By Dr. Cara Tannenbaum, Geriatrician and Director, Canadian Deprescribing Network
Anita and Richard are a typical couple in their mid-seventies: they exercise often, eat well, see their doctor regularly, spend time with their friends and grandchildren, and take care of their health.
Lately, Richard was increasingly worried about Anita’s memory lapses. “She’s always been a little forgetful but it had gotten much worse in the past few weeks,” recounts Richard. “Anita was unable to concentrate on simple tasks and she seemed like she was always in a haze.”
Occasional memory lapses are normal among older adults, but it is rarely a cause for concern. Forgetting where you put your keys or your wallet, or not being able to recall the name of an actor or a song title is completely normal. However, difficulties performing simple tasks, forgetting how to do things you’ve done many times or getting lost in familiar places is not normal.
One afternoon, Anita forgot where she had parked her car at the local mall. Security had to call the police to try to find her car and get her home. “I knew something was seriously wrong and that it was beyond what we call ‘a senior’s moment’,” explains Richard.
Worried that she may be having a depressive episode or worse, Alzheimer’s disease, he booked Anita an appointment with their family physician, Dr. Yu.
“I was surprised when Dr. Yu told me that my memory and concentration problems could be caused by my medication,” says Anita. “I’ve struggled with anxiety and insomnia in the past, which I’ve managed with the help of sleeping pills for over 20 years. It seems that sleeping and anxiety pills work by depressing, or putting the nerves in your brain to sleep. This affects memory, concentration, balance and slows your reflexes for driving.”
Dr. Yu warned Anita that as we get older, medications tend to accumulate in our body because the liver and kidneys don’t process drugs as well as when we were younger. Sleeping pills can also raise the risk of car crashes and can raise the risk of falls, hip fractures and hospitalizations.
Anita was determined to get off the pills to improve her memory. Together, Dr. Yu and Anita made a plan to wean her off the pills by gradually reducing the dose over several months. Stopping or reducing a medication that may cause harm is called “deprescribing” and it’s a growing trend among doctors and geriatricians.
Dr. Yu recommended a non-drug treatment to help her manage her anxiety and insomnia. Anita started keeping a sleep diary and making changes to some of her sleep habits. “I started going to bed one hour later, and getting up at the same time every day, regardless of whether or not I had slept well that night. I switched to drinking decaffeinated coffee and avoid taking long naps in the afternoon. I no longer watch TV in bed, and get out of bed to read if I find that I toss and turn and am unable to sleep. I also started eating smaller meals at dinnertime, which also helps me sleep better,” she explains.
Over a few short months, Anita slowly managed to taper off her sleeping pills with Dr. Yu’s help. “I’m so proud of the positive changes that I’ve made recently and I’ve been telling my friends and family to be careful about their medications too,” says Anita. “I feel more alert than I have in a long time. And I haven’t lost my car in the parking lot again!”
If you or someone you know is at risk for memory loss from sleeping pills, please see this brochure, which can help you reduce or stop your sleeping pills with the help of your doctor and try safer alternatives.