ArticleJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2021
Prescription medications for insomnia are associated with suicidal thoughts and behaviors in two nationally representative samples.
Article in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Prescribed benzodiazepines and suicidal behaviors: a systematic review, meta-analysis, and clinical implications.BMC psychiatry · 2026Pooled it
- Z-Drug Use and All-Cause Mortality: A Meta-Analysis of Observational Cohort Studies.Neuropsychiatric disease and treatment · 2026Article
- The effect and safety of sleep interventions on suicidal thoughts and behavior - A systematic review and meta-analyses.Sleep medicine: X · 2025Review
- Understanding Latine disparities in nocturnal wakefulness as a suicide risk factor.Sleep epidemiology · 2025Article
- The Association of Zolpidem and Suicidality in Psychiatric Outpatients With Insomnia.Psychiatry investigation · 2025Article
- Association among objective and subjective sleep duration, depressive symptoms and all-cause mortality: the pathways study.BMC psychiatry · 2025Article
- Trends in hypnotic drug use in depression 2007-2017: A Swedish population-based study.Journal of sleep research · 2025Article
- Sleep-related drugs utilization and suicide behaviors: a population-based study in China.BMC public health · 2025Article
- [Insomniac symptoms and suicidality-link and management].Neuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater · 2024Review
- Risk for Suicide and Homicide Peaks at Night: Findings From the National Violent Death Reporting System, 35 States, 2003-2017.The Journal of clinical psychiatry · 2024Article
- Prediction of adverse events risk in patients with comorbid post-traumatic stress disorder and alcohol use disorder using electronic medical records by deep learning models.Drug and alcohol dependence · 2024Article
- Recurrent prescription of sleep medication among primary care patients with type 2 diabetes: an observational study of real-world registry data.BMC primary care · 2023Observational
- Eyes wide open: sleep disturbance, not melatonin, is the real issue to address for suicide risk.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Article
- Genetic evidence for a potential causal relationship between insomnia symptoms and suicidal behavior: a Mendelian randomization study.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2022Article
- Clonidine is better than zopiclone for insomnia treatment in chronic pain patients.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Observational
- Do prescription hypnotic medications increase or decrease suicidality?Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2021Article
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7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesZ-drugs (eszopiclone, zolpidem, and zaleplon) are commonly used for insomnia but are also associated with suicide risk. However, it is unclear if this association is unique to Z-drugs. Therefore, the present study estimated the associations between multiple prescription insomnia medications and suicidal thoughts and behaviors.
methodsData were acquired from the National Survey on Drug Use and Health for 2015-2018 and the National Health and Nutrition Examination Survey for 2005-2018. Samples were balanced on sociodemographic and mental health covariates using inverse probability of treatment weighting. Associations of Z-drugs, trazodone, and sedative benzodiazepines (temazepam, triazolam, flurazepam) with suicidal ideation, planning, and attempts were estimated using binomial logistic regression.
resultsIn the National Survey on Drug Use and Health, Z-drugs were associated with suicidal ideation (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.14-1.54]), suicide planning (OR, 1.44; 95% CI, 1.19-1.75), and suicide attempts (OR, 1.45; 95% CI, 1.13-1.86) after adjusting for age, sex, race/ethnicity, income, depression, illicit substance use, and the 6-item Kessler Psychological Distress Scale and World Health Organization Disability Assessment Schedule II scores. When analyses accounted for the same factors, sedative benzodiazepines were associated with suicide attempts (OR, 1.76; 95% CI, 1.06-2.87) but not suicidal ideation (OR, 1.37; 95% CI, 0.99-1.88) or suicide planning (OR, 1.39; 95% CI, 0.97-2.00). In the National Health and Nutrition Examination Survey, Z-drugs were associated with suicidal ideation (OR, 2.44; 95% CI, 1.41-4.22), as was trazodone (OR, 2.33; 95% CI, 1.45-3.75), after analyses adjusted for age, sex, race/ethnicity, and exposure to various psychotropic medications.
conclusionsMultiple classes of prescription insomnia medications are associated with suicidal thinking and behaviors, even after analyses adjusted for measures of mental health.
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