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

Curr Sleep Med Rep. 2020 Mar;6(1):11-20. doi: 10.1007/s40675-020-00163-1. Epub 2020 Jan 28.

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.

Keywords: Alzheimer’s disease; dementia; insomnia; non-benzodiazepine hypnotics; sleep medications.