Sleeping Pills and Dementia Risk: What We Know and Who is at Risk

Sleeping Pills and Dementia Risk: What We Know and Who is at Risk

  • A new study finds that sleeping medications may increase the risk of dementia for some people.
  • Researchers found that the link occurred for people who are white, but the same correlation was not seen for other races.
  • White individuals were almost twice as likely as Black individuals to take sleep medications.

Use of prescription sleep medications may increase the risk of dementia for older adults who are white, a new study found. A similar link was not seen for people who are Black.

The type and quantity of medication used may be involved in this higher risk, with white people using certain types of sleep drug aids frequently.

The study was published January 31 in the Journal of Alzheimer’s Disease.

It follows other researchTrusted Source which found that Black participants in dementia-related research studies are 35% less likely to be diagnosed with Alzheimer’s disease or related dementias than white participants.

Lead author Yue Leng, PhD, an assistant professor of psychiatry at the University of California, San Francisco, said the differences between Black and white people may also be due to socioeconomic status.

“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,” she said in a news release.

However, national dataTrusted Source shows that Black Americans are about 1.5 to 2 times more likely to develop dementia than white individuals.

Sleep medication use and dementia

The new study included over 3,000 older adults without dementia who lived outside of long-term care facilities. They were enrolled in the Health, Aging and Body Composition studyTrusted Source.

Their average age was 74 years, and 42% were Black, with 58% white.

Almost 8% of whites, and almost 3% of Black individuals, reported taking a prescription sleep medication “often” (five to 15 times a month) or “almost always” (16 times a month to daily).

Overall, white individuals were almost twice as likely as Black individuals to take sleep medications. In addition, white individuals were more likely than Black individuals to take certain sleep medications:

  • Benzodiazepines such as Halcion, Dalmane or Restoril, which are prescribed for chronic insomnia — almost twice as likely
  • Trazodone (trade name Desyrel or Oleptro), an antidepressant that is sometimes prescribed to help people sleep — 10 times as likely
  • “Z-drugs” such as Ambien, which are sedative-hypnotics — more than seven times as likely

Researchers followed participants for nine years on average, during which 20% developed dementia.

White participants who “often” or “almost always” took sleep medications had a 79% higher chance of developing dementia compared to those who “never” or “rarely” used these drugs.

This increased risk was not seen among Black participants — those who frequently used sleep medications had a similar chance of developing dementia as those who rarely or never used them.

The results were similar when researchers took into account how much sleep people got each night.

Because the new study is observational, rather than a randomized controlled trial, the researchers could not prove direct cause and effect, only that there is an association between sleep medication use and dementia.

“Further studies are needed to confirm whether sleep medications themselves are harmful for cognition in older adults,” Leng told Healthline, “or if frequent use of sleep medications is an indicator of something else that links to an increased dementia risk.”

Poor sleep linked to dementia

Almost 12% of Americans 65 and over report using a sleep medication every night or most nights in the past 30 days, according to a data briefTrusted Source released last month by the Center for Disease Control and Prevention’s National Center for Health Statistics.

“With [many] older adults reporting sleep medication use, the increasing number of studies with consistent evidence supporting a link between sleep medications and dementia risk is definitely worthy of concern,” Kelsie Full, PhD, MPH, a behavioral epidemiologist and an assistant professor at Vanderbilt University in Nashville, told Healthline.

Full, though, agrees with Leng that more research is needed to better understand if sleep medications cause the development of dementia.

In one study, Full and her colleagues found that older adults who used sleep medications had a 48% greater risk of dementia, compared to those who didn’t use them.

This 2022 study, which followed people for about 6 years, was published in the Journals of Gerontology Series A.

In another study, Roger Wong, PhD, an assistant professor of public health and preventive medicine at the State University of New York Upstate Medical University in Syracuse, looked at not just the dementia risks of sleep medications, but also that of insomnia.

He and his colleague found that older adults who used sleep medications more frequently had a 30% increased risk of dementia.

This result remained after they took into account sociodemographic factors such as age, gender, race and ethnicity, education and income.

But when they factored in people’s health, the link between sleep medication usage and dementia weakened.

“A lot of people take sleep medications because of some other health condition they’re dealing with in older adulthood, especially depression and anxiety,” said Wong.

So once they adjusted for these other conditions, the result was no longer statistically significant.

Wong said further research could look at specific groups of people, such as those with depression and anxiety, to see if the link between sleep medications and dementia is still present.

The study, which used 10 years of data, was published January 2023 in the American Journal of Preventive Medicine.

The results also show that older adults who had trouble falling asleep within 30 minutes of going to bed had a 51% higher risk of dementia.

This finding, though, was no longer statistically significant after researchers took into account sociodemographic factors.

Other research, though, has found that poor sleep increases the risk of cognitive problems or dementia.

Sleep meds not only treatment for insomnia

Although more research is needed to fully understand the link between sleep problems and dementia, poor sleep is also linked to other chronic health problemsTrusted Source — heart disease, kidney disease, high blood pressure, diabetes, stroke, obesity and depression.

“Sleep is important to our overall health and well-being,” said Full. “Older adults with concerns about their sleep should start by having a conversation with their health care provider and explore options to meet with a sleep specialist.”

For people who have difficulty sleeping, sleep medications — prescription or over-the-counter — are only one treatment available.

“In general, non-pharmacological sleep interventions — such as cognitive behavioral therapy for insomnia — are encouraged as safer options,” Leng told Healthline.

This is especially important, given that certain prescription sleep medications have also been tied to an increased risk of accidental fallsTrusted Source among older adults.


Do sleeping pills increase risk of dementia?

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

What is the safest sleeping pill for the elderly?

In these settings, melatonin is considered the preferred pharmacological option for elderly patients. It is also an option for patients who are blind and suffer from non–24-hour sleep–wake rhythm disorder, given evidence supporting circadian entrainment.

What are the best sleeping pills for dementia patients?

The FDA has approved Belsomra® to address insomnia in people living with mild-to-moderate Alzheimer's disease. Belsomra is thought to inhibit the activity of orexin, a type of neurotransmitter involved in the sleep-wake cycle.

Is Lack of sleep a risk factor for dementia?

Research suggests the answer to both questions is yes. In a long-term study, Harvard Medical School followed 2,800 individuals ages 65 and older. Researchers found that individuals who slept under five hours per night were twice as likely to develop dementia compared to those who slept six to eight hours per night.

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