Question:
My sleep disorder is based on the following two occurrences.

a) It started 7 years ago, when I was 87 years old, I always

waked up at around 7 am every day, with out exception

(like a clock), and regardless what time I went to bed

b) But now, I am 95 years old and it’s worse. It takes around

2 - 3 hours for me to fall asleep, and makes me wake up at

4 am, unable to fall asleep again. Every night the samepattern the last 2 years.

WHAT or Where SHOULD I LOOK FOR HELP

Answer: The cheapest thing that works even though not listed as a sleepmedication is Xanax. Ambien, Lunesta, and all the new sleep aids thatare being advertised are still under primary patent and cost about $100per month. Xanax costs me about $12.00 per month. You doctor may giveyou some backlash about addiction, but at 95 I don't think that would beyour problem. Lack of sleep is torture enough. If you keep the dose to aminimum you should not have to worry for at least ten years, and youwould be anear record setting 105 by then, but sleeping well.

There are several very good reasons for Xanax to be a class 4 drug,apart from it's addictive and habituating nature. And, by the way, itdoes not take ten years to develop addiction, it takes less than twoweeks. All benzodiazepines are in this class including lorazepam(Ativan), chlordiazepoxide (Librium), diazepam (Valium), oxazepam(Serax), alprazolam (Xanax) because they have significant effects onthe neurological systems which cannot be detected while the patient ison the meds, except that rare high-dose seizure. In fact, these drugs(especially valium and ativan) are the first-line treatment inEmergency Rooms for seizure disorders of *any* cause. In addition, thecardiovascular effects I previously mentioned are not insignificant.That small dose for you, at 57 yrs, could cause a massive collapse of afragile cardiovascular system in a patient, at 95, who is nothabituated to Xanax, and even if I had our OP in my clinic, Xanax wouldnot be my first choice of meds for him on account of the fact that heis already at high risk just by his age, for having a fragilecardiovascular system. I don't mean impending congestive heartfailure, I mean someone whose system is puttering along okay with *or*without meds until along comes some tiny little *apparently* harmlessdrug that becomes the straw that breaks the camel's back. In the newlyrecognized field of geriatrics, it has become an axiom to not *ever*unless absolutely necessary give a patient any new drugs unless thereis no other way out, not because "doctors don't care about patientsbeing miserable", but because massive experience has told us that incertain cases, especially geriatric cases, adding a drug just like thisone has, more often than not, opened Pandora's Box and led to adomino-type process of system deterioration that ends up a few monthsdown the line in a catastrophic event. It is not an unusualpresentation at all to find an old patient in an emergency room for hipfracture who fell down because of dizziness due to his new sleep med,X-epam, whichever. After six weeks in bed trying to repair a brokenhip, there is a measurable risk of that patient remaining bedridden forthe rest of his life, severely depressed, with dementia from which theynever come back, until they succumb to heart attack or stroke; suchthat hip-fractures in the elderly are considered to be significantlyslow-life-threatening. We avoid, like the plague, giving meds thatmake elderly patients dizzy, and elderly patients get dizzy veryeasily, so that little dose of Xanax that seems so harmless can cause agreat deal of harm indeed, in this class of patients.