Older adults who regularly use medicines to help them sleep may have a higher risk of developing dementia, according to research from the University of California, San Francisco.
The study found that the association was especially strong among white participants. However, the researchers stressed that the findings do not prove that sleep medicines directly cause dementia.
Sleep problems become more common with age, and many older adults turn to prescription or over-the-counter medicines for relief. These drugs can make it easier to fall asleep or stay asleep, but some can also cause daytime sleepiness, confusion and other unwanted effects. Scientists have therefore been studying whether long-term use could affect brain health.
The researchers examined information from about 3,000 older adults who did not have dementia when the study began. Participants were part of the Health, Aging, and Body Composition study and were followed for an average of about nine years. Their average age was 74, and 58% were white while 42% were Black.
During the study period, about 20% of the participants developed dementia. Among white participants, people who reported using sleep medicines often or almost always had a 79% higher risk of developing dementia than those who rarely or never used them. Frequent use meant taking the medicines at least five times a month.
The same clear increase in risk was not seen among Black participants. Black adults in the study were also much less likely to use sleep medicines regularly. The researchers said differences in the types and amounts of medicines used could potentially help explain the different results.
White participants were about three times as likely as Black participants to regularly use sleep aids. They were also nearly twice as likely to use benzodiazepines, a group of sedating medicines that includes drugs such as Halcion and Restoril. These medicines can be prescribed for insomnia but are generally used cautiously in older people because of their side effects.
Large differences were also found for other medicines. White participants were about 10 times more likely to use trazodone, an antidepressant that is sometimes prescribed to help with sleep. They were also more than seven times as likely to use so-called Z-drugs, including zolpidem, which is sold under the brand name Ambien.
The findings cannot show whether the medicines themselves were responsible for the higher dementia risk. Sleep difficulties can sometimes appear years before dementia is diagnosed, so people developing early brain changes may be more likely to need sleep medicines. Other health and lifestyle differences could also influence the results.
This makes the relationship between sleep, medication and dementia complicated. Poor sleep itself has been linked in previous research to problems with memory and brain health, while some sleep medicines have been associated with falls, fractures and accidents in older adults. Doctors therefore have to balance the possible benefits of treatment against its risks.
People who currently use sleep medicine should not suddenly stop taking it because of this study. Some medicines can cause withdrawal symptoms or other problems when stopped abruptly. Anyone concerned about long-term use should instead speak with a doctor or pharmacist about whether the medicine is still needed and whether safer options are available.
Non-drug treatments can help many people with ongoing insomnia. Cognitive behavioral therapy for insomnia, often called CBT-I, helps people change habits and thought patterns that interfere with sleep and is widely recommended as a treatment for chronic insomnia. Regular sleep and wake times, less caffeine later in the day and a calm bedtime routine may also help.
The researchers said more studies are needed to determine whether particular sleep medicines carry different risks and why the association may vary between racial groups. Understanding those differences could help doctors choose safer treatments for older adults who struggle with sleep.
The research was led by Yue Leng and colleagues at the University of California, San Francisco, and was published in the peer-reviewed Journal of Alzheimer’s Disease. It adds to growing evidence that the long-term effects of sleep medicines deserve careful study, particularly as these drugs are commonly used by older adults.
If you care about brain health, please read studies that eating apples and tea could keep dementia at bay, and Olive oil: a daily dose for better brain health.
For more health information, please see recent studies what you eat together may affect your dementia risk, and time-restricted eating: a simple way to fight aging and cancer.
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