Can Sleeping Pills Raise the Risk of Dementia? New Study Finds a Link
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New study links sleeping pills to a greater risk of developing dementia.
The link was only found in white patients.
Doctors say there are a lot of unknowns in the link between sleeping pills and dementia risk.
About 4% of adults over the age of 20 use prescription sleeping pills in the U.S., but a new study is raising eyebrows after linking these common sleep aids to dementia.
The study, which was published in the Journal of Alzheimer’s Disease, analyzed data from 3,068 adults in their 70s (at the start of the study) who didn’t have dementia. They were asked about their sleeping pill use and frequency, and then followed for 15 years. The researchers found that 138 white participants and 34 Black participants reported taking sleep medication “often or almost always,“ and there were a wide range of drugs listed, including antihistamines, melatonin, valerian, antidepressants, antipsychotics, benzodiazepines, and “Z-drugs” like zolpidem (Ambien).
Those who reported taking sleep medications five or more times a month had a significantly higher risk of developing dementia—79% higher, to be exact. However, the link was only found in white participants.
The researchers kept the conclusion simple, writing, “frequent sleep medication use was associated with an increased risk of dementia in white older adults. Further research is needed to determine underlying mechanisms.”
If you or a loved one use sleeping pills, it’s understandable to have questions. Here’s what you need to know.
Why might sleeping pills be linked with dementia?
It’s important to point out that correlation doesn’t equal causation. Meaning, the researchers found a link, but there could be an entirely different reason why frequent users of sleeping pills later in life have a higher risk of developing dementia.
However, this isn’t the first study to link sleeping pill use with a higher risk of dementia. Two large population studies found that both benzodiazepines (which are a type of medication used for anxiety and sleep) and anticholinergics (which are used for sleep, along with allergies and colds, depression, and high blood pressure) were linked with a higher risk of dementia in people who used them for longer than a few months. In both studies, the risk was greater the longer people used these medications and the higher the dose.
But there are a lot of different sleep medications out there—and even a wide range referenced in this study—and they all work a little differently, points out Jamie Alan, Ph.D., Pharm.D., associate professor of pharmacology and toxicology at Michigan State University. “Melatonin works exactly as our own melatonin works in our body” she says. “Benzodiazepines and ‘A-compounds’ like Ambien work by increasing the activity of the GABA channel, which is generally a neuro-depressant. Antihistamines like diphenhydramine or doxylamine work by centrally blocking histamine receptors [to make you feel drowsy].”
It’s important to note that the use of sleep aids in sleep medicine is controversial. “I talk to patients about sleep medication all the time,” says W. Christopher Winter, M.D., a neurologist and sleep medicine physician with Charlottesville Neurology and Sleep Medicine and host of the Sleep Unplugged podcast. At a basic level, sleep medications work through through different pathways in your body to help you feel sedated, he explains.
“Sleep and sedation are two different things, but people have come to association sedation with sleep,” he says. Repeatedly using sleep medication to nod off at night could potentially cause lasting changes to your brain, Dr. Winter says.
In general, “sleep aids often work by altering brain chemistry [and] neurotransmitters and brain health is complex,” says Amit Sachdev, M.D., medical director in the department of neurology at Michigan State University. He adds, “we often don’t know what years of exposure does to brains.”
What should you do if you use sleeping pills?
It’s important to point out that this just one study—and study participants took a range of sleep medications. However, there is additional research to suggest a link between some sleeping pills and dementia, although researchers have stopped short of saying that sleeping pills actually cause dementia. Again, all any of these studies have found is an association.
“Everything in medicine is about risk-benefit analysis and it has to be very personalized to each patient,” says Santosh Kesari, M.D., Ph.D., neurologist at Providence Saint John’s Health Center in Santa Monica, Calif. and regional medical director for the Research Clinical Institute of Providence Southern California. “This study opens up another variable about whether race makes a difference in terms of dementia, and it’s more information that the doctor and patient can use to have discussion about the risk-benefits of using medication for sleep.”
But if you’ve been relying on medication to help you sleep, Dr. Winter recommends revisiting your treatment plan with a sleep medicine specialist. “Talk to 100 patients to take benzodiazepines for sleep and they’ll tell you, ‘I don’t sleep without it.’ But the data show that benzodiazepines don’t really significantly improve the amount of sleep beyond a few extra minutes,” he says. “Is the medication actually improving sleep quality or is it simply giving you the feeling that you were sedated?”
Dr. Sachdev agrees, noting that it’s important to “discuss the reasons why you might need a sleep aid with your doctor.”
A sleep specialist “can help you work through meaningful changes and diagnostic procedures to figure out what’s wrong with your sleep—rather than prescribing any drug to cover it up,” Dr. Winter says.
Ultimately, the use of sleep aids is a personal one, and everyone who is on sleeping pills has their own reason for it. There’s also no reason to panic and toss your pills if you use them. “This study brings up more questions than answers for me—this is a very complex issue,” Alan says. But if you’re taking sleeping pills, talk to a sleep specialist to see if it’s the best treatment plan for you. They may have an even better solution that can help you get more quality sleep, now and in the future.
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