Managing insomnia in the elderly - what prevents us using non-drug options?

Objective: To identify strategies needed to increase use of non-drug interventions in the management of insomnia in the elderly. Methods: A questionnaire was mailed to 425 general practitioners (GPs) in the South Australian Southern Division of General Practice. To provide a consumer perspective, 16 older persons attended focus groups. Results: Responses from 209 GPs showed the role of non-drug strategies in insomnia management was widely known, however access to and the usefulness of these strategies was less well known. GPs' perceptions of patients' expectations regarding medication were the greatest barrier. Patient inquiries about other options, patients' willingness to consider alternatives, printed information for patients on non-drug options, and step-by-step procedures to follow during consultations were considered enabling factors. Most consumers reported problems with sleeping but thought the GP could not help them with their sleep problems. In contrast to GPs' perceptions, consumers expressed interest in alternative treatments and willingness to participate in education sessions. Conclusions: Strategies to increase the use of non-drug alternatives need to provide GPs with information on access to, and the usefulness of, non-drug strategies. Consumers need concurrent education to inform them that GPs can help manage insomnia, and that they need to express willingness to trial non-drug strategies. Effective communication between GPs and consumers is paramount.