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Aging News & Information

Inpatient Sleeping Drug Quadrupled Fall Risk; May Boost Risk of Unexpected Sex?

Advancing age causes fall risk to rise rapidly but this drug increases risk more than aging

Nov. 19, 2012 - A drug commonly prescribed to help patients sleep in hospitals has been associated with an increased risk of falls, according to a study published in the Journal of Hospital Medicine. The Food and Drug Administration warns, too, you may even have unplanned sex after taking zolpidem (see box below).

U.S. sleep specialists from the Mayo Clinic found that the risk posed by the drug was greater than the risks posed by factors such as age, cognitive impairment, delirium or insomnia, regardless of the dosage used.

They report that the fall rate among the 4,962 patients who took zolpidem during their hospital stay was more than four times as high as the 11,358 who did not take the drug.

"Ensuring that people get enough sleep during their hospital stay is very important, but it can also prove very challenging," says the Clinic's Chief Patient Safety Officer Dr. Timothy I. Morgenthaler, who specializes in sleep disorders and pulmonary and critical care.

You May End Up Having Unplanned Sex After Taking Zolpidem: FDA

The FDA warns that people taking Zolpidem may end up doing some unintended things – like having sex. Here is what they warn:

What is the most important information I should know about Zolpidem Tartrate Tablets?

"After taking Zolpidem Tartrate Tablets, you may get up out of bed while not being fully awake and do an activity that you do not know you are doing. The next morning, you may not remember that you did anything during the night. You have a higher chance for doing these activities if you drink alcohol or take other medicines that make you sleepy with Zolpidem Tartrate Tablets. Reported activities include:

  ● driving a car ("sleep-driving")

  ● making and eating food

  ● talking on the phone

  ● having sex

  ● sleep-walking

"Call your doctor right away if you find out that you have done any of the above activities after taking Zolpidem Tartrate Tablets.”

> Read complete FDA report

"Patient falls are also a significant patient safety issue in hospitals and one that has been quite difficult to tackle, despite considerable efforts. That is why it is one of the target aims of the U.S. Department of Health and Human Services Partnership for Patients project."

"Discovering that zolpidem, which is commonly used in hospitals, is a significant risk factor for patient falls provides us with additional knowledge to help tackle this problem."

Key findings of the study include:

   ● Just under 39 percent of eligible admissions during 2010 were prescribed zolpidem (16,320 patients) but 88 percent of the prescriptions were issued on an "as needed basis."

   ● Zolpidem was administered to 30.4 percent of patients who were prescribed it and to 11.8 percent of all Mayo Clinic admissions in 2010.

   ● Just over three percent of the patients on zolpidem fell during their in-patient hospital stay, compared with 0.7 percent of the patients who did not take zolpidem.

   ● Zolipdem use continued to be associated with an increased fall risk when other key factors, including health, length of hospital stay and assessed fall risk, were taken into consideration.

"Our hospitals have an overall fall rate of about 2.5 per 1000 patient days, which is lower than many national benchmarks.

"However, we have not been able to significantly reduce this rate in recent years. Now, we calculate that for every 55 patients who received zolpidem, there was one additional fall that may have been avoided by not administering the drug," says Dr. Morgenthaler.

"As a result of our study, we are now phasing out zolpidem and moving toward sleep enhancement techniques that are not based on drugs and which we believe are safer and probably as effective."


About Zolpidem by National Library of Medicine

Zolpidem(zol' pi dem )

Why is this medication prescribed?

Zolpidem is used to treat insomnia (difficulty falling asleep or staying asleep). Zolpidem belongs to a class of medications called sedative-hypnotics. It works by slowing activity in the brain to allow sleep.

 

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More links below news story.

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How should this medicine be used?

Zolpidem comes as a tablet (Ambien) and an extended-release (long-acting) tablet (Ambien CR) to take by mouth. Zolpidem also comes as a sublingual tablet (Edluar, Intermezzo) to place under the tongue and an oral spray (Zolpimist) which is sprayed into the mouth over the tongue.

If you are taking the tablets, extended-release tablets, sublingual tablets (Edluar), or oral spray, you will take the medication as needed, not more than one time a day, immediately before bedtime. If you are taking the sublingual tablets (Intermezzo), you will take the medication as needed, not more than one time during the night if you wake up and have difficulty returning to sleep. Zolpidem will work faster if it is not taken with a meal or immediately after a meal.

Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use zolpidem exactly as directed.

You will probably become very sleepy soon after you take zolpidem and will remain sleepy for some time after you take the medication. Plan to go to bed right after you take zolpidem tablets, extended-release tablets, sublingual tablets (Edluar), and oral spray and to stay in bed for 7 to 8 hours.

Take zolpidem sublingual tablets (Intermezzo) only when you are already in bed and can remain in bed for at least 4 more hours. Do not take zolpidem if you will be unable to remain asleep for the required number of hours after taking the medication. If you get up too soon after taking zolpidem, you may experience memory problems.

Swallow the extended release tablets whole; do not split, chew, or crush them. Tell your doctor or pharmacist if you cannot swallow tablets.

Do not open the pouch that contains the blister pack of the sublingual tablet (Intermezzo) until you are ready to take the tablet. To remove the sublingual tablet (Edluar) from the blister pack, peel off the top layer of paper and push the tablet through the foil. To take either brand of sublingual tablet, place the tablet under your tongue, and wait for it to dissolve. Do not swallow the tablet or take the tablet with water.

To use the oral spray, follow these directions and those that appear in the package label:

Before using zolpidem spray for the first time, or if you have not used the spray bottle for 14 days, you must prime the pump.

Line up the arrows on the cap and the base of the container. Squeeze the cap at the arrows and pull the cap and base apart to separate. Remove the clear protective cap from the pump.

To prime the pump, hold the container upright. Point the black spray opening away from your face and other people. Press down on the pump with your forefinger, release and let it return to the starting position and repeat 4 more times. You should see a fine spray come out of the container.

To use zolpidem spray, hold the container upright with the black spray opening pointed directly into your mouth, over the top of your tongue. Press down fully on the pump to make sure that a full dose of zolpidem is sprayed.

Let the pump return to the starting position. If your doctor prescribed only one spray of zolpidem, put the clear protective cap back over the pump at the top of the base after each use. If your doctor has prescribed two sprays of zolpidem for your dose, a second spray should be used.

Snap the child-resistant cap back onto the base and rotate the cap and base so that the arrows are not lined up. This is to help prevent a child from using the spray mist bottle.

Your sleep problems should improve within 7 to 10 days after you start taking zolpidem. Call your doctor if your sleep problems do not improve during this time or if they get worse at any time during your treatment.

Zolpidem should normally be taken for short periods of time. If you take zolpidem for 2 weeks or longer, zolpidem may not help you sleep as well as it did when you first began to take the medication. If you take zolpidem for a long time, you also may develop dependence ('addiction,' a need to continue taking the medication) on zolpidem. Talk to your doctor about the risks of taking zolpidem for 2 weeks or longer. Do not take a larger dose of zolpidem, take it more often, or take it for a longer time than prescribed by your doctor.

Do not stop taking zolpidem without talking to your doctor, especially if you have taken it for longer than 2 weeks. If you suddenly stop taking zolpidem, you may develop unpleasant feelings or mood changes or you may experience other withdrawal symptoms such as shakiness, lightheadedness, stomach and muscle cramps, nausea, vomiting, sweating, flushing, tiredness, uncontrollable crying, nervousness, panic attack, difficulty falling asleep or staying asleep, uncontrollable shaking of a part of your body, and rarely, seizures.

You may have more difficulty falling asleep or staying asleep on the first night after you stop taking zolpidem than you did before you started taking the medication. This is normal and usually gets better without treatment after one or two nights.

Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with zolpidem and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/downloads/Drugs/DrugSafety/ucm089833.pdf) or the manufacturer's website to obtain the Medication Guide.

>> More at the National Library of Medicine.


More links to news about sleep and senior citizens

Senior Citizens with Sleep Problems May Have Suffered Emotional Abuse in Childhood

Research points specifically to emotional abuse, rather than physical abuse or emotional neglect

June 8, 2011


Researchers Add Colon Cancer to List of Physical Problems Possible from Lack of Sleep

Inadequate sleep previously associated with higher risks of obesity, heart disease, diabetes, and death

Feb. 8, 2011


Sleep Apnea Linked to Increased Risk of Stroke; Doubles Danger for Older Men

Men with moderate to severe sleep apnea were nearly three times more likely to have a stroke than men with no or mild sleep apnea - watch video - April 9, 2010


Healthy People Need Less Sleep as They Age; Seniors Should Not Be Sleepy in Daytime

Senior citizens slept about 20 minutes less than middle-aged adults, who slept 23 minutes less than young adults in study

Feb. 1, 2010


Senior Citizens Improve Sleep by Stimulating Biological Clock with Blue Light Glasses

As we age, the lens in the eye thickens and the pupil shrinks, reducing the amount of light passing through to the retina; earlier study opted for gold glasses to block blue light

May 29, 2009


Tests for Obstructive Sleep Apnea to be Covered by Medicare

OSA is diagnosed by counting the apnea episodes or breathing disturbances during a specific time span

March 4, 2009

Sleep Apnea Connection to Stroke and Death Explained by New Study

One in 10 senior citizens suffer with sleep apnea that is more common as people age

Jan. 6, 2009


Sleeping Less than 7.5 Hours Daily May Cause Heart Disease for Elderly with Hypertension

Particularly when it occurs with elevated nighttime blood pressure; sleep patterns should be checked for those with high blood pressure

Nov. 12, 2008


Elderly Women Increase Their Risk of Falling with Less Than Five Hours Sleep

About one-third of adults older than age 65 experience falls each year

Sept. 8, 2008


Study Indicates Older People Just Need Less Sleep than Young Adults

With the same time in bed, older people take longer to fall asleep and sleep for less time than younger people do

July 25, 2008


Older Women Who Nap Less, Go Back to Sleep Easily Achieve Healthy Aging

Study of  2,226 senior women, sixty and older, finds 20.8% are “successful agers”.

June 11, 2008


Graphic Brain Scans Shows Memory Loss from Sleep Apnea

Scans reveal dwindling of brain structures that store memory

June 11, 2008


Sleep Disruption Linked to Increased Cardiovascular Risk

Certain sleep disruptions such as obstructive sleep apnea known to convey extensive cardiovascular risk

March 30, 2007


Older Men Living at Home Survive Longer with Undisturbed Sleep and 'Robust Rhythms'

Regular sleep routine – to bed and up at regular times – means good health for senior men

June 11, 2008


Snoring Linked to Cardiovascular Disease, Hypertension and Stroke

Study says odds of heart attack are 34% higher, hypertension up 40%, stroke 60%

March 3, 2008


Harvard Wants America to Sleep Better and Contributes New Interactive Website

‘Health Sleep’ aimed at helping people better understand sleep

Feb. 27, 2008


Three New Studies Focus on Problems in Sleeping for Senior Citizens

Respiratory disturbances, periodic leg movement with cognitive impairment, and benefits of daytime nap are explored

Feb. 1, 2008


Reducing or Increasing Sleep Leads to More Deaths from Different Causes

Sleep Medicine group offers tips on how to get a good night’s sleep - Dec. 3, 2007


Risk of Death Doubles from Too Little or Too Much Sleep Says British Study

NIH says senior citizens should know sleep problems not a normal part of aging - Sept. 24, 2007


Ohio Scientists Pushing Blue-Blocking Glasses, Lights to Improve Sleep

Website says if glasses don't improve sleep, return them within 30 days and money will be refunded

By Tucker Sutherland, editor - Nov. 13, 2007


Senior Citizens Toss and Turn with Many Sleep Problems that Come with Aging

Many older people may not be getting enough sleep for healthy aging - Aug. 14, 2007


Geriatric Conditions May Hinder Half of All Senior Citizens in Daily Activities

Same level of dependency as older patients with chronic diseases - Aug. 8, 2007


Kicking Spouse in Bed at Night Can Now Be Blamed on Your Genes


Gene found responsible for Restless Legs Syndrome affecting 10% of senior citizens - July 19, 2007

Sleep Problems Among the Elderly Linked to Suicide Risk

Many older adults get less sleep than needed due to trouble falling asleep - June 14, 2007


Sleep Disruption Linked to Increased Cardiovascular Risk

Certain sleep disruptions such as obstructive sleep apnea known to convey extensive cardiovascular risk - March 30, 2007


Mistake for Doctors to Neglect Insomnia Treatment in Older Patients

Excessive daytime sleepiness is best predictor of poor health

January 3, 2007


Tips for Senior Citizens to Get a Good Nights Sleep Offered by Longevity Center

New report issued: The Role of Sleep In Healthy Aging

December 7, 2006


Sleep Studies of Older People Find Behavioral Treatment Helps Insomnia; Women Endangered by Restless Legs

October 2, 2006


Sleep Evaluation Should be Routine Medical Care Says Editorial

September 18, 2006


Advice for Senior Citizens on Finding a Good Night's Sleep

Research finds that sleep problems grow with the accumulation of illnesses, not years.

September 18, 2006

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