Effects of Sleep Medications on Cognition, Psychomotor Skills, Memory and Driving Performance in the Elderly

Verster, Joris C.; Volkerts, Edmund R.; Spence, D. Warren; Alford, Chris; Pandi-Perumal, Seithikurippu R.

doi:10.2174/157340007782408860

Cited by 6 publications

(4 citation statements)

References 106 publications

(133 reference statements)

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“…When the quality of sleep worsens, medications become necessary but lead to residual daytime sedation, poor motor coordination, and cognitive impairment 57 . Taking sleep medication could worsen self-care maintenance because of medication adverse effects that might impact cognition, as supported by previous findings 58,59 . To better discuss this result, we verified the trend of cognition measured by the Montreal Cognitive Assessment for different levels of use of sleep medication and found that cognition showed the same trend as self-care maintenance for different levels of use of sleep medication.…”

Section: Discussionsupporting

confidence: 66%

“…57 Taking sleep medication could worsen self-care maintenance because of medication adverse effects that might impact cognition, as supported by previous findings. 58,59 To better discuss this result, we verified the trend of cognition measured by the Montreal Cognitive Assessment for different levels of use of sleep medication and found that cognition showed the same trend as self-care maintenance for different levels of use of sleep medication. Furthermore, we also examined the relative frequencies of levels of daytime dysfunction for different levels of use of sleep medication, and we found that daytime dysfunction was less common among patients taking sleep medication less often than in patients taking sleep medication more often.…”

Section: Discussionmentioning

confidence: 72%

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The Association Between Self-reported Sleep Quality and Self-care in Adults With Heart Failure

et al. 2022

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Background: Sleep disturbance is one of the most common symptoms among patients with heart failure (HF), and it may affect the ability of patients to perform self-care. There is a lack of evidence on the association between sleep quality and its components and self-care in adults with HF. Objective: The aim of this study was to evaluate the association between sleep quality and its components and self-care in adults with HF. Methods: This study is a secondary analysis of baseline data from the MOTIVATE-HF study, a randomized controlled trial on patients with HF and their caregivers. Only patients' data were analyzed in this study (n = 498). Sleep quality and self-care were evaluated with the Pittsburgh Sleep Quality Index and the Self-Care of Heart Failure Index v6.2, respectively. Results: A habitual sleep efficiency of 75% to 84% was associated with lower self-care maintenance compared with a habitual sleep efficiency of 85% or greater ( P = .031), as was taking sleep medications once or twice a week compared with less than once a week ( P = .001). A frequency of daytime dysfunction less than once a week was associated with lower self-care management compared with a frequency of daytime dysfunction of 3 or more times a week ( P = .025). Taking sleep medications less than once a week was associated with lower self-care confidence compared with taking sleep medications 3 or more times a week ( P = .018). Conclusion: Poor sleep quality is frequently reported by patients with HF. Sleep efficiency, sleep medications, and daytime dysfunction may influence self-care more than the other sleep quality components.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 72%

The Association Between Self-reported Sleep Quality and Self-care in Adults With Heart Failure

et al. 2022

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“…This effect correlates with peak plasma levels of these Z-drugs but may persist into the morning. Psychomotor effects are exacerbated in elderly Z-drug users due to altered pharmacokinetics and increased sensitivity to peak drug action [46]. Although most people will be asleep in the first few hours after Z-drug ingestion, many elderly users may awaken and mobilize, predisposing them to imbalance and falls.…”

Section: Effects On Psychomotor Performancementioning

confidence: 99%

In the Zzz Zone: The Effects of Z-Drugs on Human Performance and Driving

2013

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Despite their improved pharmacokinetic profile, the Z-drugs, zolpidem, zopiclone, and zaleplon, have a spectrum of adverse effects comparable to benzodiazepines. This review focuses on the impairment from Z-drugs on cognition, behavior, psychomotor performance, and driving ability. Z-drugs are short-acting GABA agonists that reduce sleep latency without disturbing sleep architecture. Bizarre behavioral effects have prompted warnings on the prescription, dispensation, and use of Z-drugs. Psychomotor impairment, falls, and hip fractures are more likely to occur with Z-drugs that have longer half-lives, that are taken at higher-than-recommended doses and when mixed with other psychoactive substances including alcohol. Zopiclone and higher doses of zolpidem are more likely to cause anterograde amnesia than zaleplon. Z-drugs, especially zolpidem, are associated with complex behaviors such as sleepwalking, sleep-driving, and hallucinations. Patients taking zopiclone and zolpidem have an increased risk of motor vehicle collisions, over double that of unexposed drivers. Driving impairment occurs with zopiclone and higher doses of zolpidem but is unlikely to occur after 4 h post-zaleplon administration. The residual effect of Z-drugs on next-day cognitive and psychomotor performance has significant impact on lifestyle, safety, and occupational considerations, including motor vehicle and machine operation. The risk-benefit analysis of Z-drugs in the treatment of insomnia, particularly in the elderly, may not favor treatment due to the increased risks of falls and motor vehicle collisions. Prescribers should warn patients taking Z-drugs of minimum time thresholds before they operate machinery or drive motor vehicles.

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“…These reviews have focused predominately on opioids, 26-34 benzodiazepines, 29,31,35-38 antihistamines, 39,40 psychoactive drugs, 41-45 antidepressants, 36,46-49 hypnotics, 43,50 anxiolytics, 51,52 and sleep medications. 53-56 Some reviews have also examined multiple drug categories. 57-60 However, the majority of these studies have reviewed or analyzed licit drugs in broad groups.…”

Section: Introductionmentioning

confidence: 99%

Medication use and the risk of motor vehicle collisions among licensed drivers: A systematic review

Rudisill

Zhu

Kelley

et al. 2016

Accident Analysis & Prevention

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Objectives Driving under the influence of prescription and over-the-counter medication is a growing public health concern. A systematic review of the literature was performed to investigate which specific medications were associated with increased risk of motor vehicle collision (MVC). Methods The a priori inclusion criteria were: 1) studies published from English-language sources on or after January 1, 1960, 2) licensed drivers 15 years of age and older, 3) peer-reviewed publications, master's theses, doctoral dissertations, and conference papers, 4) studies limited to randomized control trials, cohort studies, case-control studies, or case-control type studies 5) outcome measure reported for at least one specific medication, 6) outcome measure reported as the odds or risk of a motor vehicle collision. Fourteen databases were examined along with hand-searching. Independent, dual selection of studies and data abstraction was performed. Results Fifty-three medications were investigated by 27 studies included in the review. Fifteen (28.3%) were associated with an increased risk of MVC. These included Buprenorphine, Codeine, Dihydrocodeine, Methadone, Tramadol, Levocitirizine, Diazepam, Flunitrazepam, Flurazepam, Lorazepam, Temazepam, Triazolam, Carisoprodol, Zolpidem, and Zopiclone. Conclusions Several medications were associated with an increased risk of MVC and decreased driving ability. The associations between specific medication use and the increased risk of MVC and/or affected driving ability are complex. Future research opportunities are plentiful and worthy of such investigation.

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Effects of Sleep Medications on Cognition, Psychomotor Skills, Memory and Driving Performance in the Elderly

Cited by 6 publications

References 106 publications

The Association Between Self-reported Sleep Quality and Self-care in Adults With Heart Failure

The Association Between Self-reported Sleep Quality and Self-care in Adults With Heart Failure

In the Zzz Zone: The Effects of Z-Drugs on Human Performance and Driving

Medication use and the risk of motor vehicle collisions among licensed drivers: A systematic review

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