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One-Year Evolution of Sleep Quality in Older Users of Benzodiazepines: A Longitudinal Cohort Study in Belgian Nursing Home Residents

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Abstract

Objectives

Chronic use of benzodiazepines and z-drugs (BZD/Zs), the most commonly used symptomatic treatment for sleep problems, is discouraged because of the unproven long-term effectiveness. In this study, we evaluated 1-year evolution of subjective sleep quality of chronic BZD/Z users compared with nonusers.

Methods

All cognitively competent residents from ten Belgian nursing homes were screened and compiled in a group of chronic BZD/Z users or nonusers, based on the medication chart. We collected demographic, functional and psychometric characteristics (depressive symptoms with the 8-item Geriatric Depression Scale), sleep parameters (with the Pittsburgh Sleep Quality Index—PSQI) and medication use. We analysed evolution of sleep quality with nonparametric statistics. Associations with worsening of sleep quality were analysed with linear regression.

Results

We collected data of 131 BZD/Z users and 95 nonusers. The mean age in both groups was 85 years and 77 % was female. Over a period of 1 year, the PSQI score evolved from 5.2 to 5.8 (p = 0.035) in the BZD/Z users, and from 4.3 to 4.7 (p = 0.078) in the nonusers. Though the mean deterioration in 1 year did not differ significantly between both groups, the BZD/Z users had a significantly worse sleep quality compared with nonusers at both time points. Depressive symptoms were significantly associated with worsening sleep quality (β = −0.243, p < 0.001).

Conclusion

Sleep quality in chronic BZD/Z users significantly decreased over 1 year and was significantly worse than in nonusers at the end of this period. This study suggests that using BZD/Zs chronically does not maintain or improve sleep quality. Depressive symptoms are an important factor in the deterioration of sleep quality.

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Acknowledgments

We thank Anne Balis, Kim Elst, Jacqueline De Pooter and Ambre Hamelink, all Masters of Science in Nursing at the University of Antwerp, for their contribution in the data collection. We also thank the management and staff of the participating nursing homes.

No sources of funding were used to conduct this study. Jolyce Bourgeois, Monique M. Elseviers, Luc Van Bortel, Mirko Petrovic and Robert H. Vander Stichele have no conflicts of interest to declare.

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Authors and Affiliations

  1. Heymans Institute of Pharmacology, Ghent University, De Pintelaan 185 (1 block B), 9000, Ghent, Belgium

    Jolyce Bourgeois, Monique M. Elseviers, Luc Van Bortel, Mirko Petrovic & Robert H. Vander Stichele

  2. Department of Nursing Science, University of Antwerp, Antwerp, Belgium

    Monique M. Elseviers

  3. Department of Geriatrics, Ghent University Hospital, Ghent, Belgium

    Mirko Petrovic

Authors
  1. Jolyce Bourgeois
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  2. Monique M. Elseviers
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  3. Luc Van Bortel
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  4. Mirko Petrovic
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  5. Robert H. Vander Stichele
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Correspondence to Jolyce Bourgeois.

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Bourgeois, J., Elseviers, M.M., Van Bortel, L. et al. One-Year Evolution of Sleep Quality in Older Users of Benzodiazepines: A Longitudinal Cohort Study in Belgian Nursing Home Residents. Drugs Aging 31, 677–682 (2014). https://doi.org/10.1007/s40266-014-0203-3

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  • DOI: https://doi.org/10.1007/s40266-014-0203-3

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