Short‐ and long‐term mortality following hypnotic use

Hedström, Anna Karin; Hössjer, Ola; Lagerros, Ylva Trolle; Åkerstedt, Torbjörn

doi:10.1111/jsr.13061

Cited by 9 publications

(2 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The lower rating of poor sleep quality among men who had a short sleep duration indicates that men with short sleep do not seem to perceive their sleep as poor. There is also a lower use of hypnotics among men who had a short sleep duration, and the use of hypnotics has been linked to higher mortality in our cohort (Hedstrom et al, 2020), as well as in other studies (Kripke, 2016).…”

Section: For Cancer Mortality (supporting

confidence: 78%

The association of short and long sleep with mortality in men and women

Åkerstedt

Bellocco

Widman

et al. 2023

Journal of Sleep Research

Self Cite

View full text Add to dashboard Cite

SummaryBoth short (< 6 hr) and long (> 8 hr) sleep are associated with increased mortality. We here investigated whether the association between sleep duration and all‐cause, cardiovascular disease and cancer mortality differs between men and women. A cohort of 34,311 participants (mean age and standard deviation = 50.5 ± 15.5 years, 65% women), with detailed assessment of sleep at baseline and up to 20.5 years of follow‐up (18 years for cause‐specific mortality), was analysed using Cox proportional hazards model to estimate HRs with 95% confidence intervals. After adjustment for covariates, all‐cause, cardiovascular disease and cancer mortalities were increased for both < 5 hr and ≥ 9 hr sleep durations (with 6 hr as reference). For all‐cause mortality, women who slept < 5 hr had a hazard ratio = 1.54 (95% confidence interval = 1.32–1.80), while the corresponding hazard ratio was 1.05 (95% confidence interval = 0.88–1.27) for men, the interaction being significant (p < 0.05). For cardiovascular disease mortality, exclusion of the first 2 years of exposure, as well as competing risk analysis eliminated the originally significant interaction. Cancer mortality did not show any significant interaction. Survival analysis of the difference between the reference duration (6 hr) and the short duration (< 5 hr) during follow‐up showed a gradually steeper reduction of survival time for women than for men for all‐cause mortality. We also observed that the lowest cancer mortality appeared for the 5‐hr sleep duration. In conclusion, the pattern of association between short sleep duration and all‐cause mortality differed between women and men, and the difference between men and women increased with follow‐up time.

show abstract

Section: For Cancer Mortality (supporting

confidence: 78%

The association of short and long sleep with mortality in men and women

Åkerstedt

Bellocco

Widman

et al. 2023

Journal of Sleep Research

Self Cite

View full text Add to dashboard Cite

show abstract

“…A similar observation was described in a prospective Swedish National March Cohort, a study comprising 41,695 participants with a mean follow-up of 18.9 years. 38 Within the first 2 years of filling a prescription for hypnotics, all-cause mortality increased by 2.38-fold among hypnotic users with cancer and cardiovascular diseases accounting for 59% of all deaths. An argument can be made that the association between all categories of hypnotics and 2-year mortality is non-causal and is ascribed to confounding by indication.…”

Section: Discussionmentioning

confidence: 99%

Association Between Hypnotic Use and All-Cause Mortality in Patients with Chronic Obstructive Pulmonary Disease and Insomnia

El-Solh,

Lawson,

Wilding

2023

COPD

View full text Add to dashboard Cite

Purpose Hypnotics are commonly prescribed in patients with COPD to manage insomnia. Given the considerable risks associated with these drugs, the aim of the study was to evaluate the risk of all-cause mortality associated with hypnotics in a cohort of veterans with COPD presenting with insomnia. Methods We conducted a retrospective cohort study that used Veterans Health Administration Corporate Data Warehouse with data supplemented by linkage to Medicare, Medicaid, and National Death Index data from 2010 through 2019. The primary outcome was all-cause mortality. Analyses were conducted using propensity score 1:1 matching to balance baseline characteristics. Results Of the 5759 veterans with COPD (mean [SD] age, 71.7 [11.2]; 92% men), 3585 newly initiated hypnotic agents during the study period. During a mean follow-up of 7.4 (SD, 2.7) years, a total of 2301 deaths occurred, with 65.2 and 48.7 total deaths per 1000 person-years among hypnotic users and nonusers, respectively. After propensity matching, hypnotic use was associated with a 22% increased risk of mortality compared with hypnotic nonusers (hazard ratio [HR] 1.22; 95% confidence interval [CI],1.11–1.35). The benzodiazepine receptor agonists (BZRAs) group experienced a higher incidence rate of all-cause mortality compared to hypnotic nonusers (Incidence rate ratio [IRR] 1.27; 95% CI, 1.14–1.43). Conversely, the mortality rate of non-BZRA hypnotics decreased after the first 2 years and was not significantly different for hypnotic nonusers (IRR 1.04; 95% CI, 0.82–1.11). Conclusion Among patients with COPD and insomnia, treatment with hypnotics was associated with a higher risk of all-cause mortality. The association was observed in patients prescribed BZRAs. The risk of mortality for non-BZRAs moderated after the first 2 years, indicating a class effect.

show abstract