Association Between the Use of Non-benzodiazepine Hypnotics and Cognitive Outcomes: A Systematic Review

Abstract

Purpose of Review

Adverse effects of sedative-hypnotic medications on cognition are concerning. Past studies have examined benzodiazepine (BZD) use and cognitive outcomes; however, few studies have examined newer non-BZD hypnotic agents (nBHs; e.g., zolpidem). This systematic review examined observational studies assessing the association between nBH use and cognitive outcomes.

Recent Findings

Five studies met eligibility requirements and were included in the review. Most studies did not find an association between nBH use and dementia diagnosis; however, we found no studies assessing other cognitive outcomes such as cognitive performance (e.g., word recall tasks). Characterization of nBH use mostly consisted of incident new use; one study assessed nBH dosing; none examined duration of use. Studies included were of strong quality.

Summary

This review found no association between nBH use and dementia diagnosis, although there is a need for more research on more cognitive outcomes and nBH use patterns.

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Funding

This study was supported by funding from the NIA (CNK: K01AG061239; MWB: R01AG049810; AAM: P30AG059299, P30AG062429). Dr. Bondi receives royalties from Oxford University Press and serves as a consultant for Eisai and Novartis pharmaceutical companies. Dr. Murphy reports personal fees from Boston Consulting Group. Dr. Malhotra is PI on NHLBI grants and has received consulting income from Merck related to medical education. ResMed provided a philanthropic donation to UC San Diego in support of a sleep center.

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Correspondence to Christopher N. Kaufmann.

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Dr. Kaufmann, Dr. Moore, and Dr. Hart each declare no potential conflicts of interest.

Dr. Murphy reports personal fees from Boston Consulting Group, outside the submitted work.

Dr. Malhotra reports his role as a PI on NHLBI grants and has received consulting income from Merck related to medical education. ResMed provided a philanthropic donation to UC San Diego in support of a sleep center.

Dr. Bondi reports royalties from Oxford University Press and serves as a consultant for Eisai and Novartis pharmaceutical companies.

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Kaufmann, C.N., Moore, A.A., Bondi, M.W. et al. Association Between the Use of Non-benzodiazepine Hypnotics and Cognitive Outcomes: A Systematic Review. Curr Sleep Medicine Rep 6, 11–20 (2020). https://doi.org/10.1007/s40675-020-00163-1

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Keywords

  • Dementia
  • Alzheimer’s disease
  • Sleep medications
  • Insomnia
  • Non-benzodiazepine hypnotics