Prescription sleep medicine linked to motor vehicle collisions in older adults and women

A recent study by University of Alabama at Birmingham student assistant John Booth, III, and UAB Department of Epidemiology Professor and Vice Chair Gerald McGwin, Ph.D., published in Sleep Medicine linked the use of prescription sleep medicines containing zolpidem among aged drivers and the incidence of motor vehicle collisions.

"Due to the side effects of such drugs—including drowsiness upon waking and impaired coordination, current zolpidem users age 80 and older, as well as those who are female, experienced higher rates of MVCs than nonusers," said Booth, a Ph.D. candidate in UAB's Department of Epidemiology. "We recommend that health care practitioners consider proposing behavioral treatment before prescribing zolpidem to restore sleep in women and patients over age 80 to reduce the risk of MVCs associated with this prescription drug."

In the overall sample, the unadjusted 5-year motor vehicle collision rate was 46 percent higher for current zolpidem users versus nonusers. More specifically, the unadjusted 5-year motor vehicle collision rate was 65 percent higher for females and 23 percent higher in males who used zolpidem. For those 80 years of age and older, the unadjusted 5-year motor vehicle collision rate was 124 percent higher for zolpidem users compared with nonusers.

According to the National Institutes of Health National Center for Complementary and Integrative Health, possible treatment alternatives to sleep medications include relaxation techniques, melatonin supplements, mind and body approaches such as meditation, as well as stimulus control such as consistent sleep schedules, and avoiding caffeine and alcohol.

A total of 2,000 north central Alabama zolpidem users, age 70 and up, who had driven within the previous three months and held a valid driver's license were studied. The researchers evaluated each participant's five-year MVC history, obtained from the Alabama Department of Public Safety, and then estimated at-fault MVC rate ratios by comparing zolpidem users' and nonusers' data in age- and sex-defined subgroups.