The use of prescription sleep medications is particularly common among older adults and women. Because side effects of such drugs — including drowsiness upon waking and impaired coordination — may impact driving safety, Mr. John N. Booth III, student assistant and PhD candidate, and Dr. Gerald McGwin, professor and vice chair, in the department of epidemiology at the University of Alabama at Birmingham, recently assessed the link between current use of medications containing zolpidem among aged drivers and incident of motor vehicle collisions (MVCs).
A total of 2,000 North-Central Alabama zolpidem users, aged 70 and up, who had driven within the previous three months and held a valid driver’s license were studied. The researchers evaluated each participant’s five-year MVC history, obtained from the Alabama Department of Public Safety, and then estimated at-fault MVC rate ratios (RR) by comparing zolpidem users and nonusers data in age- and sex-defined subgroups.
Results indicate that “unadjusted RR (95 percent confidence interval [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 percent CI) were 1.65 (1.03-2.66) and 1.61 (1.00-2.60), respectively. The unadjusted and adjusted RRs (95 percent CI) among those aged 80 and above 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 under 80 years old. Similar patterns were present for at-fault MVCs.”
The investigators concluded that the current zolpidem users — particularly those study participants aged 80 and older, as well as those who were female — experienced higher rates of MVCs than nonusers. Therefore, they recommend that health care practitioners consider proposing behavioral treatment before prescribing zolpidem to restore sleep in women and patients aged 80 and older in order to reduce the risk of MVCs associated with this prescription drug.
Co-investigators in the study include Ms. Erica R. Johnson, graduate student trainee and PhD candidate, and Ms. Kelsey Jordan, PhD candidate, in UAB’s department of epidemiology; Dr. Chelsea R. Singleton, former graduate research assistant in UAB’s department of epidemiology and Nutrition Obesity Research Center (NORC), and current post-doctoral research fellow at the University of Illinois at Chicago; Dr. Lisandro D. Colantonio, PhD candidate in UAB’s School of Medicine; Mr. John P. Donnelly, fellow/graduate student trainee in UAB’s department of emergency medicine and the Center for Outcomes and Effectiveness Research and Education; Mr. Fenglong Xie, MS, statistician in UAB’s division of clinical immunology and rheumatology; and UAB alumni Mr. Michael Behring and Mr. Ryan S. Cantor.
“Zolpidem Use and Motor Vehicle Collisions in Older Drivers” was published online in December 2015 in the journal Sleep Medicine.
Journal article: http://www.sleep-journal.com/article/S1389-9457(15)02081-X/abstract