Estimating the benefits and harms of Z-drugs for people with dementia and sleep disorders

Richardson K, Savva GM, Boyd PJ, Aldus C, Maidment I, Pakpahan E, Loke Y K, Arthur A, Steel N, Ballard C, Howard R, Fox C
Record ID 32016000801
Authors' objectives: More than 800,000 people in the United Kingdom have dementia. Around half of these have trouble sleeping, wake up often and wander during the night, or sleep during the day. This can have a big effect on their health and quality of life, and on their caregivers, other family members or care home residents whose sleep is also disturbed. Powerful sedatives are often given to people with dementia to help them to sleep. But we do not have any evidence from clinical trials about whether sedatives work or are safe in this group. Sedatives have side effects like increasing the risk of falls, confusion, or making memory worse. A group of sedatives called Z-drugs (zolpidem, zopiclone and zaleplon) are often used by people with dementia. They can help people sleep but have side effects and can be addictive. How well they work and what harm they might cause for people with dementia is not known. Aim of the research Our aim is to understand the benefits and harms of using Z-drugs for people with dementia who have trouble sleeping. We will look at whether Z-drugs improve sleep, whether they improve quality of life for people with dementia and their carers and how they affect memory and thinking during the day or other behavioural problems. We will also look at whether people who take Z-drugs fall more often, have more infections or are taken to hospital more often. We will compare Z-drugs to other sleep drugs prescribed to people with dementia, and to people who do not use any sleep medication at all. Design and methods First we will use data from GPs, who record the drugs that they prescribe to people, their illnesses including sleep problems and other health events like falls. This will tell us whether people who take Z-drugs have more accidents, infections or are taken to hospital more often. Next we will use data from clinical studies involving people with dementia. Many studies ask their participants about sleeping problems and about medicines that they use. They also test changes in quality of life, memory and health. This means that data from studies can be reused to answer questions about Z-drugs. We will use these to understand how Z-drugs affect memory and quality of life for patients and carers. Patient and public involvement People with dementia and their carers will join our team to ensure that their experience of using sedatives, and the ways in which people are affected by sleep disorders shape our research. This will ensure the greatest impact where the benefits and harms of these drugs are most keenly felt. They will help us understand what are the most relevant outcomes to examine and what is the best way to present our findings. Dissemination We will present our findings in academic papers, and we will work with the Alzheimer s Society and PPI representatives to update their guidance on how to manage sleep difficulties for people with dementia and their carers.
Project Status: Completed
Year Published: 2021
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Drug Therapy
  • Dementia
  • Sleep Wake Disorders
  • Aged, 80 and over
  • Aged
  • Zolpidem
  • Pyrimidines
  • Piperazines
  • Acetamides
  • Azabicyclo Compounds
  • Patient Harm
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
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