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Strong sleeping pills known as “Z-drugs” have been linked to an increased risk of falls, fractures and strokes in people with dementia, according to research by the University of East Anglia.

Sleep disorders are common in people with dementia, and the effects on patients and their families are significant.

There are no proven effective treatments to date, however, people with dementia are often prescribed Z-drugs (zopiclone, zaleplon, and zolpidem).

However, a new study published today shows that higher doses of these drugs are associated with an increased risk of side effects.

These adverse effects have been found to be similar or greater than those for benzodiazepines or higher dose benzos – which are also used to treat sleep disorders and are known to have several adverse effects.

The team says that patients who are already taking higher doses of Z-drugs should not suddenly stop taking their medication, but should seek advice from their family doctor.

Prof. Chris Fox of the UEA’s Norwich Medical School said, “Up to 90 percent of people with dementia have insomnia and this has a major impact on their mental, physical and caregiver health.

“Z-drugs are commonly prescribed to help people sleep. However, these drugs have never been approved for dementia and have been linked to adverse events such as falls and fracture risks in the elderly.

“We wanted to find out how they affect people with dementia, who are often prescribed them to help with insomnia.”

The team analyzed data from 27,090 patients in England who were diagnosed with dementia between January 2000 and March 2016. The mean age of the patients was 83 and 62 percent were women.

They studied the adverse events in 3,532 patients who were prescribed Z-drugs and compared them to people with sleep disorders who were not prescribed sedatives and patients who were prescribed benzodiazepines.

They also looked at whether Z-drug dosage played a role in adverse outcomes.

Prof. Fox said, “We looked at a number of adverse outcomes, including fractures, falls, deep vein thrombosis, stroke and death – over two years. And we were particularly interested to see if higher doses led to worse results.”

Higher-dose Z-drugs and benzodiazepines were defined as prescriptions corresponding to> 7.5 mg zopiclone or> 5 mg diazepam daily.

“Patients who were prescribed Z-Drugs received 17 percent higher doses. And we found that those patients with higher doses were at higher risk of falls and fractures, especially hip fractures, and stroke – compared to patients for who did not take medication had sleep disorder, “said Prof. Fox.

Those with lower doses however (

And there were no differences in adverse events for Z-drugs compared to benzodiazepines, except for lower death rates for Z-drugs.

Prof. Fox said, “This research tells us that higher dose Z-drugs should be avoided whenever possible in people with dementia and non-pharmacological alternatives should be given preference.

“Patients who are already taking higher dose Z-drugs should not stop taking their medication. However, we recommend making an appointment to see their GP for a review,” he added.

Prof. Clive Ballard of the University of Exeter Medical School, who collaborated on the study, said, “Our results are an important warning regarding the harm of sleeping pills in people with dementia.

“This research is a very timely and sadly necessary reminder that tranquilizers are not a helpful way to manage social isolation during COVID-19.

“Our study also underscores the importance of research in developing non-drug approaches to help people with dementia sleep – whether at home or in home care.”

Dr. Ian Maidment, Reader in Clinical Pharmacy at Aston University and the study’s lead pharmacist, stated, “Z-Drugs are widely used to treat insomnia in people with dementia, but are only used as a short-term treatment for maximally our work shows the importance of it that doctors, including general practitioners and pharmacists, examine patients on long-term Z-drugs. ”

Z-drugs related to fractures in dementia sufferers

More information:
“Side Effects of Z-Drugs in Sleep Disorders in People with Dementia: A Population-Based Cohort Study” was published in the journal BMC Medicine on November 24, 2020. Provided by the University of East Anglia

Quote: The danger of Z-drugs for dementia sufferers (2020, November 23) was accessed on November 23, 2020 from

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