Prescription Sleep Meds May Up Risk of Dementia by 79% in White Seniors

by Liz Neporent
February 2, 2023 at 10:05 AM UTC

Sleeping pills may be a risk factor for dementia, especially in white people.

Clinical Relevance: Frequent use of sleeping aids could increase risk of dementia, particularly in white patients

  • A study from the University of California-San Francisco warned that taking prescription sleeping pills may increase the risk of developing dementia, especially among white people.
  • White participants who frequently took sleeping pills had a 79 percent higher chance of developing dementia compared to those who rarely or never took them, while Black participants showed similar dementia risk regardless of sleeping pill usage.
  • However, another study cautioned against abruptly stopping sleeping agents due to the risk of serious side effects. It also expressed skepticism about some over the counter sleep aids and questioned the safety of antihistamines for use in insomnia.

With more than half of primary care patients complaining of insomnia, it’s no surprise that so many take sleeping pills for relief. This may not be the best idea for long term brain health, warned new research out of the University of California-San Francisco.

Popular prescription sleeping medications including Benzos, Ambien, and antidepressants, may increase the risk of developing dementia, especially among people who are white, the study found. However, type and quantity of medication seemed to be a significant factor.

The Health, Aging and Body Composition study monitored approximately 3,000 older adults without dementia who lived independently with an average age of 74. Of the participants, 58 percent were white and 42 percent were Black.

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Over the course of nine years, 20 percent of the participants were diagnosed with dementia. White participants who were frequent sleeping pill takers had a 79 percent higher chance of developing dementia compared to those who “never” or “rarely” took them. But Black subjects who regularly took prescription drugs to help get some sleep had a similar risk for developing dementia risk as subjects who abstained or rarely used the medications.

“Differences may be attributed to socioeconomic status,” said first author Yue Leng, PhD, of the UCSF Department of Psychiatry and Behavioral Sciences and UCSF Weill Institute for Neurosciences in a press release. “Black participants who have access to sleep medications might be a select group with high socioeconomic status and, thus, greater cognitive reserve, making them less susceptible to dementia.”

It’s also possible that some sleep medications were associated with a higher risk of dementia than others, Leng said.

At 7.7 percent, people who are white were three times as likely than people who are Black to take sleep medications “often,” (five to 15 times a month) or “almost always,” (16 times a month to daily), the researchers reported. Whites were almost twice as likely to use benzodiazepines, like Halcion, Dalmane and Restoril, prescribed for chronic insomnia.

People who are white were also 10 times as likely to take trazodone, an antidepressant usually sold under the names Desyrel and Oleptro, that are also sometimes prescribed as a sleep aid. And they were more than seven times as likely to take “Z-drugs,” such as Ambien, a so-called sedative-hypnotic.

The researchers said they need future studies to provide more clarity on the cognitive risks and rewards of sleep medications, especially as they relate to race. In light of their findings, they suggest people think carefully before taking them.

However, for patients already on a prescription sleeping aid, a recent The Primary Care Companion for CNS Disorders paper cautioned against stopping them abruptly, especially benzodiazepines and BzRAs, due to the risk for rebound insomnia or withdrawal symptoms such as anxiety

The same review explored the effectiveness of herbal and over the counter sleep aids and came up with mixed reviews for valerian, melatonin and nonprescription cannabinoid. It also recommended clinicians counsel patients about the risks of antihistamines with anticholinergic properties that can cause cognitive impairment, hangover effects, dizziness, or falls.

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