高齢者の慢性的なベンゾジアゼピン使用は睡眠の質に影響(Chronic benzodiazepine consumption impacts sleep quality in older adults, new research shows)

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2025-09-03 カナダ・コンコルディア大学

コンコルディア大学の研究で、ベンゾジアゼピン系薬を慢性的に使用する高齢者は、睡眠の質が改善するどころか悪化することが明らかになった。『Sleep』誌に発表された調査では、長期使用により睡眠構造の乱れや脳波リズムの障害が生じ、記憶や認知に重要な深い睡眠や脳振動が阻害される可能性が示された。研究者は、これらの薬は長期的には安全性・有効性が乏しく、脳の健康にリスクをもたらすと警告している。そのため、使用者には数か月かけて段階的に減薬し、認知行動療法(CBT-i)を併用する方法が推奨される。これにより薬をやめた直後に不眠が悪化する「リバウンド不眠」を防ぎつつ、睡眠の質を改善できる可能性がある。

<関連情報>

慢性不眠症の高齢者における睡眠構造と脳波への、慢性的なベンゾジアゼピン系薬剤およびベンゾジアゼピン受容体作動薬の使用の影響 Effect of chronic benzodiazepine and benzodiazepine receptor agonist use on sleep architecture and brain oscillations in older adults with chronic insomnia

Loïc Barbaux, Aurore A Perrault, Nathan E Cross, Oren M Weiner, Mehdi Es-sounni, Florence B Pomares, Lukia Tarelli, Margaret McCarthy, Antonia Maltezos, Dylan Smith …
Sleep  Published:17 June 2025
DOI:https://doi.org/10.1093/sleep/zsaf168

高齢者の慢性的なベンゾジアゼピン使用は睡眠の質に影響(Chronic benzodiazepine consumption impacts sleep quality in older adults, new research shows)
Graphical Abstract

Abstract

Study Objectives

Insomnia in older adults is associated with widespread benzodiazepine (BZD) and benzodiazepine receptor agonist (BZRA) use despite evidence that chronic use disrupts sleep regulation and cognition. Little is known about BZD/BZRA effects on Non-rapid eye movement (NREM) slow oscillations (SO), spindles and their coupling, which is crucial for memory in older adults. Our objective was to investigate the effects of chronic BZD/BZRA use on sleep macro-architecture, electroencephalogram (EEG) relative power, SO and spindle characteristics and coupling.

Methods

After habituation polysomnography, second-night data were analyzed from 101 participants (66.05 ± 5.84 years, range: 55–80 years, 73 per cent female) were categorized into three groups: good sleepers (GS, n = 28), individuals with insomnia (INS, n = 26) or individuals with insomnia who chronically use BZD/BZRA (MED, n = 47; diazepam equivalent: 6.1 ± 3.8 mg per use; >3 nights/week). We performed a comprehensive comparison of sleep architecture, EEG relative spectrum, and associated brain oscillatory activities, focusing on SO and spindles and their temporal coupling.

Results

MED showed disrupted sleep architecture with lower N3 and higher N1 duration and spectral activity and altered sleep-related brain oscillations synchrony, compared to INS and GS. An exploratory interaction model suggested that chronic use of higher doses (mg per use) correlated with more pronounced disruptions in sleep micro-architecture and EEG spectrum.

Conclusions

Our results suggest that chronic BZD and BZRA use is associated with poorer sleep quality. Such alteration of sleep regulation—at the macro and micro-architectural levels—may contribute to the reported association between BZD/BZRA use and cognitive impairment in older adults.

Statement of Significance

Widespread use of sedative-hypnotics is driven by high insomnia rates among older adults. Chronic use can disrupt cognitive function; however, its impact on sleep regulation is not well understood. We assessed the effect of chronic benzodiazepine use in older adults using a between-group design involving good sleepers, drug-free individuals with insomnia disorder and individuals with insomnia disorder who chronically use sedative-hypnotics as a sleep aid. We performed a comprehensive comparison of sleep architecture, electroencephalogram relative spectrum, and associated NREM brain oscillations related to memory consolidation. We showed that chronic use of sedative-hypnotics is detrimental to sleep regulation—at the macro and micro-level—and this may contribute to the reported link between sedative-hypnotic use and cognitive impairment in older adults.

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