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Sleep Medication Linked to Dementia

Regular use may be harmful to brain health, new research says

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According to one of the first studies to explore the connection between sleep medications and a dementia diagnosis long-term, regular use of such drugs could harm your future brain health.

"We know that sleep medication use is pretty common in older adults,” says Yue Leng, a postdoctoral researcher at the University of California San Francisco, and the study's lead author. “Usually when people have sleep problems, they're prescribed these medications by default. But few studies have looked into what the medications are really doing to their body and to their brain.”

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The study, released today at the Alzheimer's Association International Conference 2019, included a racially diverse group of 3,068 people, ages 70 to 79, who were cognitively healthy when the study began. Researchers questioned the participants about their use of sleeping pills and culled information about them from medical records and tests of brain function over a 15-year period.

The results: Older adults who reported using sleep medications “often” or “almost always” were 43 percent more likely to develop dementia over the course of the study than those who took them “rarely” or “never.” The association was true only for white study participants, however.

Many questions remain. The study doesn't explain why there was no association between the use of sleeping pills and dementia among black participants. Also, researchers didn't distinguish between types of sleeping aids, which may have different effects on the brain.

"The measure of sleep medication use is pretty crude in this study,” says Leng. “But we are planning further studies looking at specific types of medications, and that should tell us more.”

The data do not establish that sleeping medications cause dementia. It could be that the source of an individual's sleeplessness — and not the use of sleep aids — is responsible for cognitive decline.

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Still, Leng hopes the findings will give doctors pause when they pull out their prescription pad. “People don't really consider the long-term effects of these medications,” she says. “We want clinicians to be more cautious about prescribing them."

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Similar research from Utah State University in Logan examined the link between the long-term use of sleeping pills and the development of Alzheimer's disease among a group of 3,656 adults, ages 65 and older.

"There's been a lot of research that's looked at the association between sleep disturbances and risk for developing Alzheimer's disease,” says study author Elizabeth Vernon, a Utah State doctoral student. “We were looking at whether these sleeping aids may also contribute to the risk."

The results varied by gender and other factors. Men in the group who used sleeping agents were 3.6 times more likely to develop Alzheimer's disease.

Women's risk for the disease depended on whether they reported having a history of insomnia. When women reported they had such a problem, which was technically explained as “sleep disturbance,” taking a sleeping medication was associated with a 35 percent reduced risk of Alzheimer's disease. But Alzheimer's risk was nearly four times higher among women who didn't report having a sleep disturbance and who took sleep medication to, say, counter sleep loss associated with something like chronic pain.

These differences may stem from underlying health challenges and/or the type of sleeping aid used. Differences between the genders may also be attributable to hormonal differences or variations in the sleep patterns of men and women. “Females spend more time in slow-wave sleep, and males tend to spend more time in earlier sleep stages,” Vernon says.

Investigators aren't sure what to make of all the findings in this study but see it as a fodder for future research. Meanwhile, Vernon urges caution with any assumptions that sleep aids might help women preserve cognitive function. While it's interesting to hypothesize that, for women, the benefits of fighting slow-wave-wrecking insomnia with sleep drugs trumps their negative effects, researchers say such assumptions are premature and potentially hazardous to older women.

"Some of these medications can increase the risk of falls and confusion and memory lapses as a side effect,” Vernon says. “Consequently, it may be best to use alternative interventions, such as cognitive behavioral therapy or sleep hygiene techniques as a first line of defense to address the sleeping issue."

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