Appropriate Use of Sleeping Pills

Choosing Wisely Canada Recommendation

Don’t use benzodiazepines and/or other sedative–hypnotics in older adults as the first choice for insomnia, agitation or delirium.

*Recommended by the Canadian Geriatrics Society and the Canadian Society of Hospital Medicine.

Why is it important?

Older adults who use benzodiazepines or other sedative–hypnotics are at an increased risk for motor vehicle accidents, falls and hip fractures and daytime fatigue. Thinking can also be affected.

Benzodiazepines effectively manage anxiety and insomnia but with age, people become more sensitive to their effects and are at risk of side effects that typically outweigh any potential benefit. Chronic use of benzodiazepines is of particular concern because experts recommend only 2 to 4 weeks of continuous use by seniors (CIHI, 2017).

Patient Resources

• Insomnia and Anxiety in Older People: Sleeping pills are usually not the best solution

• Sedative-hypnotics: You may be at risk

Physician Resources

• Deprescribing.org

• Webinar recording: Prescribing and deprescribing for the elderly with Dr. Alethea Lacas

• Drowsy Without Feeling Lousy: A toolkit for de-prescribing benzodiazepines and other sedative hypnotics in primary care.

• Canadian Guidelines on Benzodiazepine Receptor Agonist Use Disorder Among Older Adults