Using ‘Z-drugs’ for people with dementia triggers frequent side-effects, researchers have warned.
These drugs – zopiclone, zaleplon, and zolpidem – are frequently prescribed, as sleep disturbance is a common and distressing symptom of dementia.
A team led by Professor Chris Fox at the University of East Anglia, UK, looked at the effects of these drugs when given at high doses.
They analysed figures from 3,532 men and women with dementia in England, with an average age of 83, all of whom were prescribed Z-drugs. Symptoms were compared with a larger group of people who also had sleep disturbance but were not prescribed sedatives, and a group prescribed benzodiazepines.
Over two years, patients given high doses of either Z-drugs or benzodiazepines had a greater rate of falls and fractures, particularly hip fractures, and stroke, than patients who were not taking these medications.
Lower doses of both classes of drug were not linked to a raised risk.
Professor Fox said: “Z-drugs are commonly prescribed to help people sleep – however these medicines were never licensed for dementia and they have been associated with adverse events such as falls and fracture risks in older people. We wanted to find out how they affect people with dementia, who are frequently prescribed them to help with sleep disturbance.
“This research shows us that higher dose Z-drugs should be avoided, if possible, in people living with dementia, and non-pharmacological alternatives preferentially considered.“
Co-author Professor Clive Ballard added: “Our study highlights the importance of research to develop non-drug approaches to help people with dementia to sleep – whether they are at home or in residential care.”
The study appeared in BMC Medicine yesterday (24 November).
Richardson, K. et al. Adverse effects of Z-drugs for sleep disturbance in people living with dementia: a population-based cohort study. BMC Medicine 24 November 2020
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