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Sleep 18(6):425–432įoley DJ, Monjan A, Simonsick EM, Wallace RB, Blazer DG (1999) Incidence and remission of insomnia among elderly adults: an epidemiologic study of 6,800 persons over three years. J Clin Sleep Med 4(5):487–504įoley DJ, Monjan AA, Brown SL, Simonsick EM, Wallace RB, Blazer DG (1995) Sleep complaints among elderly persons: an epidemiologic study of three communities. Schutte-Rodin S, Broch L, Buysse D, Dorsey C, Sateia M (2008) Clinical guideline for the evaluation and management of chronic insomnia in adults. Preliminary evidence points towards suvorexant, doxepin, and possibly ramelteon as effective and safe pharmacological alternatives for treating insomnia in older adults. The overall level of evidence was limited, making it difficult to draw robust conclusions. One study detected increased adverse effects of trazodone after 3 months but did not evaluate the effect on sleep. Suvorexant showed an improved sleep maintenance with only mild side effects ( n = 1). Ramelteon slightly improved sleep latency ( n = 4), while doxepin was found to provide a sustained sleep improvement with a safety profile that was comparable to placebo ( n = 3). No clear beneficial impact on sleep could be demonstrated in studies investigating the impact of melatonin ( n = 10), paroxetine ( n = 1), diphenhydramine ( n = 1), tiagabine ( n = 2), and valerian ( n = 1). The systematic search yielded 9483 articles, of which 24 were included in this review, describing nine different sleep medications in total. We included randomized controlled trials and prospective and retrospective quasi-experimental studies, conducted in patients older than 65 years, without psychiatric or neurological comorbidities. We conducted a systematic search of MEDLINE (PubMed), EMBASE, and the Cochrane Central register of Controlled Trials databases. We aimed to study the efficacy and safety of alternative sedative medications for treating insomnia in older people, excluding benzodiazepines and Z-drugs. Due to adverse events, an increased use of alternative sedative medications has been observed in older adults. It is frequently treated with benzodiazepines or Z-drugs. Insomnia is highly prevalent in older persons and significantly impacts quality of life, functional abilities, and health status.
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