Abstract
BackgroundBenzodiazepines are commonly prescribed in residential aged care facilities (RACFs) for their sedative and anxiolytic effects. The objective of this study was to investigate the association between benzodiazepine use and sleep quality in residents of RACFs.MethodsA cross-sectional study involving 383 participants was conducted in six Australian RACFs. Night-time sleep quality, day-time drowsiness and day-time napping behavior were assessed using a validated questionnaire. Logistic regression was used to compute adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for the association between benzodiazepine use and sleep quality. Covariates included pain, dementia severity, depression, insomnia and other sedative use.ResultsOf the 383 residents (mean age 87.5 years, 77.5% female), 96(25.1%) used a benzodiazepine on a regular basis. Residents who used long-acting benzodiazepines on a regular basis had higher night-time sleep quality than non-users (AOR = 4.00, 95%CI 1.06 – 15.15). Residents who used short-acting benzodiazepines on a PRN only basis had longer daytime napping times than non-users (AOR = 1.77, 95%CI 1.01 – 3.08). No benzodiazepine category was associated with day-time drowsiness.ConclusionsThe association between benzodiazepine use and sleep quality is dependent on the half-life and prescribing pattern of the benzodiazepine. Short-acting PRN benzodiazepines were associated with lower night time sleep quality and longer day-time napping compared to long-acting regular benzodiazepines. Longitudinal studies are needed to determine whether these findings reflect channeling of short-acting agents to residents at higher risk of sleep disorders.
Highlights
Benzodiazepines are commonly prescribed in residential aged care facilities (RACFs) for their sedative and anxiolytic effects
Our study found no significant association between night-time sleep quality and age, sex and medical diagnoses, in particular dementia severity and depression [2, 4, 10]
This study found no association between benzodiazepine use and day-time drowsiness, whereas previous research indicates benzodiazepine users are at a greater risk of somnolence [10, 28]
Summary
Benzodiazepines are commonly prescribed in residential aged care facilities (RACFs) for their sedative and anxiolytic effects. The objective of this study was to investigate the association between benzodiazepine use and sleep quality in residents of RACFs. Ageing is associated with a decrease in sleep length and quality [1]. Ageing is associated with a decrease in sleep length and quality [1] This is largely attributed to altered circadian rhythms, lowered melatonin levels and increasing rates of medical co-morbidities. Residents of RACFs experience a higher prevalence of sleep disorders. People with dementia have higher rates and increased severity of sleep disorders with sleep disturbance present in up to 71% of people with dementia compared to 55.7% of people without dementia [7]. Pain is associated with sleep disorders and is highly prevalent among residents [8]
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