Hypnotic use in older people

Avoid using hypnotics in older people. Harms associated with hypnotic use (eg falls, fractures, impaired cognition) generally outweigh the benefits. In fact, a meta-analysis¹ found that 13 older people would need to be treated with a hypnotic for one person to have improved sleep; however, only 6 older people would need to be treated for one person to experience an adverse event. If a hypnotic is used to treat insomnia in an older adult:

• follow the approach to hypnotic use as per here
• use the lower end of the dose range recommended for the shortest possible time.

For advice on deprescribing hypnotics after prolonged use for insomnia, see here.