(ChemotherapyAdvisor) – Patients prescribed high doses of hypnotics had a 35% increased risk of cancer and 5.3 times the hazard of dying compared with nonusers, results of a study published in BMJ Open February 27 has found.
In 2010, an estimated 6% to 10% of U.S. adults took a hypnotic drug for poor sleep. This study, conducted within a large integrated U.S. health system, extracted data from longitudinal electronic medical records for a 1:2 matched cohort survival analysis: 10,529 patients had received hypnotic prescriptions and 23,676 had not. Mean age of the patients was 54 years and all were followed for an average of 2.5 years between January 2002 and January 2007.
“Patients prescribed any hypnotic had substantially elevated hazards of dying compared to those prescribed no hypnotics,” the investigators noted. HR was 3.60 for those prescribed 0.4–18 doses annually (lowest tertile), 4.43 for 18–132 doses annually (middle tertile), and 5.32 for >132 doses per year (highest tertile), demonstrating a dose-response association.
In separate analyses, HRs for death were elevated for zolpidem, temazepam, eszopiclone, zaleplon, other benzodiazepines, barbiturates, and sedative antihistamines. For those in the highest tertiles of annualized dosages, HRs for death were 5.7 for zolpidem alone and 6.6 for temazepam alone. The top third of users were prescribed 92.8% of all prescription doses of hypnotics.
The cancer HR of 1.99 for the highest tertile of temazepam was significantly greater than corresponding HRs for zolpidem or for all hypnotics combined. Cancer risk from zolpidem was significant for the highest tertile; HRs for temazepam were significant for the middle tertile and the highest tertile.