But a large new University of Michigan Health System study suggests that the real culprit may be the underlying insomnia, rather than the medications used to treat it. Residents with untreated, or partially treated, sleeplessness have a much higher risk of falls than those who take sleep medications and get relief from their insomnia.

Even though medications are only one way of treating insomnia, the new finding has implications for the way sleep problems are addressed -- or not addressed -- in nursing homes, and perhaps for the prevention of falls that often trigger major health crises in the elderly.

"Many physicians assume that when an older patient has insomnia, and is given a hypnotic drug to help induce sleep, the drug will make the patient likely to fall and develop a hip fracture," says U-M sleep specialist Alon Avidan, M.D., MPH, first author of the study published online by the Journal of the American Geriatrics Society. "But our findings suggest that people whose insomnia is effectively treated are less likely to fall than untreated insomniacs."

Hypnotic drugs are sleep-aiding medications that include many older, long-lasting drugs such as benzodiazepines and barbiturates, as well as newer, shorter lasting and commonly advertised drugs with fewer side effects.

The study included more than 34,000 Michigan nursing home residents over age 65. Data were collected over six months as part of ongoing mandatory assessments by nursing home staff.

Individuals who had untreated insomnia at the start of the study period were 90 percent more likely to fall in the next six months compared with those who did not have insomnia. In contrast, those who were taking hypnotic drugs to treat their insomnia at the
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
6-Apr-2005