Sleep disorders are increasingly prevalent among older adults, with millions of Americans experiencing insomnia and relying on prescription sleep medications to manage their conditions. A recent study from the USC Schaeffer Center for Health Policy & Economics highlights the negative health consequences associated with the long-term use of these medications and proposes that reducing their prescriptions could enhance the quality of life and longevity for older individuals.

Elevated Risks of Prescription Sleep Medications

Despite the known risks of severe side effects—including falls, broken bones, cognitive impairment, and dependence—many older adults continue to use sleep medications such as benzodiazepines and Z-drugs (e.g., Ambien). These medications are often prescribed long-term, even when medical guidelines discourage this practice. The misuse of these drugs tends to escalate with age, particularly among women and white adults.

The ASC Schaeffer Center's study reveals that reducing the use of sleep medications in older adults could lead to:

  • Avoidance of falls: A projected decrease of 8.5% in lifetime fall incidence.
  • Decrease in cognitive impairment: A reduction of 2.1% in cognitive impairment incidents.
  • Increased life expectancy: An extension of life by an average of 1.3 months, equating to approximately 1.7 million additional life-years in the population.

These improvements would translate predominantly into healthier life years, free from limitations typically associated with the use of sleep drugs.

Quality of Life Improvements

Currently, around 15.3 million adults aged 50 and older in the United States use prescribed sleep medications. The study examined several outcomes, such as the impacts on cognitive function, fall risk, nursing home usage, medical costs, and lifetime earnings. The findings suggest that individuals aged 65 to 74 would see the most significant benefits to their cognitive abilities and physical health by discontinuing these medications.

Outcome Potential Improvement from Reducing Sleep Medication Use
Lifetime Falls 8.5% reduction
Cognitive Impairment 2.1% reduction
Life Expectancy 1.3 months increase
Cost Savings $6,600 per person, totaling $101 billion nationally

Encouraging Safer Prescribing Practices

Given the risks associated with sleep medications, the American Academy of Sleep Medicine recommends cognitive behavioral therapy for insomnia (CBT-I) as the first-line treatment. CBT-I fosters better sleep habits and can be delivered through various platforms, offering a viable alternative to medication without the side effects. The findings of the USC Schaeffer Center point to several possible interventions:

  • Electronic Health Records: Integration could prompt physicians to justify prescriptions and promote CBT-I as an alternative.
  • Peer Comparisons: Periodic reports on prescribing patterns compared to peers could encourage safer prescribing practices.
“Insomnia is a serious issue for many older adults, but regular use of sleep medication can pose real risks. Supporting physicians in reducing prescriptions and promoting safer, proven alternatives will ultimately benefit patients and society.” – Jason Doctor, Senior Scholar at the Schaeffer Center

Conclusion

This study's implications align with a deeper understanding of sleep health and the necessity to mitigate the risks associated with sleep medications for older adults. Promoting CBT-I and enhancing awareness among healthcare providers could lead to improved health outcomes and quality of life for this demographic.

Literature Cited

[1] Heun-Johnson, H., et al. (2025). Lifetime burden of prescription medication for insomnia in middle-aged and older adults in the US: a microsimulation study. The Lancet Regional Health—Americas.

[2] Hanke Heun-Johnson et al, for more information visit here.