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Management of Sleep Disorders in Community‐Dwelling Older Women and Men at the Time of Diagnosis
Author(s) -
Pop Paula,
Bronskill Susan E.,
Piggott Katrina L.,
Stall Nathan M.,
Savage Rachel D.,
Visentin Jessica D.,
McCarthy Lisa M.,
Giannakes Vasily,
Wu Wei,
Gruneir Andrea,
Gatley Jodi M.,
Rochon Paula A.
Publication year - 2019
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.16038
Subject(s) - medicine , sleep (system call) , gerontology , physical therapy , pediatrics , operating system , computer science
Objectives Sedative and hypnotic medications are associated with harm, and guidelines suggest limiting their use. Only limited evidence has described how older adults are managed following an initial sleep disorder diagnosis. We aimed to describe clinical management patterns of sleep disorders in older women and men at the time of initial diagnosis. Design Population‐based retrospective cohort study using linked administrative databases. Setting Ontario, Canada. Participants Community‐dwelling adults aged 66 and older, diagnosed with a new sleep disorder by a primary care provider (n = 30 729; 56% women and 44% men). We compared women and men for each outcome. Measurements The primary outcome was prescription of a medication used for sleep within 30 days of a new sleep disorder diagnosis. Additional analysis included medical investigations such as sleep studies and visits to specialists who manage obstructive sleep disorders within 90 days of diagnosis. Results Among the 30 729 older adults with a new sleep disorder diagnosis, 5512 (17.9% total; 18.8% of women and 16.9% of men) were prescribed a medication used for sleep. Compared with men, women were somewhat more likely to be prescribed at least one sedative medication (adjusted odds ratio = 1.09; 95% confidence interval = 1.03‐1.16). A total of 2573 (8.4%) older adults underwent a sleep study, and 3743 (12.2%) were evaluated by a specialist; both occurred more commonly in men. Conclusion In our cohort, almost 1 in 5 older adults with a new sleep disorder diagnosis were prescribed a medication used for sleep; of these, a higher proportion were women. Comparatively few older adults were further evaluated; of these, a higher proportion were men. Our study highlights the high rates at which medications are prescribed to older adults with a new sleep disorder diagnosis and identifies potential sex differences in the management of such diagnoses. J Am Geriatr Soc 1–8, 2019. J Am Geriatr Soc 67:2094–2101, 2019