The Link Between Sleep Medication & Cognitive Decline, According To Research
We all need a little help winding down and getting to sleep now and then. Sometimes this means over-the-counter and prescription sleep medicines. While these can be effective for people with diagnosed sleep issues like insomnia, they are not without risk. Here's what one recent study found on the link between the use of these medications and cognitive decline and dementia.
Sleep aids and brain health
The study1, published in Sleep Medicine in 2021, analyzed data from more than 6,000 participants over 65 years old over eight years. The researchers looked for differences in the long-term health of participants who used sleep medications, including both prescription medications (like Ativan and Ambien) and over-the-counter ones (like Advil PM or Benadryl).
The results showed that about 15% of the study participants used sleep medicine routinely, and those who used them “most nights” or “every night” were 30% more likely to develop dementia during the study period. The authors accounted for differences in age, sex, marital status, education, or other chronic conditions that may have affected their risk of dementia.
This is troubling considering the number of people who rely on sleep medications to get a good night's rest. More than 70 million Americans have a sleep disorder, and a Medical Expenditures Panel Survey showed that the number of adults in the U.S. using a prescription sleep medication increased 67% (from 8.1 million to 13.5 million) between 1996 and 2013.
Why do these medications impact dementia risk?
The study authors outlined a few plausible mechanisms driving the connection between sleep aids and cognitive decline. For one, a greater clearance of cellular waste occurs during sleep than during waking hours, which means that any disruptions in sleep or sleep quality may lead to a buildup of neurotoxic waste. And while sleep aids may help people fall asleep faster, they don't necessarily ensure better sleep quality. Certain medications can also disrupt your sleep architecture2—the order of operations that occurs in normal, healthy sleep.
This study does have some limitations. It doesn’t fully explain the ins and outs of the connection, and it leaves quite a few open questions about the mechanism of action behind it. The authors point out that it’s also possible that insomnia is a very early symptom of dementia that a person experiences far before doctors are able to detect and diagnose the syndrome’s onset, which would explain the link.
Alternatives to medication
Whatever the reason for the link, the authors explain that it’s worthwhile to explore alternative and behavioral-based interventions for improving sleep, such as cognitive behavioral therapy3 and regular exercise4. We're big advocates of good sleep hygiene, regular sleep and wake times, and regulating the circadian rhythm by getting plenty of daytime sunlight and eating meals earlier.
It's worth noting that not all sleep aids have a negative effect on the brain. Non-hormonal, more natural options can improve sleep quality without the side effects. For example, studies have shown that magnesium glycinate, which combines magnesium and the amino acid glycine, can improve sleep quality and sleep efficacy. Other ingredients that show potential in promoting sleep and relaxation include valerian5, hops6, tart cherry7, and lavender8.
Here's a list of brain-safe, non-hormonal sleep aids to consider. As always, consult with a doctor before making any medication changes.
We’ve all heard it a thousand times: Sleep is key to optimal health! Make sure you get at least 7–8 hours of high-quality zzz’s! Don’t skimp on sleep! Unfortunately, for many of us, getting good sleep is easier said than done. We may struggle to fall asleep, stay asleep, or fall back asleep after a 4 a.m. wakeup. This study shows us that while certain over-the-counter and prescription medications can help people fall asleep, they should be a last resort due to their impact on long-term brain health.
Gretchen Lidicker is an mbg health contributor, content strategist, and the author of CBD Oil Everyday Secrets: A Lifestyle Guide to Hemp-Derived Health and Wellness and Magnesium Everyday Secrets: A Lifestyle Guide to Epsom Salts, Magnesium Oil, and Nature's Relaxation Mineral. She holds a B.S. in biology and earned her master’s degree in physiology with a concentration in complementary and alternative medicine from Georgetown University.