Benzodiazepines, used to induce sleep and treat anxiety, are unquestionably among the most commonly used medications in Italy. Prescribing them as a first choice for elderly persons afflicted with insomnia is often unnecessary, and should not be done without first evaluating other methods for improving the quality and duration of sleep. In any case, intermittent use of these medications should be recommended, for periods no longer than four weeks, and treatment should not be continued without periodical re-assessment regarding the need and possible appearance of side-effects. This also goes for other medications used to treat insomnia, like zolpidem, zaleplon and zopiclone (the “Z-drugs”).

Advice from Altroconsumo

- Insomnia must be combatted with lifestyle changes. For example, one of the first rules to follow is to avoid falling asleep in front of the television right after dinner, to then wake up in the middle of the night and not be able to fall back asleep again.
- If you suffer from insomnia, it is advisable to avoid taking an afternoon nap.
- Carrying out a specific physical activity during the day, especially an enjoyable one, results in better quality of sleep. It is best to avoid intense physical activity, however, before going to bed.
- A light dinner that contains tryptophan-based foods (milk, fish, legumes, nuts) may help one sleep.
- Establishing simple evening routines (a hot tea, some reading) may help.
- In the elderly, insomnia is often brought on by anxiety. Maintaining an active social life, going out with friends, participating in a social club, taking adult education classes, going to church and the like may help combat it.

In collaboration with

SIMG - The Italian College of General Practice and Primary Care
CNF - Cochrane Neurosciences Field