New research highlights the serious risks associated with sleeping pills for older individuals, finding that they may be significantly more likely to fall and suffer a life-altering hip fracture, especially during the first weeks after starting treatment.
In a study published last month in the medical journal PLOS One, researchers found that the risk of hip fracture more than doubled for elderly individuals if they took benzodiazepines, such as Valium or Ativan; or new “Z-drugs”, like Ambien or Lunesta.
Researchers conducted a meta-analysis of hip fracture studies conducted up to May 2015, using data from MEDLINE and SCOPUS. A total of 18 studies with the number of participants ranging from 500 to 900,000 people were included. Participants were 65 years or older, most in their mid 70s or older.
The elderly risk of hip fracture was evaluated among individuals taking benzodiazepines or z-drugs, which were developed as a “safer” alternative to benzodiazepines and all have generic names beginning with the letter “z”.
Both types of drugs were significantly associated with increased risk of hip fracture. In fact, benzos, like Klonipin and Xanax, and Z-drugs, like Ambien and Sonata, increased a new user’s risk of hip fracture by 2.5 times, compared to patients not taking either of the drugs.
Individuals recently prescribed the medications face the greatest risk, and that heightened risk lasts for about two weeks. However, patients taking the sleeping pills long term also face an increased risk.
Those taking sleeping pills at the 15 to 30 day mark have a 53 percent increased risk of hip fracture. Patients taking them long term, past the 30 day mark, face a 20 percent increased risk of hip fracture.
Another study published in 2014 indicated certain older individuals who fall and suffer a hip fracture are more likely to die or become completely disabled within six months of the fall. Another study published in March indicated elderly patients who suffer a fall face twice the risk of dying soon after the fall, compared to their peers.
The problem is that sleeping pills, both benzodiazepines and z-drugs, are associated with daytime drowsiness, delayed reaction times, and impaired balance. Researchers said the hip fractures resulted in the mortality of between 20 to 50 percent of patients. A significant number experienced permanent disability.
Other research indicates sleeping pills are often overprescribed to elderly patients, with more than one-third of older adults use sedatives.
Researchers recommend doctors focus on the heightened risk in at-risk older patients and recommend interventions to help prevent hip fractures. Interventions like strength training, removing hazards in the home, visual impairment correction, and medication reviews can help prevent fall accidents.
A study published in 2015 indicated using interventions help to reduce the risk of falls among elderly individuals more than widely used bone density tests and osteoporosis medication.
Doctors can also turn to other sleep aid alternatives first, before prescribing sleeping pills. Those drugs include frequent exercise, especially a few hours before bed, avoiding caffeine after 3 p.m., and limiting alcohol intake.