Drugs for patients who require long-term therapy should be selected to minimize side effects. Long-acting drugs should be used with caution in the elderly. Dr. Meyer is Professor of Medicine, University of Colorado Health Sciences Center, and Associate Chief of Staff, Ambulatory Care, Veterans Affairs Medical Center, Denver. Insomnia is a subjective condition of insufficient or nonrestorative sleep despite an adequate opportunity to sleep. Four percent of Americans take medication to help them sleep.
Insomnia is more common in women.
Sleep, Aging, and Insomnia Sleep and wakefulness result from the complex interaction of internal biological clocks, environmental influences, and arousal or quiescence-inducing activities. Daily propensity for sleep occurs at night and midafternoon. Exposure to light in the evening affects the circadian rhythm so that desire to sleep is delayed, while exposure to bright light in the early morning tends to make one seek sleep earlier in the evening. Sleep is divided into cycles with different characteristics and brain wave patterns. Electroencephalograms of patients experiencing normal sleep show changes through stage 1 to stage 4 sleep.