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Citation
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Tubbs AS, Fernandez FX, Ghani SB, Karp JF, Patel SI, Parthasarathy S, Grandner MA. J. Clin. Sleep Med. 2021; ePub(ePub): ePub. |
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Abstract
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STUDY OBJECTIVES. Z-drugs (eszopiclone, zolpidem, and zaleplon) are commonly used for insomnia, but are also associated with suicide risk. However, it is unclear if this association is unique to Z-drugs. Therefore, the present study estimated the associations between multiple prescription insomnia medications and suicidal thoughts and behaviors.
METHODS. Data were acquired from the National Survey on Drug Use and Health (NSDUH) for 2015 to 2018 and the National Health and Nutrition Examination Survey (NHANES) for 2005 to 2018. Samples were balanced on sociodemographic and mental health covariates using inverse probability of treatment weighting. Associations of Z-drugs, trazodone, and sedative benzodiazepines (temazepam, triazolam, flurazepam) with suicidal ideation, planning, and attempts were estimated using binomial logistic regression.
RESULTS. In the NSDUH, Z-drugs were associated with suicidal ideation (OR 1.32 [1.14-1.54]), suicide planning (OR 1.44 [1.19-1.75]), and suicide attempts (OR 1.45 [1.13-1.86]) after adjusting for age, sex, race/ethnicity, income, depression, illicit substance use, and K6 and WHODAS scores. When accounting for the same factors, sedative benzodiazepines were associated with suicide attempts (OR 1.76 [1.06-2.87]), but not suicidal ideation (OR 1.37 [0.99-1.88]) or suicide planning (OR 1.39 [0.97-2.00]). In the NHANES, Z-drugs were associated with suicidal ideation (OR 2.44 [1.41-4.22], as was trazodone(OR 2.33 [1.45-3.75]), after adjusting for age, sex, race/ethnicity, and exposure to various psychotropic medications.
CONCLUSIONS. Multiple classes of prescription insomnia medications are associated with suicidal thinking and behaviors, even after adjusting for measures of mental health.
Language: en |