Sleep Disorders/Dementia

[petrushkaminushka]

I have been taking clonazepam 1 mg. bedtime for sleep for at least ten years--I'll soon be 77..   It works like a charm not only for sound sleep through night, but also eliminates tooth grinding and nightmares.  However, my doctor has been concerned about my continuing on this medicine because of my strong family history of developing dementia at about my age.  So I  have recently tried to stop taking my sleep aid.  At present, I am going two or three nights without the clonazepam, but taking an antihistamine for my nasal clogging and dripping at bedtime.  I can sleep reasonably well some nights, but I often stay awake a lot throughout the night and during the day I'm experiencing a lot of short spells of both anxiety and depression--which I assume is related to eliminating the clonazepam.  Question:  how important is it to stop using clonazepam at night given my history of two parents and three siblings having dementia in old age?  Do you have suggestions regarding sleep aids with family history of dementia?  Pat T.

[Jerry_NJ]

More a question than an answer:  I have never heard of clonazepam, but if it helped with dreaming problems, then it might be something I should discuss with my Primary care, or even the Pulmonary specialist that oversaw my sleep study early this year.  I suffer from both chronic "troublemares"  and chronic nasal congestion when lying down.

I am 74 and diagnosed with mild obstructive sleep apnea which has responded well to my loss of 25 pounds, about 10% of my previous weight, I am 6' 5", down from 6' 6" of my younger years.

[skydnsr]

In the best of all possible worlds, it's best not to have to take clonazepam, but if your parents did not take clonazepam, then obviously their dementia was not due to clonazepam.  Now, sometimes clonazepam can cause symptoms of forgetfulness that mimic dementia, but those symptoms should go away when the clonazepam is discontinued.  

Forgetfulness is considered to be a "cognitive side effect" of longterm clonazepam use.  It doesn't go away immediately upon stopping the clonazepam.  It can persist for anywhere from a few days to up to six months, but it should go away eventually -- as long as you're not also developing dementia at the same time.  

Are you perhaps starting to experience some forgetfulness?  Maybe this is what your doctor is worried about.  Under those circumstances, it is certainly difficult to know whether you are having side effects of longterm clonazepam use or you are showing early signs of dementia.  The problem is that the treatment for those two conditions is different.  

Have you had a sleep study within the last year?  If not, then I would do that.  I personally don't think that anyone should be on clonazepam for 11 years in the absence of periodic consultation from a sleep medicine specialist.  

And have you had a psychiatric or psychological evaluation to rule out dementia?  That would also provide important information.  Psychological testing, in particular, can help differentiate between normal aging and early dementia.  

When you have the results of both of a sleep study and a cognitive evaluation, then I think that you and your primary care doctor will be in a better position to decide about the clonazepam.  Those evaluations will also show what kind of specialty care you need to be getting on an ongoing basis.  Good luck.