Sleeping Drugs Contribute to Nursing Home Falls: Study

A new study suggests that the use of sleeping aid drugs, such as Ambien, Lunesta, and Sonata, may be increasing the risk of nursing home falls and hip fractures. 

Researchers from Harvard Medical School looked at the impact of certain insomnia medications on the balance, memory and other cognitive abilities of older patients, by analyzing nursing home medical records.

According to findings published online by the medical journal JAMA Internal Medicne, use of the sleep aids increased the risk of patients suffering a hip fracture by 66%.

The dangers of giving seniors in long-term care settings benzodiazepine drugs, like Valium, have long been known. However, this latest study looked specifically at non-benzodiazepines, including Ambien, Lunesta, and Sonata.

Researchers looked at medical data on 15,528 long-term U.S. nursing home residents over the age of 50 who suffered a hip fracture between July 1, 2007, and December 31, 2008.

They found that 11 percent of the residents who suffered the fractures were given a nonbenzodiazepine hypnotic drug before they suffered the hip fracture. When compared with other nursing home residents and their fall rates, the researchers found that those given Ambien or similar drugs were 66% more likely to fall and suffer a hip fracture.

Nursing home residents who had just recently been put on the drugs had more than double the risk.

“New users and residents having mild to moderate cognitive impairment or requiring limited assistance with transfers may be most vulnerable to the use of these drugs,” the researchers concluded. “Caution should be exercised when prescribing sleep medications to nursing home residents.”

The findings come about two months after the FDA issued a safety alert about potential risks of problems with Ambien at high doses, which called on the makers of insomnia medications containing the active ingredient zolpidem to lower the recommended dosage because the drugs are too powerful.

The recommendation to lower the dosage was based on studies that revealed zolpidem blood levels in some patients remained high the morning after taking the drug. A high zolpidem blood level can impair patients from performing activities which require alertness, including driving.

The FDA is requiring lower recommended doses for women from 10 mg to 5 mg for immediate-release products, and from 12.5 mg to 6.25 mg for extended-release products. It is recommending, but not requiring, that doctors consider the same dosing levels applicable for men as well. 

Zolpidem is an active ingredient in immediate release products include Ambien, Edluar, and Zolpimist, as well as extended-release products include Ambien CR and its generic equivalents.