A recent study suggests that sleep medications may increase the risk of dementia in white individuals.
However, the type and quantity of medication may influence this risk.
Previous research has shown that Black individuals are more likely than white individuals to develop Alzheimer’s disease, the most common form of dementia, and that their risk factors and symptoms can differ.
The final corrected version of the study was published in the Journal of Alzheimer’s Disease on January 31, 2023.
The research followed approximately 3,000 older adults who did not have dementia and were living outside of nursing homes.
These participants were enrolled in the Health, Aging, and Body Composition study and were monitored for an average of nine years.
The participants’ average age was 74, with 58% identifying as white and 42% as Black.
During the study, 20% of participants developed dementia. Among white participants who frequently took sleep medications—defined as “often” (five to 15 times a month) or “almost always” (16 times a month to daily)—the risk of developing dementia was 79% higher compared to those who rarely or never used them.
However, Black participants, who reported lower rates of sleep medication use, did not show an increased risk of dementia related to these medications.
Socioeconomic Factors and Medication Use
Dr. Yue Leng, Ph.D., from the UCSF Department of Psychiatry and Behavioral Sciences and UCSF Weill Institute for Neurosciences, suggested that socioeconomic status might play a role.
“Black participants who have access to sleep medications might belong to a select group with higher socioeconomic status and thus greater cognitive reserve, making them less susceptible to dementia. It is also possible that some sleep medications carry a higher risk of dementia than others,” she said.
The study found notable differences in medication use between white and Black participants:
- 7.7% of white participants frequently used sleep medications, compared to 2.7% of Black participants.
- White participants were nearly twice as likely to use benzodiazepines, such as Halcion, Dalmane, and Restoril, which are commonly prescribed for chronic insomnia.
- White participants were 10 times more likely to take trazodone, an antidepressant sometimes prescribed as a sleep aid.
- White participants were seven times more likely to use “Z-drugs” like Ambien, a sedative-hypnotic.
Implications for Sleep and Dementia Risk
Future studies may provide more clarity on the cognitive risks and benefits of sleep medications and how these risks differ across racial groups. For now, patients with sleep problems should be cautious when considering medications, according to Leng.
“The first step is to determine the underlying cause of sleep issues. If sleep apnea is suspected, a sleep test may be necessary,” Leng advised.
“For insomnia, cognitive behavioral therapy for insomnia (CBT-i) is the preferred first-line treatment. If medication is needed, melatonin may be a safer alternative, but more research is required to understand its long-term effects on health.”
These findings emphasize the need for careful evaluation of sleep medications, particularly among older adults who may already be at risk for cognitive decline. More research is needed to determine whether specific medications or dosages contribute to dementia risk and how different racial groups may be affected differently.
If you care about dementia, please read studies about Vitamin B9 deficiency linked to higher dementia risk, and flavonoid-rich foods could help prevent dementia.
For more information about brain health, please see recent studies that cranberries could help boost memory, and how alcohol, coffee and tea intake influence cognitive decline.
The research findings can be found in Journal of Alzheimer’s Disease.
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