Is usage of hypnotics associated with mortality?

Objective: To investigate the influence of hypnotic usage on all-cause and cause-specific mortality in a middle-aged population. Methods: A cohort of 1750 men and 1773 women aged 30-65 years who responded to a postal questionnaire in 1983. The questionnaire included questions about hypnotic usage, sleep duration, sleep complaints, medical conditions, depression, demographic and life style variables. Mortality data for the period 1983-2003 were collected. Results: Regular hypnotic usage wits reported by 1.7% of men and 2.2% of women, and was associated with short sleep, sleeping difficulties, several health problems and depression. During the 20-year follow-up period 379 men (21.5%) and 278 women (15.5%) died. After adjustment for potential risk factors in multivariate analyses regular hypnotic usage was associated with significantly increased risk of all-cause mortality in men (Hazard ratios [HR], 4.54; 95% confidence interval [CI], 2.47-8.37) and in women 2.03 (95% CI 1.07-3.86). With regard to cause-specific mortality, regular hypnotic usage in men was a risk factor for coronary artery disease death, cancer death, suicide and death from all remaining causes. In women it was a risk factor for suicide. Conclusions: Our results show an increased risk of all-cause mortality and cause-specific mortality in regular users of hypnotics. (C) 2009 Elsevier B.V. All rights reserved.