Hypnotics, Sleep, and Mortality in Elderly People

Abstract

Earlier reported relationships between excess mortality and use of medication for sleep are replicated in this study. Among elderly people, however, this relationship does not derive from the pharmacological characteristics of prescription hypnotics. Rather, it appears that reported self-medication to promote sleep, using a variety of non-sedative products, provides an epidemiological "marker" for a group within which levels of morbidity and mortality are particularly high. Excess mortality associated with very short or long sleep duration was not replicated in this study. Overall, these findings provide little epidemiological support for a wide-spread interaction between benzodiazepine hypnotic use and sleep disordered breathing in old age.

Hypnotics and mortality in an elderly general population: A 12-year prospective study

“…Previous studies have been inconsistent, with some studies observing significant relationships between hypnotic prescriptions and mortality [16,[20][21][22][23][24][25]37] and others not [16][17][18][19]. Our findings suggest that these differences are probably largely due to failure to take into account confounding associations, notably common affective symptoms and sleep complaints, although other factors such as study design, participant age, and class of hypnotics probably also influence study outcome.…”

“…Four observational studies in young adults [16,17] and elderly people [18,19] found no significant associations between hypnotics and all-cause mortality. Other studies reported a significant association with excessive all-cause deaths in adults [20][21][22].…”

Sleep Duration and Mortality in Japan: the Jichi Medical School Cohort Study

“…Many previous studies, [1][2][3][4][5][6] though not all, [7][8][9][10] reported that both long and short sleep duration increased risk of death. However, there have been only a few studies controlling for various relevant confounding factors.…”

“…3,5,9,19 Indeed, there is neither clear definition nor established measure of the quality of sleep, and some studies indicated that insomnia was not associated with increased mortality. 4,10,20,21 The third limitation is that background psychological factors were not considered. Sleep patterns are known to be associated with psychological factor.…”

“…Although there were some studies examining the relationship between sleep duration and mortality, [1][2][3][4][5][6][7][8][9][10] it has not been fully discussed. Most previous reports have found that there was a Ushaped relationship between sleep duration and all-cause mortality in both males and females.…”