Perspectives

Choosing Wisely Canada: Sleeping Pills Won’t Do Seniors Much Good

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Sleeping pills don’t provide enough extra sleep for older Canadians to warrant the risk of deadly side effects—and doctors and patients alike should think twice about their use, says Choosing Wisely Canada chair Dr Wendy Levinson in a release. Choosing Wisely Canada is a campaign to “help physicians and patients engage in healthy conversations about potentially unnecessary tests, treatments, and procedures, and to help physicians and patients make smart and effective choices to ensure high-quality care.”

Nearly one-third of older people take sleeping pills even though they have special risks for this age group, Levinson says, adding that there are safer and better ways to improve sleep or reduce anxiety.

Sleeping pills affect the brain and spinal cord as sedative-hypnotics or tranquilizers. Side effects for seniors can range from next-day drowsiness to constipation and trouble urinating. They also can double the risk of falls and hip fractures, which are common among seniors. “The ads may promise lots of blissful sleep, but studies show those who use sleeping pills only sleep a little longer and better than those who don’t,” Levinson says. “Seniors and their doctors should look hard at nondrug treatments just as they should be holding healthy conversations generally about unnecessary testing and treatment.”

Nondrug treatments that should be discussed with physicians include everything from regular exercise to avoiding caffeine after 3 PM, or earlier in some cases, Choosing Wisely Canada says.

Levinson made the comments in conjunction with an announcement that 12 additional medical specialty societies and six new community partners have joined the Choosing Wisely  Canada campaign. The new partners bring the number of specialty societies and community partners participating in the campaign to 21 and six, respectively.

The 12 new specialty societies released 61 new physicians’ recommendations at a press conference to encourage doctor-patient communication in true patient-centered care and value.“Our aim is to encourage a culture change in which patients and physicians no longer assume that more is automatically better in high-quality care,” said Dr Cindy Forbes, president-elect of the Canadian Medical Association. “This is a physician-led exercise that involves patients in decisions about their care that is based on the latest and best evidence.”