Use of medications for insomnia or anxiety may increase mortality risk

Taking medications to treat insomnia and anxiety increases mortality risk by 36%, according to a study by the School of Psychology at the University of Laval (Canada). Details of the study were published in the September issue of the Canadian Journal of Psychiatry.

Geneviève Belleville, PhD, a professor in the School of Psychology, analyzed 12 years of data on more than 14,000 Canadians in Statistics Canada’s National Population Health Survey. The data includes information on the social demographics, lifestyle, and health of Canadians aged 18 to 102, surveyed every 2 years between 1994 and 2007.

During this period, respondents who reported having used a 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 mortality rate of 10.5%. After controlling for personal factors that might affect mortality risk-including alcohol and tobacco consumption, physical health, physical activity level, and the presence or absence of depressive symptoms-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 the use of these medications and increased mortality. Sleeping pills and anxiolytics affect reaction time, alertness, and coordination, which means they are conducive to falls and other accidents. The medications may also have an inhibiting effect on the respiratory system, which could aggravate certain breathing problems during sleep. The medications are also central nervous system inhibitors that may affect judgment, increasing the risk of suicide.

“Given that cognitive behavioral therapies have shown good results in treating these disorders, doctors should systematically discuss such therapies with their patients as an option,” Dr Belleville told Formulary. “Combining a pharmacological approach in the short term with psychological treatment is a promising strategy for reducing anxiety and promoting sleep.”

Dr Belleville said that more research is needed to understand the reasons why use of sedative drugs is associated with mortality. Research also needs to continue on the development of nonpharmacological strategies to manage anxiety and insomnia.