Sleeping Pills Linked to Higher Risk for Dementia

阿兰•丹尼莫泽什长达每日健康报告er

Seniors who frequently take sleeping medications may be raising their risk for developingAlzheimer'sdisease, a new study warns.

Sleepmedications are one of the most commonly used medications in older adults, the authors say, but their frequent use may not be without harm.

Researchers found that older white adults who said they “often” or “almost always” tooksleep aidshad a 79% higher chance of developingdementiacompared to those who “never” or “rarely” used them.

The connection was only seen among white adults, not Black participants.

In addition, “further studies are needed to confirm whethersleepmedications themselves are harmful for cognition in older adults or [if] frequent use ofsleepmedications is an indicator of something else that links to an increaseddementiarisk,” said study lead author Yue Leng.

In other words, the investigation “cannot prove causation,” stressed Leng, an assistant professor in the Department of Psychiatry and Behavioral Sciences at the University of California, San Francisco.

Percy Griffin, director of scientific engagement with theAlzheimer'sAssociation, seconded the thought.

“We do want to be careful,” said Griffin, who wasn't part of the study. He noted that observational studies of this kind can only identify an association between a “modifiable risk factor” -- like medication habits -- anddementiarisk. “They don't prove cause and effect,” he said.

For the study, Leng and her team enlisted roughly 3,000 seniors to share theirsleepmedication routines starting in 1997.

Participants were between 70 and 79 years old, and none haddementia. All lived in Memphis or Pittsburgh. Nearly 6 in 10 were white and 4 in 10 were Black.

Three times over five years all were asked how often they took sleeping aids: never, rarely (once a month or less), sometimes (2 to 4 times a month), often (5 to 15 times a month), or almost always (16 to 30 times a month).

Participants also discussed the quality of their sleep, indicating how frequently they struggled with falling asleep and/or getting up too early in the morning. Routine sleep duration was also noted.

Sleep aidsencompassed bothover-the-counterand prescription medications. Commonover-the-counteroptions includedantihistamines,melatoninandvalerian. Prescription meds includedantidepressants, antipsychotics,benzodiazepinesand so-called Z-drugssuch asAmbien(zolpidem).

Overall, 7.7% of the white participants said they took some type of sleep medication often or almost always.

Yet 2.7% of Black participants reported a similar level of routine usage.

Among white and Black participants, frequent usage was highest among women, those struggling withdepressionand the more highly educated.

The team noted thatbenzodiazepineuse for chronicinsomnia-- includingHalcion(triazolam), Dalmane (flurazepam) andRestoril(temazepam) -- was twice as high among white seniors compared with Black seniors. White participants were also seven times more likely to take a Z-drug likeAmbien, and 10 times as likely to take theantidepressanttrazodone(Desyrel和Oleptro)。

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After tracking participants for up to 15 years, the researchers found about one-fifth developeddementia.

While white seniors who used sleeping pills frequently faced a 79% higher risk fordementia, that was not the case among Black seniors -- and not just because far fewer Black adults took sleeping aids frequently. Those who did use them often appeared to face no higher risk for developing dementia than those who rarely or never took a sleeping med.

Leng said the racial gap her team identified was “surprising to us," particularly since prior research suggests that Black people generally face a higher risk for developingAlzheimer'sthan their white peers.

“One possible explanation could be that Black adults who have access to sleep meds are a selected group of people with high socio-economic status,” which might afford them amental healthleg up that's protective against dementia, Leng said.

Yet even among white seniors, Leng “wouldn't say sleep meds 'boost'Alzheimer'sdisease risk” based on the findings. And her team stressed that “it remains controversial whether sleep medications are good or bad for cognition in the long run.”

It could turn out that certain meds might contribute to dementia risk, while others don't. Or that havingsleep problems-- the reason for using sleep meds -- is a symptom of dementia onset, Leng suggested.

Both she and Griffin agreed additional research is needed.

“More work needs to be done,” said Griffin. “And we shouldn't be sounding the alarm bells just quite yet.”

Meanwhile, he offered some cautionary advice: “In general, before anyone takes any sleep medication, or any medication for that matter, they should have a conversation with their doctor to see how it might interact with any other medication they might already be taking." Their medical history and life story in general should also be considered, he added.

The study results appear online Jan. 31 in theJournal ofAlzheimer's Disease.

SOURCES: Yue Leng, PhD, assistant professor, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco; Percy Griffin, PhD, director of scientific engagement, Alzheimer's Association, Chicago;Journal ofAlzheimer's Disease,Jan. 31, 2023

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