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Zolpidem increased cancer risk in patients with sleep disorder: A 3-year follow-up study
Sheng-Chiao Lin1, Yu-Chieh Su2, Yung-Sung Huang3, Ching-Chih Lee4
1 Department of Otorhinolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
2 Department of Internal Medicine, Division of Hematology-Oncology, Buddhist Dalin Tzu Chi General Hospital; Cancer Center, Buddhist Dalin Tzu Chi General Hospital; School of Medicine, Tzu Chi University, Hualian, Taiwan
3 Department of Internal Medicine, Division of Neurology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
4 Department of Otorhinolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung; Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan
Correspondence Address:
Ching-Chih Lee
Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Road, Zuoying District, Kaohsiung City 81362
Taiwan
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1011-4564.181522
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Background: Zolpidem has been increasingly used in patients with sleep disorder due to its minimal respiratory depressor effects and short half-life. Materials and Methods: Recent case reports indicate that zolpidem usage may be associated with increased cancer mortality. This study aimed to determine the impact of zolpidem usage on the risk of incident cancer events in sleep disorder patients over a 3-year follow-up. Of the 6924 subjects diagnosed with sleep disorder in 2004, 1728 had used zolpidem. A Cox proportional hazard model was performed to estimate 3-year cancer event-free survival rates for patients using zolpidem and those not using it, after adjusting for confounding and risk factors. Results: At the end of follow-up, 56 patients had incident cancers, 26 (1.5%) who used zolpidem, and 30 (0.6%) who did not. After adjustments for gender, age, comorbidities, and other medications, patients using zolpidem had a 1.75 times (95% confidence interval [CI], 1.02–3) greater risk of cancer events than those not using zolpidem during the 3-year follow-up. Greater mean daily dose and longer use were associated with increased risk. Among patients with sleep disorder, mean daily dose >10 mg and length of drug use >2 months was associated with 3.74 times greater risk (95% CI, 1.42–9.83; P = 0.008) of incident cancer events. Conclusions: In this study, zolpidem use increased cancer events risk in sleep disorder patients. Risks and benefits of chronic zolpidem usage should be explained to sleep disorder patients, and long-term use should be monitored. |
