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Citation
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Booth JN, Behring M, Cantor RS, Colantonio LD, Davidson S, Donnelly JP, Johnson E, Jordan K, Singleton C, Xie F, McGwin G. Sleep Med. 2016; 20: 98-102. |
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Abstract
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Background/Objectives
Prescription sleep medication use is most prevalent among women and older adults. Morning drowsiness and impaired coordination are side-effects of sleep medications that may affect driving safety. The association between current use of zolpidem-containing medications and motor vehicle collisions (MVCs) was evaluated among very old drivers.
Patients/Methods
Participants were current drivers aged ≥70 years residing in north-central Alabama, spoke English, had a valid driver's license, and drove within the past 3 months (n=2,000). Current zolpidem use was determined by pill-bottle review. Participant's 5-year MVC history was determined from Alabama Department of Public Safety accident reports. The 5-year MVC and at-fault MVC rate ratios (RR) were estimated comparing zolpidem users with nonusers in the overall sample and a-priori defined age and sex subgroups.
Results
The unadjusted RR (95%CI) of MVCs comparing zolpidem users with nonusers was attenuated after adjustment (1.46 [1.02-2.08] and 1.38 [0.97-1.98], respectively). Among women, the unadjusted and adjusted RRs (95%CI) were 1.65 (1.03-2.66) and 1.61 (1.00-2.60), respectively. The unadjusted and adjusted RRs (95%CI) among those aged ≥80 years were 2.24 (1.19-4.57) and 2.35 (1.20-4.61), respectively. There were no statistically significant associations among men or participants <80 years old. Similar patterns were present for at-fault MVCs.
Conclusion
Current zolpidem users, specifically women and individuals aged ≥80 years, had higher MVC rates than nonusers. Practitioners should consider behavioral treatment before initiating low doses of zolpidem and escalating it as needed to achieve restorative sleep in females and individuals aged ≥80 years to reduce the risk of zolpidem-associated MVCs.
Language: en |