Little Evidence for the Long-Term Efficacy of Sleep Medication Among Women in Midlife

Unhealthy sick Caucasian woman suffers from insomnia or headache during the day, takes sleeping pill while laying in bed with glass of water, depressed girl holds antidepressant medications, painkiller for menstrual pain, close up. Photo of Stressed woman drinking pill or medicine with glass of water on bed at home after wake up in the morning
With the use of sleep medication increasing, little is known about the long-term benefits of these medications. The researchers compared reductions in sleep difficulties across a large cohort of women who used and did not use prescription sleep medication.

The long-term effectiveness of sleep medications among women in midlife should be re-evaluated. These findings, from a longitudinal cohort study, were published in BMJ Open.

Community-dwelling women were recruited for the Study of Women’s Health Across the Nation (SWAN) at 7 sites in the United States between 1995 and 1997. Follow-up data between 2014 and 2016 for propensity-matched women (N=685) with some sleep disturbances were analyzed for sleep quality and medication use.

At baseline, study participants were aged mean 49.5 (standard deviation [SD], 8.5) years, BMI was 29.1 (SD, 7.4) kg/m2, 57.5% were White, 46.1% had hypertension, 44.2% osteoarthritis, and 42.9% were postmenopausal. Most women (n=447) did not use sleep medications.

Women in the medication and no medication groups had trouble initiating sleep 3 nights per week (34.5% vs 30.7%), waking frequently 3 nights per week (66.4% vs 65.1%), early morning awakening 3 nights per week (34.0% vs 30.2%), and any disturbance 3 nights per week (76.9% vs 72.0%) at baseline, respectively.

At the 1- and 2-year follow-up, sleep disturbances were not significantly changed among either cohort, except, non-users of sleep medications had lower early morning awakening scores at year 1 (P =.02) but not at year 2 (P =.92).

Among only benzodiazepine users, no significant differences were observed for sleep disturbances compared with the non-user group (all P =.17). Among women who used selective benzodiazepine receptor agonists and other hypnotics, no differences were observed for difficulty initiating sleep (P =.12) or early morning awakening (P =.28), but waking frequently during sleep was significantly reduced among the non-user group (P =.05).

This study may have been limited by relying on self-reported sleep difficulties.

These data did not support long-term sleep medication use, as there was no improvement in self-reported sleep disturbances among women in midlife. Additional study is needed especially due to the fact that sleep disturbances are common, and the use of sleep aids has been increasing.

Disclosure: An author declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Solomon DH, Ruppert K, Habel LA, et al. Prescription medications for sleep disturbances among midlife women during 2 years of follow-up: a SWAN retrospective cohort study. BMJ Open. 2021;11(5):e045074. doi:10.1136/bmjopen-2020-045074