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Type: Journal article
Title: The association between benzodiazepine use and sleep quality in residential aged care facilities: a cross-sectional study
Author: Chen, L.
Bell, J.
Visvanathan, R.
Hilmer, S.
Emery, T.
Robson, L.
Hughes, J.
Tan, E.
Citation: BMC Geriatrics, 2016; 16(1):196-1-196-9
Publisher: Biomed Central
Issue Date: 2016
ISSN: 1471-2318
Statement of
Lynna Chen, J. Simon Bell, Renuka Visvanathan, Sarah N. Hilmer, Tina Emery, Leonie Robson, Jessica M. Hughes and Edwin C. K. Tan
Abstract: BACKGROUND: Benzodiazepines are commonly prescribed in residential aged care facilities (RACFs) for their sedative and anxiolytic effects. The objective of this study was to investigate the association between benzodiazepine use and sleep quality in residents of RACFs. METHODS: A cross-sectional study involving 383 participants was conducted in six Australian RACFs. Night-time sleep quality, day-time drowsiness and day-time napping behavior were assessed using a validated questionnaire. Logistic regression was used to compute adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for the association between benzodiazepine use and sleep quality. Covariates included pain, dementia severity, depression, insomnia and other sedative use. RESULTS: Of the 383 residents (mean age 87.5 years, 77.5% female), 96(25.1%) used a benzodiazepine on a regular basis. Residents who used long-acting benzodiazepines on a regular basis had higher night-time sleep quality than non-users (AOR = 4.00, 95%CI 1.06 - 15.15). Residents who used short-acting benzodiazepines on a PRN only basis had longer daytime napping times than non-users (AOR = 1.77, 95%CI 1.01 - 3.08). No benzodiazepine category was associated with day-time drowsiness. CONCLUSIONS: The association between benzodiazepine use and sleep quality is dependent on the half-life and prescribing pattern of the benzodiazepine. Short-acting PRN benzodiazepines were associated with lower night time sleep quality and longer day-time napping compared to long-acting regular benzodiazepines. Longitudinal studies are needed to determine whether these findings reflect channeling of short-acting agents to residents at higher risk of sleep disorders.
Keywords: Sleep; sleep disorders; sleep quality; benzodiazepines; hypnotics and sedatives; homes for the aged; nursing homes
Rights: © The Author(s). 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
RMID: 0030059228
DOI: 10.1186/s12877-016-0363-6
Appears in Collections:Medicine publications

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