Telomere shortening velocity of patients administered with hypnotics is accelerated in a gender-differential manner

The telomere length and its distribution were compared between patients administered with and without hypnotics to see if regular administration of hypnotics is associated with their aging-related somatic telomere shortening. Male patients presented significant shortening of telomere length of circulating leukocytes in association with age (-41.9 bp/year, p = 0.045) in contrast with controls (-18.3 kb/year, p = 0.155). On the other hand, female patients presented no significant shortening of telomere length with aging (-16.4 bp/year, p = 0.372) in contrast with controls (-55.9 bp/year, p = 0.00005). These results suggested that regular administration of hypnotics is associated with aging progression in a gender-related manner. The administration of hypnotics could be an indicator as the somatic aging status and for the screening of background lifestyle-associated diseases promoting biological aging.

[Benzodiazepine Dependency in the Elderly: How to Deal with it]

Benzodiazepine/hypnotic abuse and dependency increase with advanced age. Especially in the elderly, severe adverse events accompany the regular intake of these substances. Sedation, cognitive and psychomotor effects, falls, accidents and injuries are very frequent. The withdrawal of the medication is often associated with major complications. Therefore, prevention is important. These substances should not be prescribed against minor sleep and anxiety disorders and their use should not be restricted to 3–4 weeks. Withdrawal symptoms can include insomnia, anxiety, memory and concentration impairments, ataxia, and in severe states psychotic symptoms, delirium and epileptic seizures. Discontinuation treatment starts with primary-care practitioners, who are still the main prescribers. Long-lasting dependency, on the other hand, often needs in-patient treatment.

[Insomnia in the general practitioner's office: from diagnosis to initial interventions]

Insomnia is the most frequent type of sleeping disorder and - following pain - the second most common symptom reported in the general practitioner's office. The prevalence of insomnia increases with age. Untreated, insomnia is regarded as risk factor for other comorbid somatic and mental disorders. Therefore, it is important to make a thorough diagnostic and differential diagnostic assessment. Particularly interventions aiming at improving sleep hygiene and therapy using sleep restriction can help alleviate insomnia. Pharmacologically, herbal drugs and antidepressants with sleep inducing effects can be used, for short-term treatment also benzodiazepine/gaba-ergic agonists.