Complementary and alternative medicine for sleep disturbances in older adults

Abstract

Complementary and alternative medicines (CAM) are frequently used for the treatment of sleep disorders, but in many cases patients do not discuss these therapies directly with their health care provider. There is a growing body of well-designed clinical trials using CAM that have shown the following: (1) Melatonin is an effective agent for the treatment of circadian phase disorders that affect sleep; however, the role of melatonin in the treatment of primary or secondary insomnia is less well established. (2) Valerian has shown a benefit in some, but not all clinical trials. (3) Several other modalities, such as Tai Chi, acupuncture, acupressure, yoga, and meditation have improved sleep parameters in a limited number of early trials. Future work examining CAM has the potential to significantly add to our treatment options for sleep disorders in older adults.

Figure 1

Diagram of complimentary and alternative medicine subtypes

Figure 2

Number of publications of different types of CAM for sleep based on Medline search.

Figure 3

Reasons cited for not having discussed CAM with their physician. Adapted from American Association of Retired Persons/National Center for Complimentary and Alternative Medicine, “Complementary and Alternative Medicine: What People 50 and Over Are Using and Discussing with Their Physicians”, 2007

Figure 4

Prevalence of CAM use by age group. Adapted from Pearson et al., “Insomnia, trouble sleeping, and complementary and alternative medicine: Analysis of the 2002 national health interview survey data”, Arch Inter Med, 2006.