Montreal Study Reveals Dangers of Benzodiazepines for Seniors

Benzodiazepines, widely prescribed in Quebec for anxiety and insomnia, do not enhance sleep quality in older adults and may worsen their sleep over time. A recent study by researchers at Concordia University indicates that these medications not only fail to improve sleep but also increase the risk of falls among seniors. The findings were published in the medical journal Sleep.

The research involved 101 older adults, categorized into three groups: good sleepers, individuals with insomnia, and chronic users of benzodiazepines or benzodiazepine receptor agonists (BZRAs). The latter group included those consuming these medications at least three times a week for over three months. Prominent benzodiazepines include Valium, Xanax, and Ativan.

Loïc Barbaux, the study’s lead author and a PhD candidate at Concordia University, noted that while benzodiazepines may not raise immediate concerns for younger adults, their use in individuals over 65 is strongly discouraged by the American Geriatrics Society. “The increased adverse effects associated with their use demand caution,” he explained.

The study highlights the impact of benzodiazepines on brain rhythms during sleep, which are crucial for memory consolidation and cognitive health in adults aged 55 to 80. Barbaux emphasized that older adults are particularly vulnerable to the risks of these medications, which can lead to withdrawal symptoms and enhance the likelihood of falls, posing significant dangers such as hip fractures.

Data from the Institut national de santé publique du Québec (INSPQ) indicates a positive trend, with a notable decline in the prescription of potentially inappropriate medications among those aged 65 and older. From 2012 to 2022, the proportion of seniors using such medications decreased from 49 to 45 percent, largely due to a drop in benzodiazepine usage from 28.4 to 16.7 percent.

Understanding Sleep Quality in Older Adults

Barbaux pointed out that while users of benzodiazepines often report a short-term improvement in sleep quality, the objective measurements reveal a different story. Researchers monitored the sleep of participants through overnight polysomnography, which assesses overall sleep structure and brain wave activity.

The findings showed no significant change in rapid eye movement (REM) sleep, but there was a marked reduction in deep sleep, which typically occurs in the initial stages of the night and is essential for memory consolidation. “The reality is that we are witnessing a deterioration in critical parameters, particularly those linked to cognitive health,” Barbaux explained.

Despite the challenges, alternatives to benzodiazepines exist. Cognitive behavioral therapy, particularly when combined with a tapering off of medication, has demonstrated effectiveness in restoring sleep quality. Barbaux noted that ongoing research is crucial to develop tailored interventions that address both the subjective and objective aspects of sleep in older populations.

As the issue of insomnia among seniors becomes increasingly prevalent, understanding the implications of medication use is vital for health professionals. “The real challenge,” said Barbaux, “will be to find interventions that specifically cater to the unique needs of this demographic.”

This report was initially published in French on September 13, 2025, by The Canadian Press, whose health coverage is supported by a partnership with the Canadian Medical Association.