A new study from the University of Southern California found that reducing prescriptions of sleep medication in older adults could provide substantial health and economic benefits. Avoiding use of these medications among older adults would reduce lifetime incidence of falls by 8.5% and cognitive impairment by 2.1%, according to the study. It would also increase life expectancy by 1.3 months, which translates to 1.7 million life-years gained across the population—most of which would be spent in good health.

Insomnia itself carries serious risks for older adults, including depression, heart disease and cognitive decline. But while many people take sleep medications hoping to improve their quality of life, long-term use appears to do more harm than good, the authors say.

For the study, researchers leveraged a  model to project the impacts of sleep medication use in older adults. They compared current use of the drugs with a scenario in which no one uses them, examining various outcomes such as cognitive decline, fall risk, nursing home use, medical costs and lifetime earnings.

People ages 65 to 74 saw the largest potential benefit in cognitive function and physical health from avoiding these drugs. In addition to the health benefits, researchers found it would mean lifetime savings of $6,600 per person, or about $101 billion across the United States. Most of the savings come from improvements in quality of life.

Professional organizations such as the American Academy of Sleep Medicine recommend cognitive behavioral therapy for insomnia (CBT-I), rather than sleep medication, as a first-line treatment, the authors noted. The treatment is structured to help people adopt better sleeping habits and can be delivered in-person, virtually or through an app (for example, the Department of Veterans Affairs’ CBT-I Coach). CBT-I is just as effective as sleep medication in the short term and is more effective in the long run, without the side effects.

To download the full study, published in The Lancet Regional Health: Americas, click here