Many seniors in our practice at Centrum Pharmacy have relied on medications like Ativan, Valium, or Xanax for years to help them sleep. These drugs, known as benzodiazepines, can provide short-term relief. But in older adults, they often do more harm than good, especially when used long-term.
What New Research Tells Us
A new study from Concordia University (published in the medical journal Sleep) found that benzodiazepines and related drugs (called benzodiazepine receptor agonists, or BZRAs) actually worsen sleep quality in seniors rather than improving it.
The study followed 101 adults aged 55 and older, including:
- Good sleepers
- Those with insomnia
- Those with insomnia who regularly used benzodiazepines or BZRAs
Researchers discovered that while seniors felt they were sleeping better, their objective sleep quality (the actual structure and restorative value of their sleep) was significantly worse.
“Unfortunately, the medications don’t have the effects we wanted,” said study author Loïc Barbaux. “We wanted them to improve sleep quality, but they lead to a decline in important parameters, particularly for memory and cognitive health.”
Benzodiazepines Reduce Deep Sleep
The study showed that benzodiazepine users had a marked decrease in deep sleep, the stage of sleep responsible for:
- Memory consolidation
- Cellular repair and brain recovery
- Cognitive performance the next day
Interestingly, REM sleep (dream sleep) was not significantly affected, but deep, slow-wave sleep was greatly diminished. This helps explain why seniors using these medications often feel “foggy,” forgetful, or groggy even after a full night’s rest.
Why They’re Especially Risky in Older Adults
The American Geriatrics Society and Choosing Wisely Canada both advise against benzodiazepine use in seniors, even for short-term sleep issues. Here’s why:
- Altered Metabolism: Seniors process drugs more slowly, causing benzodiazepines to build up and prolong sedation.
- Cognitive Impairment: Long-term use is linked to confusion, delirium, and memory loss.
- Falls and Fractures: Sedation, muscle relaxation, and delayed reflexes make falls up to 60% more likely, a major concern given the risk of hip fractures.
- Addiction and Withdrawal: Dependence can develop quickly, and stopping suddenly can trigger tremors, agitation, anxiety, or seizures.
- Sleep Disruption: Despite the initial drowsiness, these drugs reduce restorative sleep and worsen daytime fatigue over time.
The Trend Is Changing
Encouragingly, the use of benzodiazepines among Quebec seniors has dropped significantly:
- In 2012, 28.4% of people aged 65+ used benzodiazepines.
- By 2022, that number fell to 16.7% (source: Quebec National Institute of Public Health).
This reflects a growing awareness among healthcare professionals that these medications are potentially inappropriate for older adults, and that safer, more effective strategies exist.
Better Alternatives Exist
Seniors can successfully restore sleep and reduce anxiety without relying on benzodiazepines. Safer and more sustainable options include:
- Cognitive Behavioural Therapy for Insomnia (CBT-I): proven to improve both subjective and objective sleep quality.
- Sleep hygiene strategies: consistent bedtime, limiting screens, and avoiding caffeine or alcohol before bed.
- Gentle natural supports: melatonin (under professional guidance), light therapy, or mindfulness-based relaxation.
- Non-benzodiazepine medications (if absolutely needed): prescribed at the lowest effective dose and reviewed regularly.
Helping Seniors Transition Safely
At Centrum Pharmacy, we recognize that discontinuing benzodiazepines after years of use can be emotionally and physically difficult. We work closely with physicians to create gradual, individualized tapering plans to minimize withdrawal and restore natural sleep cycles safely.
Our pharmacists can:
- Review your medication list for interactions or risks
- Help plan a stepwise dose reduction
- Suggest alternative therapies and supports
- Coordinate with your doctor for ongoing monitoring
Our Commitment
Our goal at Centrum Pharmacy is to help seniors enjoy healthier, more restorative sleep and better cognitive well-being, without dependence on medications that may quietly cause harm. If you or a loved one are still using benzodiazepines for sleep, talk to our team today about safer, evidence-based alternatives.
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Disclaimer: The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your healthcare provider first. Full Disclaimer.
