The Relationship Between Sleep Medications and Cognitive Impairment Risk
Recent studies have shed light on the potential connection between sleep medications and an increased risk of cognitive impairment, including dementia. This information is particularly relevant for older adults who often struggle with sleep issues and may rely on various medications to help them rest.
A study published in January 2025 found that certain sleep medications were associated with a higher risk of developing dementia later in life[1]. The research included both over-the-counter and prescription medications commonly used for sleep, such as antihistamines, melatonin, antidepressants, and benzodiazepines.
Interestingly, the study revealed that people who reported taking sleep medications “often or almost always” had a significantly increased risk of developing dementia 15 years later. However, this association was only observed among White participants and was independent of sleep duration and quality[1].
The timing and duration of medication use also appear to play a role. Studies cited by Harvard Health showed that using anticholinergic drugs or benzodiazepines for longer than a few months was associated with an increased dementia risk. For anticholinergic drugs, taking them for three years or more was linked to a 54% higher dementia risk compared to taking the same dose for three months or less[1].
It’s important to note that while these studies show a connection, they don’t definitively prove that these medications cause dementia. Other factors may be involved, and more research is needed to fully understand the relationship.
Given these findings, experts suggest that even younger adults should consider using sleep medications sparingly or avoiding them altogether. The National Center for Health Research advises that patients aged 55 or older may want to avoid regular or long-term use of anticholinergics and sleeping pills[1].
For those seeking alternatives to improve sleep without medications, several strategies are recommended:
1. Establishing consistent bedtime routines
2. Regular exercise
3. Avoiding large meals close to bedtime
4. Limiting caffeine, nicotine, and alcohol intake
5. Avoiding naps
6. Practicing breathing exercises
When it comes to allergy relief, alternatives to diphenhydramine (which has anticholinergic properties) include steroid nasal sprays, cetirizine, fexofenadine, or loratadine[1].
It’s worth noting that not all sleep-related issues increase cognitive impairment risk. A separate study found that people who took longer to reach the REM (rapid eye movement) stage of sleep were more likely to have biomarkers associated with Alzheimer’s disease[2]. This suggests that the quality and structure of sleep, not just the use of sleep aids, may play a role in cognitive health.
While these findings may seem concerning, it’s crucial to remember that sleep is essential for overall health, including cognitive function. Poor sleep quality and sleep disorders have also been linked to an increased risk of cognitive decline[4]. Therefore, addressing sleep issues is important, but it should be done in consultation with a healthcare provider to weigh the potential risks and benefits of various treatment options.
In conclusion, while sleep medications can provide relief for those struggling with insomnia or other sleep disorders, their long-term use may carry risks, particularly for cognitive health. As research in this area continues to evolve, it’s important for individuals, especially older adults, to discuss their sleep concerns and medication use with their healthcare providers. Together, they can develop a personalized approach to improving sleep that balances immediate relief with long-term brain health.
