Millions of people have trouble falling asleep, staying asleep or waking too early. When these problems continue, they are often described as insomnia.
Poor sleep can affect memory, mood, energy and daily life, so it is understandable that many people turn to medicines for relief.
Sleep medicines come in several forms. Some are prescription drugs that calm the brain, while others are medicines originally developed for conditions such as depression but are sometimes used to help people sleep. These treatments can be useful, particularly for short periods, but researchers are studying whether frequent use may have unwanted effects later in life.
One study involving more than 3,000 older adults found a possible connection between frequent use of sleep medicines and dementia. None of the participants had dementia when the research began. During an average follow-up of about nine years, around one in five developed the condition.
Dementia is not a single disease but a general term for serious problems with memory, thinking and the ability to manage everyday activities. Alzheimer’s disease is its most common cause. Because dementia becomes more common with age, researchers are trying to identify factors that might raise or lower a person’s risk.
The sleep study found an especially noticeable pattern among White participants. Those who reported using sleep medicines often or almost always had a 79% higher risk of developing dementia compared with those who rarely or never used them. The same association was not seen among Black participants.
Researchers cautioned that differences in the types and amounts of medicines used could help explain the finding. White participants were more likely to report frequent sleep-medication use and had greater use of certain prescription treatments. These included benzodiazepines, trazodone and medicines sometimes known as “Z-drugs,” such as zolpidem.
The findings do not prove that sleep medicines cause dementia. Studies that follow people over time can identify a connection, but they cannot always show what caused it. For example, sleep problems themselves may sometimes be an early sign of changes in the brain that begin years before dementia is diagnosed.
Other health conditions could also influence both sleep and dementia risk. This makes the relationship complicated and means people should not suddenly stop prescribed medicines because of one study. Stopping some sleep medicines abruptly can also cause withdrawal or other problems.
Instead, people who regularly need medicine to sleep may want to discuss the issue with their doctor. A medical assessment can sometimes uncover another cause of poor sleep, such as sleep apnea, pain, depression or other health problems. Treating the underlying problem may improve sleep without relying heavily on sleeping pills.
Another option is cognitive behavioral therapy for insomnia, often called CBT-I. It helps people change habits and thought patterns that can keep insomnia going. Unlike sleeping pills, its benefits can continue after treatment ends, and it is widely recommended as a first treatment for long-lasting insomnia.
Melatonin is another commonly discussed sleep aid. It is a hormone naturally produced by the body that helps control the sleep-wake cycle. Although it may be useful in some situations, researchers still need more evidence about the effects of regular long-term use, especially in older adults.
The study was led by Dr. Yue Leng of the University of California, San Francisco and was published in the Journal of Alzheimer’s Disease. The researchers said more work is needed to understand why the association differed between racial groups and whether particular sleep medicines carry different levels of risk.
For now, the research is a reason to use sleep medicines thoughtfully rather than a reason to fear them. For people with persistent insomnia, discussing the cause of the problem, the type of medicine being used and possible non-drug treatments with a health professional may be a sensible way to protect both sleep and long-term health.
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