Nursing home residents taking sleep aids such as Ambien are more likely to fall and fracture a hip. Picture: AFP
Nursing home residents taking sleep aids such as Ambien are more likely to fall and fracture a hip than residents not being treated for insomnia, according to a U.S. study.
Hip fractures account for more than 320,000 hospital admissions every year in the United States and are a major source of disability among seniors.
Lead author Sarah Berry, from Hebrew SeniorLife and Harvard Medical School, said that the known dangers among elderly patients of older benzodiazepine sedatives, such as Valium and Xanax, have led many doctors to turn to newer medicines - but that doesn't mean they're any safer.
"There's been less research on some of these newer drugs," Berry told Reuters Health.
The studies that have been done on the newer drugs, known as non-benzodiazepines, show that they can impair balance, memory and driving ability, Berry said.
She and her colleagues analyzed the medical records of more than 15,000 U.S. nursing home residents who suffered a hip fracture in 2007-2008. Of them, 11 percent had been prescribed a non-benzodiazepine drug - such as Ambien, Lunesta or Sonata - before their fracture.
Comparing patients' medication use in the few weeks before their injury to months earlier, the researchers - whose report appeared in JAMA Internal Medicine - calculated that taking a non-benzodiazepine was tied to a 66-percent increase in the risk of fracture.
Newer users who'd been on sleep aids for fewer than two months were more than twice as likely to fracture their hip, compared to people not currently using the drugs.
A Dutch study from earlier this year found that seniors taking psychiatric drugs including hypnotics were at higher risk of falling, the cause of most hip fractures.
"As with any medicine - including those prescribed to treat sleeping disorders - physicians and patients should discuss the appropriate use, potential benefits and side effects based on information and data to date," a representative from Sanofi, which markets Ambien, told Reuters Health in an email.
"Sanofi stands behind the robust clinical data that have demonstrated the safety and efficacy of Ambien since its approval in the U.S. in 1992, representing more than 20 years of real-world use and 22 billion nights of patient therapy worldwide," he added.
Insomnia is common in nursing homes, and can itself lead to falls and fractures, the researchers said. Berry recommended that doctors try to treat elderly insomniacs without drugs whenever possible and keep an extra close eye on those who do need medication.
"Clearly no sleeping is a problem, but if we can address it without a drug then I think it's safer for the patient," she said.