TY - JOUR
T1 - The use of alternative medicine for the treatment of insomnia in the elderly
AU - Cherniack, Evan Paul
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2006/3
Y1 - 2006/3
N2 - Insomnia is a frequent problem among the elderly, for which patients often self-medicate. The use of alternative medicine by individuals worldwide, including the elderly, is increasing and insomnia is a common reason for its use. Conventional treatments do not benefit all, and there is uncertainty about the effects of their long-term use. Many alternative therapies have been considered for the treatment of sleep disorders in published medical reports. These consist of pharmacological therapies, including melatonin, valerian, lavender, hops, kava, Chinese and Japanese herbal compounds, pyridoxine, St John's wort and German chamomile, and non-pharmacological therapies, including massage, acupuncture, music therapy, tai chi, magnetism and white noise. Comparison of these treatments, either with each other or with conventional therapies, is difficult because many studies inadequately define insomnia, have few subjects or lack randomization or controls. Many have not been tested specifically on elderly subjects. As a result of the problems in the trials of these treatments, drawing a definitive conclusion about the effectiveness of these therapies is difficult. Melatonin appears to be the most promising. It has been shown to produce some limited benefit by studies to date, although it has not been investigated in enough appropriate subjects to definitively conclude that there is a benefit at a sufficiently low risk. A promising role for melatonin might be in the treatment of elderly people with sleep-phase disorders. Other pharmacological treatments with potential await well-designed studies on the elderly. There are many non-pharmacological therapies that offer the potential advantages of a low side-effect profile, but the investigations of these have been even less rigorous.
AB - Insomnia is a frequent problem among the elderly, for which patients often self-medicate. The use of alternative medicine by individuals worldwide, including the elderly, is increasing and insomnia is a common reason for its use. Conventional treatments do not benefit all, and there is uncertainty about the effects of their long-term use. Many alternative therapies have been considered for the treatment of sleep disorders in published medical reports. These consist of pharmacological therapies, including melatonin, valerian, lavender, hops, kava, Chinese and Japanese herbal compounds, pyridoxine, St John's wort and German chamomile, and non-pharmacological therapies, including massage, acupuncture, music therapy, tai chi, magnetism and white noise. Comparison of these treatments, either with each other or with conventional therapies, is difficult because many studies inadequately define insomnia, have few subjects or lack randomization or controls. Many have not been tested specifically on elderly subjects. As a result of the problems in the trials of these treatments, drawing a definitive conclusion about the effectiveness of these therapies is difficult. Melatonin appears to be the most promising. It has been shown to produce some limited benefit by studies to date, although it has not been investigated in enough appropriate subjects to definitively conclude that there is a benefit at a sufficiently low risk. A promising role for melatonin might be in the treatment of elderly people with sleep-phase disorders. Other pharmacological treatments with potential await well-designed studies on the elderly. There are many non-pharmacological therapies that offer the potential advantages of a low side-effect profile, but the investigations of these have been even less rigorous.
KW - Alternative medicine
KW - Insomnia
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U2 - 10.1111/j.1479-8301.2006.00107.x
DO - 10.1111/j.1479-8301.2006.00107.x
M3 - Review article
AN - SCOPUS:33645145267
VL - 6
SP - 21
EP - 30
JO - Psychogeriatrics
JF - Psychogeriatrics
SN - 1346-3500
IS - 1
ER -