Sleep medications linked to falls

DEAR DR. ROACH: You've discussed sleep aids and your belief that it is best to get off all of this type of medication. I am healthy, 75 (take no meds), exercise with weights, do swimming and running regularly, and since 2007 have been taking an over-the-counter sleep aid called doxylamine nightly with no apparent side effects. Do you see a problem with continuing? – A.B.

ANSWER: Unfortunately, I do see a problem. Odds are that you won't have a problem taking this medication; it's cheap and is effective for you. However, there is unequivocal, abundant, incontrovertible evidence that antihistamines like doxylamine or diphenhydramine increase fall risk. If you drive, they increase accident risk. They also can cause confusion.

Although the benefit to you from quitting is small, if I can get enough people to minimize their sleep medications, I know I will prevent some falls. Falls are so often the first step in a progression from health to disability that I want to do all I can to prevent them.

Adequate lighting in the house at nighttime, especially between the bedroom and bathroom, avoiding obstructions like area rugs and the addition of stairway railings and tub grab bars all help reduce fall risk. Exercise programs — like the kind you are doing, but also tai chi — are great at preventing falls. So is getting your eyes checked.

No single one of these interventions can prevent all falls. All of them together will prevent many. Your medication list, even a simple over-the-counter sleeping aid, is the best place to start looking to reduce risk of falls.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]. To view and order health pamphlets, visit rbmamall.com, or write to P.O. Box 536475, Orlando, FL 32853-6475. (c) 2015 North America Synd. Inc. All Rights Reserved