umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Use of short-acting and long-acting hypnotics and the risk of fracture: a critical analysis of associations in a nationwide cohort
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health. School of Sports Science, UiT The Arctic University of Norway, Tromsö, Norway..
2019 (English)In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 30, no 10, p. 1983-1993Article in journal (Refereed) Published
Abstract [en]

Summary: Numerous observational studies suggest that hypnotics increase the risk of fractures, and long-acting hypnotics are suggested to be especially harmful. This study showed that the highest risk of fracture was found before start of treatment and remained after end of therapy, suggesting that the increased risk during treatment is influenced by other factors, such as underlying disease.

Introduction: The purpose of this study was to evaluate associations between the use of short-acting and long-acting hypnotics and the risk of fracture.

Methods: Four cohorts were formed from all individuals living in Sweden aged ≥ 50 years in 2005 (n = 3,341,706). In the first cohort, individuals prescribed long-acting propiomazine (n = 233,609) were matched 1:1 with controls. In the second cohort, individuals prescribed short-acting z-drugs (zopiclone, zolpidem, and zaleplon, n = 591,136) were matched 1:1 with controls. The third and fourth cohorts consisted of full sibling pairs with discordant propiomazine (n = 83,594) and z-drug (n = 153,314) use, respectively.

Results: The risk of fracture was greatest among users of hypnotics in the 90 days before the initiation of treatment, both for propiomazine (odds ratio [OR], 2.52; 95% confidence interval [CI], 2.28–2.79) and z-drugs (OR, 4.10; 95% CI, 3.86–4.35) compared with that in matched controls. Furthermore, this risk was significantly reduced after the initiation of treatment with propiomazine (OR, 1.42; 95% CI, 1.27–1.60) and z-drugs (OR, 1.67; 95% CI, 1.56–1.80) and remained the first year following the last prescribed dose both for propiomazine (OR, 1.28, 95% CI, 1.21–1.36) and z-drugs (OR, 1.19, 95% CI, 1.16–1.23). The pattern was similar in the sibling cohorts, with the greatest risk of fracture seen in the 90 days before treatment with hypnotics was initiated.

Conclusion: The use of short-acting and long-acting hypnotics is associated with an increased risk of fracture. This risk was highest before initiation of treatment and remained after end of therapy. The results suggest that the increased risk during treatment is influenced by other factors such as underlying disease.

Place, publisher, year, edition, pages
Springer, 2019. Vol. 30, no 10, p. 1983-1993
Keywords [en]
Fractures, Hypnotics
National Category
Orthopaedics
Identifiers
URN: urn:nbn:se:umu:diva-162803DOI: 10.1007/s00198-019-05085-5PubMedID: 31363793Scopus ID: 2-s2.0-85069899684OAI: oai:DiVA.org:umu-162803DiVA, id: diva2:1346774
Available from: 2019-08-29 Created: 2019-08-29 Last updated: 2019-11-07Bibliographically approved

Open Access in DiVA

fulltext(1358 kB)11 downloads
File information
File name FULLTEXT02.pdfFile size 1358 kBChecksum SHA-512
6506aed601c0f8b53658350044c40042423c42cf9e1c6fff662f3d08b25753432cf40f499beaf8468d81fac1dbaee60bc294a649995a8a45aaec4232d23439b8
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMedScopus

Authority records BETA

Nordström, PeterNordström, Anna

Search in DiVA

By author/editor
Nordström, PeterNordström, Anna
By organisation
Geriatric MedicineSection of Sustainable Health
In the same journal
Osteoporosis International
Orthopaedics

Search outside of DiVA

GoogleGoogle Scholar
Total: 74 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 174 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf