center, the elderly are unable to correctly judge the distance, size and movement speed of objects. Hearing also declines with aging, and the ability to receive sounds weakens. Taking sleeping pills may cause side effects such as inability to concentrate, which is especially dangerous for the elderly.
   
   The degradation of these physiological functions makes the elderly face the outside world as if they are separated by a layer of “fogged glass”. The side effect of sleeping pills, which brings about inattention, makes the situation worse, leaving the elders not even knowing where to look. This is why elderly people who are used to driving should be especially careful when taking sleeping pills. If the drug effect makes them lose consciousness, the car body may be scratched, or even their lives may be lost.
   
3. Complex sleep behaviors in the elderly can be fatal
   It should also be noted that sleeping pills may cause drug-induced sleepwalking and other complex sleep behaviors. This means that after taking sedative drugs, the patient is in a state similar to sleep and still performs complex movements. Moreover, when the patient wakes up the next day, he has almost no memory of what happened during that period. Patients may experience the following behaviors:
   
   
   • Sleepwalking
   • Dream driving (driving while sleeping)
   • Eating while sleeping
   • Changing clothes while sleeping
   • Cooking while sleeping
   • Cleaning while sleeping
   • Shopping while sleeping
   • Having sex while sleeping

Although the incidence rate of complex sleep behaviors is not high. Research in my country also points out that the gap between the incidence of complex sleep behaviors over the age of 65 and the incidence of people aged 20 to 55 does not reach statistical significance. But even so, complex sleep behaviors still occur in a large proportion of the elderly, and are likely to bring serious injury and death risks. Just imagine: sleepwalking on the street without looking at the traffic lights, driving your car to the edge of a cliff while dreaming, or cooking while sleeping without even realizing it is about to burn down the kitchen. This is very dangerous, so the Food and Drug Administration of the Ministry of Health and Welfare has specially Name the following four non-benzodiazepine drugs to remind patients to be careful when taking them:

1. Zolpidem
2. Zopiclone
3. Zaleplon
4. Eszopiclone

The above four drugs were required to add warnings on the drug inserts in 2013. The Food and Drug Administration decided in April 2020 to prohibit physicians from prescribing these four drugs to patients who already have complex sleep behaviors, while other patients If you have complex sleep behaviors while using these four types of drugs, you should stop using them immediately and return for medical consultation.

Not only the above four drugs, but also benzodiazepines and non-benzodiazepine drugs may cause complex sleep behaviors, but these four drugs are more likely to occur. Therefore, if an elder in the family takes sleeping pills, special attention must be paid. Taiwanese news also reported that after taking sleeping pills, the elderly would steal goods in stores or sell items at low prices, but the people involved did not remember anything afterwards!

How to take sleeping pills

Remember, after taking any sleeping medication, you should lie down to sleep “immediately” and do not engage in other activities.Sleeping pills are not a panacea, so be careful not to become overly dependent or overdose.