Association Between Benzodiazepines and Dementia in South Korea: A Nation-Wide Study

The connection between the use of hypnotics and dementia has sparked significant interest and controversy in the medical community. This perspective aims to provide a succinct overview of the current understanding of this intricate relationship. Some studies have indicated a potential association between long-term use of specific hypnotics, such as benzodiazepines and Z-drugs, and an increased risk of dementia [1,2]. Consequently, concerns have arisen regarding potential cognitive impairment associated with these medications [3]. However, findings pertaining to the dose-response relationship have been inconsistent, and the precise mechanism by which hypnotics may heighten dementia risk remains unclear. Proposed mechanisms include disruptions in sleep architecture, impaired memory consolidation, heightened susceptibility to falls and resultant brain trauma, and direct neurotoxic effects of certain medications [4]. Nevertheless, several factors warrant contemplation in this context.Firstly, publication bias should be considered, as researchers may have a propensity to publish positive findings, and the topic of hypnotics-induced dementia may be subject to such biases due to its sensational nature [5]. Secondly, although Taiwanese studies with large sample sizes are frequently cited in relation to hypnotics and dementia, caution is advised as these studies rely on medical insurance data and may have limitations [6]. Thirdly, meta-analyses showing positive results have encompassed heterogeneous subjects [7]. Moreover, while depression has been controlled in most positive studies, more than half of the studies did not control for anxiety [8]. Additionally, most studies have explored the

mentioning

confidence: 99%

mentioning

confidence: 99%

The Intricate Interplay Between Dementia and Hypnotics

Park

2023

“…and the innate circadian rhythm is restored. What is challenging is the process of kicking the habit of using sleeping pills, starting activities early in the morning for exposure to sufficient light, and putting them into practice.This issue of Chronobiology in Medicine published a paper on the link between the use of benzodiazepines and dementia [1]. Considering that mental illness is common and many are prescribed benzodiazepines, it is important for clinicians to study and be alert to the advantages or pitfalls of benzodiazepines.…”

mentioning

confidence: 99%

“…This issue of Chronobiology in Medicine published a paper on the link between the use of benzodiazepines and dementia [1]. Considering that mental illness is common and many are prescribed benzodiazepines, it is important for clinicians to study and be alert to the advantages or pitfalls of benzodiazepines.…”

mentioning

confidence: 99%

“…Many studies examining the link between sleeping pills and diagnosis of dementia have reported that long-term use of such drugs can harm future brain health [2,3]. Sun et al [1] reported that benzodiazepines, especially long-acting benzodiazepines, are related to dementia. This paper will aid clinicians in comprehending and paying closer attention to the use of benzodiazepines, which are frequently used off-label to treat insomnia in addition to relieving anxiety.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Do Sleeping Pills Really Make People Sleep Well?

Lee

2022

Self Cite

Some expect that sleeping pills are merely sleep-inducing drugs and will have no significant side effects, which is a misleading idea. Since practically all sleeping pills developed to date are tolerant, prolonged usage will reduce their effectiveness. Additionally, the use of sleeping pills can lead to dependence, which makes insomnia worse and more persistent. As a sleep specialist, one of the difficulties is helping patients who have been taking sleeping pills for years to stop taking them. It takes a lot of effort to persuade patients to stop using sleeping pills, and successfully quitting them is not easy. Sometimes sleep specialists have no choice but to confront patients about giving up sleeping pills. However, patients who are already reliant on sleeping pills should not hesitate to go through this challenging procedure to treat insomnia because the problem cannot be resolved unless they quit taking the pills.Fortunately, in most cases, persistent persuasion eventually reduces and finally eliminates the use of sleeping pills. Although the process is never easy, stopping the use of sleeping pills is not that difficult if the patient's sleep disorder is treated (e.g., sleep apnea, restless legs syndrome, etc.) and the innate circadian rhythm is restored. What is challenging is the process of kicking the habit of using sleeping pills, starting activities early in the morning for exposure to sufficient light, and putting them into practice.This issue of Chronobiology in Medicine published a paper on the link between the use of benzodiazepines and dementia [1]. Considering that mental illness is common and many are prescribed benzodiazepines, it is important for clinicians to study and be alert to the advantages or pitfalls of benzodiazepines. De-

Sleeping Pills and Increased Mortality and Suicide

Lee

2023

Self Cite

If you suffer from insomnia, it is easy to be tempted by sleeping pills that promise to make it easier to fall asleep. With the advent of Z-drugs, which claim to have fewer side effects than previous sleeping pills, they tend to be over-prescribed. But are they safe? It is well known that many celebrities have died from sleeping pill overdoses in the past. The deaths of Marilyn Monroe, the American actress of the century, Heath Ledger, the Australian-born actor best known for his role as the Joker in The Dark Knight, and Michael Jackson, the pop star of the century, have also been linked to dependence on sleeping pills and drug overdoses for sleep.When sleeping pills are taken for a long time, their effectiveness gradually decreases and the dose must be increased to achieve the same effect. This is called tolerance. In addition, dependence occurs when a person cannot sleep without sleeping pills. This problem of tolerance and dependence has been known for a long time. Surprisingly, recent studies have shown that long-term use of sleeping pills is not only associated with tolerance and dependence, but also with increased rates of physical illness and mortality. In 1979, Daniel F. Kripke of the University of California, San Diego, published the first study linking sleeping pills to increased mortality [1], and since then a significant number of studies have linked sleeping pills to increased mortality [2]. These studies have reported that prescription sleeping pills increase the incidence of several cancers and infectious diseases, as well as suicide rates. A study conducted in Taiwan using 10 years of National Health Insurance data reported a 2.08-fold increase in suicide or attempted suicide among those taking zolpidem compared with those not taking zolpidem [3]. In Korea, a study analyzing 12 years of