Almost half of older Americans have trouble sleeping, and more than a third of them have taken sleeping aids. But according to the National Poll on Healthy Aging, most don't talk to their doctor about their sleeping problems.

Most poll respondents said they hadn't talked to their doctor about their sleep, even though more than a third said their sleep posed a problem.

Those who turn to medications may not realize that sleeping aids, whether they are prescription, over-the-counter, or "natural," all carry health risks, especially for older adults. The risks exist whether the sleeping aids are taken alone or in combination with other substances. In fact, national guidelines strongly warn against prescription sleep medicine use by people over age 65.

Regardless, the poll of people ages 65 to 80 found that 8 percent of older people take prescription sleep medicine regularly or occasionally. Among those who report sleep troubles three or more nights a week, 23 percent use a prescription sleep aid. Most who use these drugs to help them sleep had been taking them for years, even though manufacturers and the U.S. Food and Drug Administration say they should only be used for a short length of time.

"Although sleep problems can happen at any age and for many reasons, they can't be cured by taking a pill, either prescription, over-the-counter or herbal, no matter what the ads on TV say," says the poll's director Dr. Preeti Malani.

"Some of these medications can create big concerns for older adults, from falls and memory issues to confusion and constipation," she said, adding this was true even if the pill was sold without a prescription.

"The first step for anyone having trouble sleeping on a regular basis should be to talk to a doctor about it," Malani continued. "Our poll shows that nearly two-thirds of those who did so got helpful advice — but a large percentage of those with sleep problems simply weren't talking about it."

In all, 14 percent of the poll respondents said they regularly took a prescription sleep medication, prescription pain medication, OTC sleep aid, or herbal supplement to help them sleep. Another 23 percent took one of these options occasionally with most occasional users saying they chose OTC sleep aids.

Sleeping pills and other medications come with risks. A Chinese study found that the prescription sleeping aid Ambien (zolpidem) raises the risk of heart attack by 50 percent. Even taking as few as four standard 35 milligram doses a year increased risk by 20 percent. "The risk of an acute myocardial infarction was greatly increased with zolpidem exposure," the researchers reported.

A separate study found that Ambien also increased the risk of aortic dissection — a potentially fatal condition in which the aorta tears and causes internal bleeding. (Actor John Ritter died from an aortic dissection.)

Even sleep aids purchased without a prescription carry health risks since most of them contain diphenhydramine, an antihistamine that can cause side effects such as confusion, urinary retention and constipation.

According to the Centers for Disease Control and Prevention, up to 70 million American adults have difficulty sleeping. Sleeping disorders increase with aging, and affect almost half of adults 60 and older.