Journals of Gerontology Series B: Psychological Sciences and Social Sciences, Vol 55, Issue 1 P54-P62, Copyright © 2000 by The Gerontological Society of America
Effects of chronic insomnia and use of benzodiazepines on daytime performance in older adults
A Vignola, C Lamoureux, CH Bastien and CM Morin
Ecole de Psychologie, Universite Laval, Ste-Foy, Quebec, Canada.
This study evaluated the impact of insomnia and chronic use of
benzodiazepines on the cognitive and psychomotor performance of older
adults. Three conditions, matched on age, gender, and education, were
compared: 20 prolonged users of benzodiazepines for insomnia, 20
unmedicated insomniacs, and 20 good sleepers. The participants completed
neuropsychological tests of memory, attention/concentration, psychomotor
speed, and executive functions, as well as subjective evaluations of their
actual performance. Individuals with insomnia, both medicated and
unmedicated, performed worse than good sleepers on the
attention/concentration factor. There was no other objective evidence of
performance impairments. However, unmedicated insomniacs had lower
performance expectancies and subjectively rated their performance more
negatively relative to medicated insomniacs and good sleepers. Both
insomnia conditions also rated their performance as lower compared with
their perceived potential. It is suggested that the attention/concentration
difficulties experienced by medicated and unmedicated older adults with
insomnia may be linked to a state of hyperarousal. The discrepancies
between subjective reports of daytime deficits and objective impairments
may reflect a generalized faulty appraisal of sleep and daytime functioning
among individuals with insomnia complaints. The implications of those
findings for the assessment and treatment of late-life insomnia are
discussed.
