HEALTH NEWS

Study Title:

Sleep Medications and Mortality Risk

Study Abstract

Objective: Although widely used in the general population, sleeping pills and minor tranquilizers, also known as antianxiety agents, have been associated with undesirable outcomes. Reports about the association of these drugs with an elevated mortality rate are inconsistent and controversial. This study was designed to assess the mortality hazard associated with anxiolytic and hypnotic drug use in the National Population Health Survey in Canada. It was hypothesized that anxiolytic and hypnotic drug use would be associated with an elevated mortality hazard.

Method: A population-based sample of 14 117 people aged 18 to 102 years participated in a longitudinal panel survey, with data collected every second year from 1994 to 2007. The primary outcome measures reported in this study are self-report use of anxiolytic and
hypnotic drugs, and death.

Results: For respondents who reported anxiolytic or hypnotic drug use in the past month the odds of mortality were 3.22 times more (95% CI 2.70 to 3.84) than for those who did not use anxiolytic or hypnotic drugs in the past month. After controlling for confounding
sociodemographic, lifestyle, and health factors (including depression), the odds ratio was reduced to 1.36 (95% CI 1.09 to 1.70) but remained significant.

Conclusion: Sedative drug use is associated with a small but significant increase in mortality risk. Further research is required to confirm the mechanisms by which sedative drug use increases mortality risk. Where possible, physicians should systematically consider
possibilities for nonpharmacological treatment of sleep disturbances and anxiety.

From press release:

Taking medications to treat insomnia and anxiety increases mortality risk by 36%, according to a study conducted by Geneviève Belleville, a professor at Université Laval's School of Psychology.

Details of the study are published in the latest edition of the Canadian Journal of Psychiatry.

Dr. Belleville arrived at these results through analysis of 12 years of data on over 14,000 Canadians in Statistics Canada's National Population Health Survey. The data includes information on the social demographics, lifestyle, and health of Canadians age 18 to 102, surveyed every two years between 1994 and 2007.

During this period, respondents who reported having used medication to treat insomnia or anxiety at least once in the month preceding the survey had a mortality rate of 15.7%. Respondents who reported not having used such medications had a rate of 10.5%. After controlling for personal factors that might affect mortality risk, notably alcohol and tobacco consumption, physical health, physical activity level, and the presence or absence of depressive symptoms among participants, Dr. Belleville established that the consumption of sleeping pills or anxiety-relieving medications was associated with a 36% increase in the risk of death.

A number of hypotheses have been put forward to explain the link between use of these medications and increased mortality. Sleeping pills and anxiolytics affect reaction time, alertness, and coordination and are thus conducive to falls and other accidents. They may also have an inhibiting effect on the respiratory system, which could aggravate certain breathing problems during sleep. These medications are also central nervous system inhibitors that may affect judgment and thus increase the risk of suicide.

"These medications aren't candy, and taking them is far from harmless," commented Dr. Belleville. "Given that cognitive behavioral therapies have shown good results in treating insomnia and anxiety, doctors should systematically discuss such therapies with their patients as an option. Combining a pharmacological approach in the short term with psychological treatment is a promising strategy for reducing anxiety and promoting sleep."

Study Information

Geneviève Belleville
Mortality Hazard Associated With Anxiolytic and Hypnotic Drug Use in the National Population Health Survey.
Canadian Journal of Psychiatry
2010 September
Université Laval's School of Psychology