Sleep inducers do not impact CV event, death risk
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Sleep inducer prescriptions were unrelated to increased risk for mortality, major adverse CV events and HF events in patients at a CV hospital, researchers reported in the European Journal of Preventive Cardiology.
“Cardiovascular diseases or concomitant cardiovascular risks are major reasons for prescribing pharmacological sleep inducers as they may trigger insomnia through anxiety or polypharmacy,” Emi Fujii, MD, of the department of cardiovascular medicine at the Cardiovascular Institute in Tokyo, and colleagues wrote. “This study investigated the association between sleep inducer prescriptions and the prognosis of patients visiting a cardiovascular hospital.”
In a retrospective study, 23,348 patients in the Cardiovascular Institute database from April 2010 to March 2017 were stratified by whether they had a sleep inducer prescription. The researchers propensity-matched 5,082 patients for the analysis.
Sleep inducers were identified as benzodiazepines or nonbenzodiazepines, such as Z-drugs, ramelteon or suvorexant (Belsomra, Merck).
Endpoints that were analyzed included all-cause mortality; major adverse CV events (MACE) such as CV death, ACS and stroke; and HF events.
A propensity score-matching model was created because of the different baseline characteristics of the two groups. Fujii and colleagues adjusted for several variables and used logistic regression analysis for sleep inducer prescription odds.
Among the cohort, 12% patients were prescribed sleep inducers, of whom 86.4% received benzodiazepines. The average period for follow-up was 879 days.
In the matched cohort, there were no differences between the groups in clinical characteristics.
In a Kaplan-Meier analysis, sleep inducer prescription was not associated with all-cause death (sleep inducer, 4%; no sleep inducer, 3.4%; log-rank P = .27), MACE (sleep inducer, 6.3%; no sleep inducer, 6.5%; P = .68) or HF events (sleep inducer, 6.6%; no sleep inducer, 5.4%; P = .08).
“Although in our matched cohort, sleep inducer prescription was unrelated to mortality, various other demographic characteristics, such as social/financial situations or comorbidities, may have been confounding,” Fujii and colleagues wrote.
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