Sleep Medications Linked To Reduced Deep Sleep And Disrupted Memory

Long-term usage of benzodiazepines and Z-drugs whitethorn thief older adults autumn asleep, but caller investigation shows they change slumber architecture and encephalon activity successful ways that could undermine representation and next-day functioning.

Study: Effect of chronic benzodiazepine and benzodiazepine receptor agonist usage connected slumber architecture and encephalon oscillations successful older adults pinch chronic insomnia. Image credit: Ground Picture/Shutterstock.com

In a caller study published successful Sleep, a group of researchers tested whether chronic benzodiazepine (BZD) and benzodiazepine receptor agonist (BZRA) usage alters slumber architecture and non-rapid oculus activity (NREM) oscillations successful older adults pinch insomnia.

Background 

Insomnia affects astir one-third of older adults, and benzodiazepines (BZDs) and benzodiazepine receptor agonists (BZRAs, aliases “Z-drugs”) are often prescribed. These medications tin trim slumber onset latency and amended slumber continuity, but their semipermanent usage is associated pinch risks specified arsenic falls, cognitive impairment, and residual daytime sedation.

Slow-wave slumber and its associated neural oscillations are cardinal to representation consolidation and cognitive function. Chronic sedative usage whitethorn disrupt these processes, highlighting nan request for further investigation connected really circumstantial narcotics and doses impact slumber architecture and encephalon activity successful aging populations.

About nan study

Older adults aged 55-80 years were classified arsenic bully sleepers (GS), individuals pinch insomnia upset (INS), aliases individuals pinch insomnia positive chronic sedative usage (MED). All provided consent and completed polysomnography (PSG). Participants successful MED continued their prescribed medicine (BZDs aliases BZRAs). Sleep architecture was scored utilizing American Academy of Sleep Medicine (AASM) rules.

An electroencephalogram (EEG) was recorded from 13 scalp electrodes. Derived indices included full slumber play (TSP), full slumber clip (TST), slumber onset latency (SOL), clip successful furniture (TIB), slumber ratio (SE), arousal density, and slumber fragmentation scale (SFI). Spectral powerfulness was estimated pinch accelerated Fourier translator and Welch’s method and summarized arsenic comparative powerfulness successful slow oscillation (SO), delta, theta, alpha, sigma, and beta bands. Spindles were detected pinch an algorithm; slow spindles astatine frontal (Fz) and accelerated spindles astatine parietal (Pz).

Slow oscillations were detected utilizing a finite impulse consequence (FIR) filter; coupling betwixt SO and spindles was quantified pinch phase-amplitude coupling (PAC), modulation scale (MI), and preferred coupling shape (CP). Group differences were analyzed utilizing study of variance (ANOVA) and non-parametric tests pinch mendacious find complaint control. Exploratory analyses related to medicine dose (diazepam equivalents) and long to slumber metrics were performed, and BZD versus BZRA users were compared.

Study results

The study analyzed 101 participants (mean property 66 years; 73% women): GS n=28, INS n=26, and MED n=47 taking nightly sedative-hypnotics for much than 3 nights per week. Compared pinch GS, some INS and MED showed little slumber efficiency, much aftermath aft slumber onset, and altered shape distribution.

Chronic medicine usage was linked to lighter, little restorative sleep. The MED group spent much clip successful shape N1 (the lightest shape of NREM sleep) and little successful shape N3 (deep slow-wave NREM sleep) than some GS and INS, pinch shape N2 (intermediate NREM sleep) besides prolonged versus INS. Rapid oculus activity (REM) slumber long did not disagree crossed groups, though REM latency (trend; not important aft multiple-comparison correction) tended to beryllium longer successful MED.

Fragmentation patterns differed crossed groups. Arousal density was higher successful INS than successful GS and MED, while nan SFI was higher successful MED than successful INS, indicating much predominant transitions to lighter slumber stages.

In nan spectral analysis, nan MED group showed little NREM theta powerfulness compared pinch GS, and little REM theta powerfulness than GS and INS. During NREM sleep, frontal sigma powerfulness was higher and frontal low-beta powerfulness little successful MED comparative to GS. The delta-to-beta ratio, an scale of cortical arousal, was reduced successful MED compared pinch some GS and INS. Analysis of discrete oscillations revealed selective changes: frontal spindle density was higher successful MED than successful INS, while SO density and amplitude did not disagree crossed groups.

Critically, nan temporal alignment of rhythms was altered successful MED. MI was little successful MED compared pinch GS, and nan preferred CP occurred later successful MED compared pinch GS and INS, a floor plan unfavorable for representation consolidation. Within MED, higher diazepam-equivalent dose per usage correlated pinch longer SOL and longer latencies to stages N2 and N3, and pinch higher NREM sigma and beta power. Longer cumulative long of usage was related to shorter parietal spindle duration.

Despite little SE, TST was higher successful MED than successful GS, accordant pinch much clip successful bed. However, restorative heavy slumber was reduced. After adjusting for dose, outcomes did not disagree betwixt BZDs and BZRAs.

Age was regressed retired of each slumber measures, and insomnia severity scores were higher successful INS and MED than successful GS, pinch MED somewhat little than INS. No group differences were observed for SO delta aliases alpha power; nan coupling metrics did not standard pinch dose. Together, nan macro- and micro-level signatures bespeak that chronic sedative-hypnotic usage is associated pinch poorer slumber regularisation successful precocious life and whitethorn thief to explain, though nan study did not straight test, reports of next-day grogginess and cognitive diminution by disrupted oscillatory coupling.

Conclusions

Medicine-assisted slumber is not nan aforesaid arsenic restorative sleep. In older adults pinch insomnia, chronic BZD and BZRA usage is associated pinch much ray sleep, little heavy sleep, reduced theta activity, altered spindle dynamics, and weaker, delayed coupling betwixt slow oscillations and spindles, mechanisms linked to memory.

These nonsubjective changes whitethorn thief explicate reports of next-day grogginess and cognitive diminution successful semipermanent users and support cautious, dose-aware prescribing. Expanding entree to cognitive behavioral therapy for insomnia and processing alternatives that sphere encephalon rhythms could amended slumber and protect cognition today.

Download your PDF transcript now!