The use of triazolam in older patients with periodic leg movements, fragmented sleep, and daytime sleepiness
Article Abstract:
Several studies have been performed which indicate that there is a direct association between sleep fragmentation and daytime sleepiness. Older individuals, in particular, frequently complain of decreased daytime alertness as a consequence of fragmented nighttime sleeping patterns. Periodic leg movements (PLMS) during nighttime sleep often result in fragmented sleep patterns and excessive daytime sleepiness. Although medications to aid sleep such as benzodiazepines are available, they may also result in additional residual daytime sleepiness because of the long metabolic life of these agents. Triazolam, a short-acting benzodiazepine, was evaluated for its effectiveness in improving daytime alertness and decreasing fragmented nocturnal sleep. Eleven patients between the ages of 55 and 75 who were referred to a sleep disorder center for excessive daytime sleepiness, and who also reported PLMS during nocturnal sleep, were examined. All the individuals were in good health and none of the patients had any chronic conditions or were using drugs such as tranquilizers or hypnotics. Psychological profiles of the subjects were also determined to be normal. The patients were each given 0.125 milligrams (mg) of triazolam, 0.25 mg of triazolam, or a placebo during a double-blind crossover trial for three nights. Both doses of triazolam resulted in increased sleep efficiency and total sleep time, and decreased stage changes during sleep. However, no differences were noted in the total leg movements when the medication was given. For most patients, measurements of objective alertness and daytime performance were substantially improved with triazolam. It was concluded that the 0.125mg dose of triazolam, used on an acute basis, is effective in improving daytime functioning and reducing fragmented sleep patterns in patients with PLMS over 55 years of age. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journals of Gerontology
Subject: Seniors
ISSN: 0022-1422
Year: 1990
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The implications of the acquired immunodeficiency syndrome for gerontology research and geriatric medicine
Article Abstract:
In December 1989, it was estimated that almost one-third of the 115,000 cases of acquired immunodeficiency syndrome (AIDS) in the United States occurred in patients over age 40 years. Human immunodeficiency virus type 1 (HIV-1) infection among older patients usually results from a history of male homosexual activity or from contaminated blood products. Although the incidence of HIV-1 disease among the elderly is decreasing, this infection is associated with a more rapid disease progression and a shorter survival period in older patients. HIV-1 causes adverse effects on the immune or natural defense system, in particular a marked decrease in CD4+ T cells, a type of immune cell. This can result in: impairment of immune function; the occurrence of opportunistic infections, caused by microorganisms that are not normally infective; and development of Kaposi's sarcoma, the formation of cancerous lesions on the skin and other body sites. It is not clear whether immune responses against HIV-1 are beneficial or contribute to the disease process. However, the more rapid progression of HIV disease in the elderly may be related to the decreased immune function associated with aging. The increased frequency of adverse drug reactions and changes in drug metabolism associated with aging should be considered when prescribing antiviral therapy for older AIDS patients. The prevention and management of tuberculosis, pneumonia, influenza, and nerve disease, which contribute to the severity of AIDS in the elderly, require further investigation. The provision of health care for the elderly, incapacitated AIDS patient must also be addressed. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journals of Gerontology
Subject: Seniors
ISSN: 0022-1422
Year: 1990
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