Caffeinated analgesics and insomnia in elderly persons – includes editor comment – adapted from the Journal of the American Geriatrics Society 1995;43:860-4 – Tips from Other Journals
In community studies, 20 to 35 percent of elderly persons report having nighttime sleep problems. Caffeine consumption has been shown to be associated with trouble falling asleep and maintaining sleep. Brown and colleagues conducted a study of community-dwelling persons to determine whether an association exists between consumption of caffeine-containing medication and sleep problems.
A total of 2,885 persons aged 67 and older completed a questionnaire regarding use of over-the-counter (OTC) and prescription medications, general health status and information about sleep habits.
Of the 2,885 participants, 155 (5.4 percent) were taking medications containing caffeine. Of those medications, 85.2 percent were OTC analgesic preparations containing either aspirin or acetaminophen, 10.3 percent were prescription analgelics, 3.8 percent were cold and allergy remedies, and 0.6 percent were other medications.
After adjusting for factors that could interfere with failing asleep, including depressive symptoms, painful conditions and use of other medications known to interfere with sleep, use of medication containing caffeine was associated with a significantly increased risk (odds ratio: 1.6) of having difficulty falling asleep. Although persons who were specifically taking OTC analgesics that contained caffeine had a significantly increased risk (odds ratio: 1.9) of difficulty sleeping, those taking similar noncaffeinated OTC analgesics reported no increased sleep problems.
The data suggest that medication containing caffeine, particularly OTC analgesic preparations, may be associated with sleep problems in the elderly. (Brown SL, et al. Occult caffeine as a source of sleep problems in an older population. J Am Geriatr Soc 1995;43:860-4.)
EDITOR’S NOTE. In addition to coffee, tea, chocolate and colas, prescription and OTC medications that contain aspirin and/or acetaminophen in combination with caffeine may, contribute to sleep problems in the elderly. A cup of coffee may contain between 64 and 124 mg of caffeine. A typical OTC analgesic preparation contains 32 mg of caffeine per tablet. At a dosage of two tablets four times daily, this translates into four weak cups of coffee per day. Checking with the pharmacist about medications containing caffeine and instructing patients to read labels on OTC medications and use comparable OTC analgesics that do not contain caffeine may be a simple, inexpensive, safe and effective treatment of insomnia in some elderly persons.
COPYRIGHT 1996 American Academy of Family Physicians
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