Increased Risk of Hospitalization Related to Motor Vehicle Accidents Among People Taking Zolpidem: A Case–Crossover Study

Yang, Yao; Lai, Jung‐Nien; Lee, Chang-Hsing; Wang, Jung‐Der; Chen, Pau‐Chung

doi:10.2188/jea.je20090195

Cited by 39 publications

(34 citation statements)

References 19 publications

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“…The odds of a next-day MVC hospitalization were 1.5-times higher among zolipdem users than nonusers, with a stronger association in males. (Yang et al 2011) Additionally, among a large Norwegian cohort selected from population-based registries, the standardized incidence of MVCs was more than 2-times higher among zolpidem users compared with nonusers. (Gustavsen et al 2008) In each of these studies, the association was stronger in males than females.…”

Section: Discussionmentioning

confidence: 99%

“…(Gustavsen et al 2008, Orriols et al 2011, Yang et al 2011, Chung et al 2013, Lai et al 2014) Gustavsen et. al.…”

Section: Introductionmentioning

confidence: 99%

“…(Gustavsen et al 2008, Orriols et al 2011) Additionally, a positive association between MVCs and prescription zolpidem use one day earlier was reported in a case-crossover study. (Yang et al 2011) However, these studies failed to evaluate this association in drivers aged > 65 years and did not consider the potential role of sex as an effect modifier and account for driving behaviors. These are important limitations since the pharmacokinetics of zolpidem differs by age and sex (Greenblatt et al 2013, Greenblatt et al 2014) and the rate of MVC-related deaths per mile driven is highest in older adults.…”

Section: Introductionmentioning

confidence: 99%

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Zolpidem use and motor vehicle collisions in older drivers

et al. 2016

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Background/Objectives Prescription sleep medication use is most prevalent among women and older adults. Morning drowsiness and impaired coordination are side-effects of sleep medications that may affect driving safety. The association between current use of zolpidem-containing medications and motor vehicle collisions (MVCs) was evaluated among very old drivers. Patients/Methods Participants were current drivers aged ≥70 years residing in north-central Alabama, spoke English, had a valid driver's license, and drove within the past 3 months (n=2,000). Current zolpidem use was determined by pill-bottle review. Participant's 5-year MVC history was determined from Alabama Department of Public Safety accident reports. The 5-year MVC and at-fault MVC rate ratios (RR) were estimated comparing zolpidem users with nonusers in the overall sample and a-priori defined age and sex subgroups. Results The unadjusted RR (95%CI) of MVCs comparing zolpidem users with nonusers was attenuated after adjustment (1.46 [1.02-2.08] and 1.38 [0.97-1.98], respectively). Among women, the unadjusted and adjusted RRs (95%CI) were 1.65 (1.03-2.66) and 1.61 (1.00-2.60), respectively. The unadjusted and adjusted RRs (95%CI) among those aged ≥80 years were 2.24 (1.19-4.57) and 2.35 (1.20-4.61), respectively. There were no statistically significant associations among men or participants <80 years old. Similar patterns were present for at-fault MVCs. Conclusion Current zolpidem users, specifically women and individuals aged ≥80 years, had higher MVC rates than nonusers. Practitioners should consider behavioral treatment before initiating low doses of zolpidem and escalating it as needed to achieve restorative sleep in females and individuals aged ≥80 years to reduce the risk of zolpidem-associated MVCs.

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Section: Discussionmentioning

confidence: 99%

“…(Gustavsen et al 2008, Orriols et al 2011, Yang et al 2011, Chung et al 2013, Lai et al 2014) Gustavsen et. al.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Zolpidem use and motor vehicle collisions in older drivers

et al. 2016

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“…Post hoc, it was realized that some included studies only presented crude estimates, 63-82 while others adjusted their outcome measures for various potential confounders such as age, gender, miles driven, day of the week, etc. 83-89 For those studies that presented adjusted estimates or did not include 95% confidence intervals for crude estimates, 83-89 then the adjusted point estimates and 95% confidence intervals for the population were reported. If a study's point estimate was greater than 1, this indicated that there was excess risk of collision; a point estimate less than 1 indicated that the medication use was associated with a decreased risk of collision (i.e.…”

Section: Methodsmentioning

confidence: 99%

Medication use and the risk of motor vehicle collisions among licensed drivers: A systematic review

Rudisill

Zhu

Kelley

et al. 2016

Accident Analysis & Prevention

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Objectives Driving under the influence of prescription and over-the-counter medication is a growing public health concern. A systematic review of the literature was performed to investigate which specific medications were associated with increased risk of motor vehicle collision (MVC). Methods The a priori inclusion criteria were: 1) studies published from English-language sources on or after January 1, 1960, 2) licensed drivers 15 years of age and older, 3) peer-reviewed publications, master's theses, doctoral dissertations, and conference papers, 4) studies limited to randomized control trials, cohort studies, case-control studies, or case-control type studies 5) outcome measure reported for at least one specific medication, 6) outcome measure reported as the odds or risk of a motor vehicle collision. Fourteen databases were examined along with hand-searching. Independent, dual selection of studies and data abstraction was performed. Results Fifty-three medications were investigated by 27 studies included in the review. Fifteen (28.3%) were associated with an increased risk of MVC. These included Buprenorphine, Codeine, Dihydrocodeine, Methadone, Tramadol, Levocitirizine, Diazepam, Flunitrazepam, Flurazepam, Lorazepam, Temazepam, Triazolam, Carisoprodol, Zolpidem, and Zopiclone. Conclusions Several medications were associated with an increased risk of MVC and decreased driving ability. The associations between specific medication use and the increased risk of MVC and/or affected driving ability are complex. Future research opportunities are plentiful and worthy of such investigation.

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“…A large-scale retrospective study using the Taiwanese National Insurance Health Database (Table 2) showed that use of zolpidem is associated with an increased risk of motor vehicle accidents in the following day (odds ratio ¼ 1.74; 95% confidence interval ¼ 1.25e2.43). 17 The acute performanceimpairing effects of zolpidem are comparable to those of benzodiazepines (BZDs), despite using different sample populations, methods of study, and different comparison drugs. 21 At doses as low as 7.5 mg in non-elderly participants, zolpidem has shown comparable dose-and time-dependent impairment in learning, recall, and performance.…”

Section: Performance Impairmentsmentioning

confidence: 99%