Mortality hazard associated with anxiolytic and hypnotic drug use in the National Population Health Survey.
OBJECTIVE
Although widely used in the general population, sleeping pills and minor tranquilizers, also known as antianxiety agents, have been associated with undesirable outcomes. Reports about the association of these drugs with an elevated mortality rate are inconsistent and controversial. This study was designed to assess the mortality hazard associated with anxiolytic and hypnotic drug use in the National Population Health Survey in Canada. It was hypothesized that anxiolytic and hypnotic drug use would be associated with an elevated mortality hazard.


METHODS
A population-based sample of 14 117 people aged 18 to 102 years participated in a longitudinal panel survey, with data collected every second year from 1994 to 2007. The primary outcome measures reported in this study are self-report use of anxiolytic and hypnotic drugs, and death.


RESULTS
For respondents who reported anxiolytic or hypnotic drug use in the past month the odds of mortality were 3.22 times more (95% CI 2.70 to 3.84) than for those who did not use anxiolytic or hypnotic drugs in the past month. After controlling for confounding sociodemographic, lifestyle, and health factors (including depression), the odds ratio was reduced to 1.36 (95% CI 1.09 to 1.70) but remained significant.


CONCLUSIONS
Sedative drug use is associated with a small but significant increase in mortality risk. Further research is required to confirm the mechanisms by which sedative drug use increases mortality risk. Where possible, physicians should systematically consider possibilities for nonpharmacological treatment of sleep disturbances and anxiety.
Belleville
Geneviève
G
Université Laval, Quebec, Canada. Genevieve.Belleville@psy.ulaval.ca
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002170:Canada / Q000453:epidemiology; D016001:Confidence Intervals; D005260:Female; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects* / Q000627:therapeutic use; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D016017:Odds Ratio; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult
D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives