The journal Lancet Regional Health - Americas recently published the results of a microsimulation model suggesting that the current use of sleep medications in the U.S. worsens both quantity and quality of life. The study implemented the Future Elderly Model (FEM), a publicly available model of U.S. adults ages 51 and older, often used to predict health and economic outcomes, such as the effects of aspirin use, the potential of an effective treatment for heart failure, etc. This model relied on data from a number of datasets, such as the Health and Retirement Study (HRS), as well as studies pointing to associations between sleep medications and injuries due to falling and cognitive impairment. For example, a 2017 systematic review published in PLoS One found an increase in hip fractures resulting from benzodiazepine and Z-drugs (such as zolpidem) use, including longer-term use (52 to 90% increase, respectively) and short-term use (approximately 140% increase for both drug classes).
The simulation cohort included approximately 15 million older adults taking sleep medications. Avoiding these medications was predicted to decrease the lifetime incidence of falls by 8.5%, cognitive impairment by 2.1%, and increase life expectancy by 0.11 years. Collectively, this was predicted to save 1.7 million life years and 1.3 million quality-adjusted life years in this cohort alone, with a savings of $6,600 per person and $101 billion in total. The authors conclude that given the current data, “if a patient tries to improve quality of life by regularly using sleep drugs to improve sleep, then, on the whole, this aim is achieved less effectively than if they had never used them.”