Publication:

Long duration treatment of chronic insomnia in elderly shows poor cognition

Background Chronic insomnia is a common, underlined condition during old age. Long duration therapy for chronic insomnia leads to show symptoms of difficulty in day time functioning and other risk factors among geriatric population.

Methods An observational, cross-section study was conducted in the out patient department of geriatric medicine, Sir Sunderlal Hospital, BHU, Varanasi, to see the association of cognitive functions on old age chronic insomnia patients under long duration drug therapy. The chronic insomnia patients (age >60 years) under long duration therapy (not less than twelve months) were screened for sleep quality and cognitive performance simultaneously with Pittsburgh sleep quotient index (PSQI) and Addenbrooke’s cognitive examination test, both in Hindi version.

Results Chronic insomnia was seen in high prevalence of 26% among old age population. Cognitive performance was significantly decreased in working memory in chronic insomnia subjects compared to their healthy counterparts (0.85±0.55, 1.71±0.53), other domains like orientation and coordination also showed symptoms of mild cognitive impairment, difficulty in day time functioning and other co morbidities among geriatric population. Chronic insomnia was significantly associated with concomitant diseases which include diabetes, hypertension, and arthritis. Based in a clinically significant study, 23% of patients with chronic insomnia did not perceive the ailment, and 32% more elderly women had insomnia than men of the same age.

Conclusions The study suggested the elderly population should be evaluated routinely for long-term use of hypnotic medications for chronic insomnia. The non pharmacological therapies may be included during treatment of geriatric population like maintenance of sleep hygiene; melatonin and bright light therapy.