Use of hypnotics and the risk of or mortality from heart disease: a meta-analysis of observational studies

Abstract

Background/AimsSome observational epidemiologic studies have reported conflicting results on the relationship between hypnotics use and the risk of developing and/or dying from heart disease. We investigated these associations using a meta-analysis of available literatures.MethodsWe searched the databases PubMed and EMBASE, along with the bibliographies of relevant articles to find additional publications in February 2016.ResultsOf 495 articles satisfying our initial criteria, two case-control studies and six cohort studies met our inclusion criteria and were included in the final analyses. Compared with never having used any kind of hypnotics, the odds ratio for overall use was 0.84 for risk of or mortality from heart disease (95% confidence interval, 0.79 to 0.89) in a random-effects meta-analysis of all eight studies. With respect to the geographical region, use of hypnotics was associated with a decreased risk or mortality of heart disease in Asia but not in Western countries. Among various types of sleep medications, zolpidem showed a decreased risk (–29%) of developing or dying from heart disease, but benzodiazepines were related with an increased risk (80%) of or mortality from heart disease.ConclusionsThe current meta-analysis of observational epidemiological studies suggested an evidence of association between hypnotics use and a decreased risk of heart disease.

Relationship Between Sleep Quality, Sleep Disturbance, and Estimated Cardiovascular Risk

“…In comparing the PSQI scores between the studied individuals, the present study found a significant relationship between the use of sleep medication and the severity of CVR (p value = 0.023) compared to the results of the study of Kim et al 2018 who found that the risk of mortality from CVD was significantly decreased with the use of hypnotics (29) . The reason for the difference in the results could be that most participants in our study did not receive sleep medications during the last month.…”

Trends, correlates, and disease patterns of sedative-hypnotic use among elderly persons in Taiwan

“…The use of sedative-hypnotics may be due to insomnia as a symptom of the depression and anxiety found commonly in patients with circulatory conditions [ 34 , 35 ]. However, studies on the risk of mortality from heart disease in sedative-hypnotic uses are inconsistent [ 36 , 37 ]. Some studies even indicated that hypnotic use might be related to lower mortality [ 38 ].…”

Updates in insomnia diagnosis and treatment

“…10 There is also concern that long-term use of z-drugs may increase the risk of cardiovascular events, cancer, and all-cause mortality, but the data thus far have only come from observational trials and findings have been inconsistent. [12][13][14] Antidepressants are a strong treatment alternative especially in patients reporting comorbid mood disorders. Cognitive behavioral therapy as noted above is a more effective long-term solution for insomnia than simply using an antidepressant.…”

“…10 There is also concern that long-term use of z-drugs may increase the risk of cardiovascular events, cancer, and all-cause mortality, but the data thus far have only come from observational trials and findings have been inconsistent. 12–14…”