Universities study finds ‘Z-drugs’ linked to increased risk of falls in dementia patients

Strong sleeping pills known as “Z-drugs” are linked to an increased risk of falls, fractures and stroke among people with dementia, according to a study.

Sleep disturbance is common among people with dementia and the impact on patients and their families is significant.

To date there are no proven effective treatments available, however people with dementia are often prescribed zopiclone, zaleplon and zolpidem, known collectively as Z-drugs.

Researchers from the universities of East Anglia and Exeter found that stronger doses of these drugs are linked with an increased risk of adverse effects.

These were found to be similar or greater than those for higher dose benzodiazepines, which are also used to treat sleep disturbance.

The team say that patients already taking higher doses of Z-drugs should not stop taking their medication suddenly, however they should seek a review with their GP.

Professor Chris Fox, from the University of East Anglia, said: “As many as 90% of people with dementia suffer sleep disturbances and it has a big impact on their mental and physical health, as well as that of their carers.

“Z-drugs are commonly prescribed to help people sleep. 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.”

The team analysed data from 27,090 patients in England diagnosed with dementia between January 2000 and March 2016. The average age of the patients was 83 and 62% were women.

They looked at the adverse events for 3,532 patients who had been prescribed Z-drugs and compared them with people suffering sleep disturbance who had not been prescribed sedatives, and patients who had been prescribed benzodiazepines.

They also looked to see whether Z-drug dosage played a part in adverse outcomes.

Prof Fox said: “We studied a range of adverse outcomes including fractures, falls, deep vein thrombosis, stroke and death, over two years. And we were particularly interested to see whether higher doses led to worse outcomes.

“For patients prescribed Z-drugs, 17% were given higher doses.

“And we found that these patients on higher doses were more at risk of falls and fractures, particularly hip fractures, and stroke, compared with patients who were not taking any medication for sleep disturbance.”

Those on lower doses were not found to have an increased risk of adverse outcomes.

Prof Clive Ballard, of the University of Exeter, added, said: “Our findings serve an important caution regarding the harms of sleeping tablets in people with dementia.

“This research is a very timely and unfortunately necessary reminder that sedative medications are not a helpful way to manage social isolation during Covid-19.

“Our study also 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, Adverse effects of Z-drugs for sleep disturbance in people living with dementia: a population-based cohort study, is published in the journal BMC Medicine.

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