Many people have trouble falling asleep or staying asleep, a problem commonly known as insomnia. To cope, some turn to sleep aids—medications that are either prescribed by a doctor or bought over the counter. These include drugs like benzodiazepines, certain antidepressants, and sedative-hypnotics such as Ambien.
While these medications can help people get the rest they need in the short term, recent research is raising concerns about their long-term effects—particularly a possible link to dementia.
A large study led by researchers in the United States followed more than 3,000 older adults over an average period of nine years. None of the participants had dementia at the start. During the study, however, around 20% of them developed the condition.
This led researchers to take a closer look at how often these individuals used sleep medications and whether it affected their risk of developing dementia.
What they found was surprising. White participants who frequently used sleep medications had a 79% higher chance of developing dementia than those who didn’t use them. But among Black participants, who generally used these drugs less often, there was no increased risk. This difference between racial groups might be explained by access to medications.
White participants were more likely to have access to a wide range of sleep drugs, including benzodiazepines, trazodone, and so-called Z-drugs like Ambien. Black participants had less access overall, which may explain the difference in outcomes.
The researchers also suggested that it’s not just whether someone uses sleep medications, but how often and which types they use that could impact their risk. This makes it important to think carefully about the kind of sleep aid being used and for how long.
Because of these concerns, experts are urging people to try other methods before turning to medication. In some cases, insomnia may be caused by an underlying issue, such as sleep apnea—a condition where breathing stops and starts during sleep. Identifying and treating these problems may improve sleep without the need for drugs.
One of the most effective non-drug treatments for insomnia is cognitive behavioral therapy, or CBT. This type of therapy focuses on changing negative thoughts and habits that interfere with sleep. It has been shown to work well and does not carry the same risks as medication.
Some people also turn to melatonin, a natural hormone that helps regulate sleep. Melatonin is generally considered safe for short-term use, but scientists still don’t know enough about its long-term effects. More research is needed to know whether it can truly replace stronger sleep medications in the long run.
The study, led by Dr. Yue Leng and published in the Journal of Alzheimer’s Disease, adds to growing evidence that common lifestyle choices and medications can have serious health consequences later in life. It reminds both patients and doctors that even everyday treatments like sleep aids should be used with care—especially in older adults.
In short, while sleep medications may help people get much-needed rest, they are not without risks. This is particularly important for certain groups, like older white adults, who may be more likely to use these drugs and experience long-term effects.
It also shows why healthcare providers need to offer personalized advice and consider safer, non-drug alternatives whenever possible.
As research continues, it’s becoming clearer that good sleep—and good health—may be best supported not by pills, but by long-term, natural approaches that support both the body and brain.
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