The launch of the first prescription-only melatonin provides
a new approach to managing sleep problems in older adults
New research shows that 60% of people with a sleep disorder called
primary insomnia have never visited their doctor for advice or
treatment, despite having had, on average, primary insomnia for
nearly 12 years. Half of those who had not sought professional
advice thought their sleep problems were “too trivial”
to bother the doctor with, and almost a third felt that there
wasn’t anything a doctor could do about it.1
The research coincides with the launch of a new treatment for
primary insomnia. For the first time in the UK, GPs can offer
melatonin on prescription to treat adults aged 55 years and over,
on a short-term treatment course.2 Circadin® is a synthesised
form of melatonin, which is released over several hours2 in order
to mimic the body’s own production of melatonin. Melatonin
is a hormone released by the pineal gland in the brain that plays
a key role in regulating sleep, as part of the body’s biological
clock; otherwise known as the circadian rhythm.
Commenting on the results of the research, which explored the
sleeping habits of 1,000 older adults, Dr Alan Wade, a GP and
clinical researcher from Glasgow with a specific interest in sleep
and insomnia said: “the findings of this research demonstrate
that we are a nation at risk of sleep-walking through our later
years, due to our reluctance to seek proper help and advice. Not
being able to get good quality sleep isn’t just a problem
at night, but it will also negatively impact on getting on with
daily life - social life, working life and family life”.
Speaking about managing primary insomnia, Dr Wade added: “Changes
can occur in the biological clock regulating the body’s sleep-wake
cycle and part of this could be due to a link between getting
older and falling levels of melatonin. Circadin is the first prescription
sleep treatment that can work in a natural way to restore the
sleep cycle, resulting in better quality, restful sleep that enables
people to feel alert and refreshed enough to function well the
next day”.
A quarter of people surveyed with primary insomnia felt too tired
to go out and socialise on an almost daily basis. One third of
people in a long-term relationship admitted that their insomnia
had affected their relationship with their partner, whilst over
a third of those in employment felt sleepy at work everyday or
on most days.1
Insomnia is known to occur more commonly as people get older;
the incidence of primary insomnia doubles in the elderly population,
compared to the adult population.3 Over three quarters (77%) of
people with primary insomnia in the survey felt that their sleeping
difficulties had got worse with age.1
Developed in collaboration between sleep experts and Lundbeck
UK, ‘Sleep Advice for Adults with
Insomnia’ provides advice and tips for people
experiencing primary insomnia, as well as educational information
about sleep and insomnia. It is available to download at:
www.sleepadvice.co.uk
Notes
a) Insomnia is a recognised “sleep disorder”. It is
characterised by poor sleep quality with difficulty in initiating
and maintaining sleep, and these difficulties last for at least
one month.3 Insomnia can be either “primary” or “secondary”.
In primary insomnia the disturbance is not attributed to another
general medical condition, mental health disorder, or substance
(e.g. medication, alcohol or street drugs) as is the case in secondary
insomnia. 4
b) The research survey on sleeping habits of 1,000 adults aged
55-70 years old showed that 24% screened positive for symptoms
of primary insomnia.1
c) Recent data have shown that up to 37% of patients presenting
at general practices in the UK have insomnia.5
d) Circadin is a 2mg tablet, prolonged-release formulation of
melatonin. It is indicated for the short-term treatment of primary
insomnia characterised by poor quality of sleep in patients who
are aged 55 or over.
e) Circadin is generally well tolerated and clinical trials reported
no evidence for treatment-related withdrawal symptoms or rebound
insomnia. 6,7
References:
1. A study on the incidence and impact of insomnia among 55-70
year olds. Kember Associates. April 2008
2. Circadin Summary of Product Characteristics
3. American Psychiatric Association. Diagnostic and statistical
manual of mental disorders, DSM-IV-TR (text revised) <http://www.psychiatryonline.com/index.aspx>
4. Global Burden of Disease (GBD) Study 2000-2002: GBD sequelae
and case definitions
<http://www.who.int/healthinfo/statistics/gbdestimatescasedefinitions.pdf>
5. Morphy H, Dunn KM, Lewis M et al. Epidemiology of insomnia:
a longitudinal study in a UK population. Sleep 2007; 30(3): 274-80
6. Prolonged-release melatonin improves sleep quality and morning
alertness in insomnia patients aged 55 years and older and has
no withdrawal effects. Lemoine P, et al. J. Sleep Res 2007; 16:
372-380
7. Efficacy of prolonged release melatonin in insomnia patients
aged 55-80 years: quality of sleep and next-day alertness outcomes.
Wade AG, et al. Current Medical Research and Opinion. 2007; 23(10):
2597-2605
