Common sleep medicine puts older adults at risk for night time falls, confusion

Elders given zolpidem for sleep
were found to be at
high risk for falls and cognitive
decline in a study. 

A popular medicine that helps older adults sleep can cause harm warn researchers.

The commonly prescribed medication, zolpidem, sold under the brand names Ambien, Zolpimist, Edluar, Hypogen, Somidem and Iveda, was found in a study to increase the chances of falls and cognitive decline in elders.

Researchers found that 58 percent of older adults and 27 percent of the young adults studied experienced loss of balance after awakening, 2 hours after falling asleep.

The study included 25 healthy adults who were assessed using a technique known as the “tandem walk” that involves placing one foot in front of the other on a 16-foot-long, six-inch-wide beam on the floor using normal step length.

When the participants were not given any medication, none of them fell off the six-inch wide beam.

Kenneth Wright, lead study author at University of Colorado, Boulder says,
"The balance impairments of older adults taking zolpidem were clinically significant and the cognitive impairments were more than twice as large compared to the same older adults taking placebos, This suggests to us that sleep medication produces significant safety risks."
He explains that sleep alone leads to grogginess that can impair walking and increase fall risk. In the study, zolpidem also impaired memory in addition to enhancing sleep inertia.

The researchers say the findings are important given the statistics that 30 percent of hospitalizations among elders over 65 are from falls. In a previous study, the researchers found subjects who took no sleep medications at all were cognitively impaired after being awakened from 8 hours of sleep.

One explanation for the difference in fall risk between older and younger subjects given zolpidem could be in the dosing. Older study participants were given the recommended 5 mg dose. For younger subjects, 10 mg is the normally prescribed dose.

"One of the goals of this study was to understand the risk of this sleep medication and of sleep inertia on human safety and cognition and to educate adults and health care workers about potential problems," said Wright. "We are not suggesting that sleep medications should not be used, because they have their place in terms of the treatment of insomnia."

Wright says a solution to reduce the chances of falls among elders from sleep medication is to install bedside commodes. He explains insomnia can also lead to falls. In the study, 25 percent of older adults failed the tandem walking balance test. The new study shows sleep medication leads to fall risk and cognitive decline in elders who frequently take medications for insomnia.

Journal of the American Geriatric Society: DOI: 10.1111/j.1532-5415.2010.03229.x