Frequent Use of Sleep Medications May Up Dementia Risk in White Adults

A higher risk for incident dementia is associated with frequent sleep medication use for White older adults, but not for Black older adults.

Frequent use of sleep medications is associated with an increased risk for dementia in White older adults compared with those who rarely or never used them; but, no such association was discovered for Black older adults, according to study findings published in the Journal of Alzheimer’s Disease.

Despite studies on hypnotic use and dementia, as well as studies on dementia rates in Black and White populations, none of these studies have compared the 2. In this study, researchers looked at racial differences in the association between using sleep medications and the risk of developing dementia.

Researchers collected data from the Health, Aging and Body Composition, a longitudinal and prospective cohort study spanning 15 years. Of the 3,068 participants who completed the baseline questionnaire, they were aged 70-79 years; 41.7% were Black; and 51.5% were women.

During baseline (1997-1998), researchers asked participants about the frequency of sleep medication use, with response options including: “Never” (0); “Rarely” (1/month or less); “Sometimes” (2-4/month); “Often” (5–15/month); and “Almost Always” (16–30/month).

[T]hose who reported taking sleep medication often or almost always had a significantly increased risk of developing dementia 15 years later.

During 2 more follow up periods (1999-2000; 2000-2002), participants completed the questionnaires again.

Researchers reviewed and recorded medication types which included over-the-counter medications and prescription medications. Dementia onset was indicated according to a series of criteria including hospital admission, prescription of dementia medication, and evidence of cognitive function decline.

Over 9.2 years, researchers found 617 (20%) of participants developed dementia.

There was no increased risk for dementia for individuals who took sleep medications sometimes. Among participants, hazard ratios (HRs) were 1.01 (95% CI, 0.61-1.68) for White and 0.70 (95% CI, 0.36-1.37) for Black individuals who “sometimes” used sleep medications. Similarly, HRs were 1.83 (95% CI, 1.28-2.61) for White and 1.32 (95% CI, 0.68-2.56) for Black participants who “often or almost always” used sleep medications.

The largest association was found only among White participants who “often or almost always” used sleep medications (HR =1.79; 95% CI, 1.21-2.66), while Black participants did not show a statistically significant association (HR =0.84; 95% CI, 0.38-1.83). All findings were compared to the “never or rarely users.” Adjustment for sleep duration, disturbances, and time lag did not alter results. Medication type was not analyzed in this study due to the limited number of participants in each section.

While the reason for the lack of comparable association between the use of sleep aids and the risk for dementia in the Black study population is still unknown, it is possible that this is due to prescription drugs being less accessible to the Black population. Researchers also noted is the possibility of bias in the prescription of sleep aids, which might contribute to the different findings between the 2 study populations.

Researchers found that “those who reported taking sleep medication often or almost always had a significantly increased risk of developing dementia 15 years later.” They concluded, “Further study of type of sleep medications will help to understand potential mechanisms, especially for the observed race differences.”

Study limitations included a limited age range, specifically in older populations rather than the inclusion of midlife participants, and specific dosages and duration of sleep medications, which was not considered.

Disclosures: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see original source for full list of disclosures.


Leng Y, Stone KL, Yaffe K. Race differences in the association between sleep medication use and risk of dementia. J Alzheimers Dis. Published online January 31, 2023. doi:10.3233/jad-221006