Ambien increases risk of falls in hospitalized patients

Here's another article about Ambien and increased fall risk. This study was done at Mayo, where Ambien was associated with a significantly increased risk of falls in hospitalized patients. Mayo has decided not to use Ambien anymore in their hospitalized patients, and instead, use a drug free approach. Details were not given about that approach, and hopefully they will have success. Poor sleep quality during hospitalization can be a challenge, and I am not sure standard behavioral therapies used on an outpatient population would work during an acute hospitalization. More studies will be needed for sure.

Newer sleep aids are associated with falls in elderly

Older sleep aids that are related to Valium have been shown to increase falls in elderly patients, especially those with dementia. This article shows how elderly people are at much higher risk of falls with the newer sleep aids like Ambien.

Zolpidem use, Balance and Cognition upon awakening

In the January 13th issue of the Journal of the American Geriatrics Society, there is a study about the effects of Zolpidem on balance and cognition upon awakening. Zolpidem is the active ingredient in Ambien and Ambien CR. This study involved 12 older patients (average age 67 years) and 13 younger adults (average age 22 years). All participants were healthy, physically active, and mentally sharp. Balance was assessed by the tandem walk test, where participants walk on a six-inch beam. Cognition was tested by assessing short term memory and processing speed. The researchers studied balance and cognition right before bedtime and 2 hours after falling asleep after the participants took 5mg of Zolpidem. Researchers also studied balance and cognition after all of the participants went to bed two hours later, to study the effects of partial sleep deprivation without taking Zolpidem.

The results showed that 58% of the older adults and 27% of the younger adults had balance problems after taking 5mg of Zolpidem. Cognition was also impaired in both groups, but the decrease in cognition was more pronounced in younger adults than older adults.

This study underscores the importance of using caution with sleeping pills because of the risk of falls in elderly patients that use these medications. The fact that younger adults had more severe cognitive changes is also important. Five milligrams of Zolpidem is the recommended starting dose for patients older than 65, but 10mg is the more common dosage in younger patients. I wonder if the cognitive changes would be more pronounced at the higher dosage in younger adults.