People with dementia should avoid high doses of the so-called Z-drugs zopiclone, zaleplon and zolpidem, which are used for sleep disorders. Their use may be associated with increased risks of fractures and strokes, researchers report.
Some observational studies have shown that the use of Z-drugs in older people is associated with adverse events such as an increased risk of falls and fractures. Scientists from the UK decided to study the effect of these drugs on dementia. Their findings were published in BMC Medicine.
The researchers collected data on 27,000 patients with dementia diagnosed between 2000 and 2016. The average age was 83 years. Z-drugs were prescribed to 3532 patients in the sample, 584 (17%) started treatment with high doses.
Next, we compared the adverse events that occurred in patients on high doses of Z-drugs with three other groups of people with dementia. Compared with those who experienced sleep disturbances and did not take sedatives, there was an increased risk of fractures, falls and ischemic stroke. Similar results were shown by comparison with patients who sought help from a doctor for a different problem and did not use sedatives.
In the third group, patients started using benzodiazepines. Scientists have observed similar adverse events with Z-drugs and benzodiazepines. The exception was the mortality rate, which was lower in the Z-drug group.
The authors of the publication believe that, if possible, Z-drugs should be avoided in dementia and high doses should be monitored. It is important to consider alternative non-pharmacological treatments for sleep disorders.