Retrospective Population Cohort Study on Hip Fracture Risk Associated with Zolpidem Medication

• Published in: Sleep (New York, N.Y.) Vol. 37; no. 4; pp. 673 - 679
• Main Authors: Lin, Fang-Yu, Chen, Pei-Chun, Liao, Chun Hui, Hsieh, Yow-Wen, Sung, Fung-Chang
• Format: Journal Article
• Language: English
• Published: United States Associated Professional Sleep Societies, LLC 01.04.2014
• Subjects: Adolescent; Adult; Aged; Cohort Studies; Female; Hip Fractures - chemically induced; Hip Fractures - complications; Hip Fractures - epidemiology; Humans; Hypnotics and Sedatives - administration & dosage; Hypnotics and Sedatives - adverse effects; Incidence; Insurance Claim Reporting; Kaplan-Meier Estimate; Male; Middle Aged; Osteoporosis - complications; Osteoporosis - epidemiology; Population Study on Hip Fracture Risk and Zolpidem Medication; Pyridines - administration & dosage; Pyridines - adverse effects; Retrospective Studies; Risk Assessment; Risk Factors; Young Adult; retrospective cohort study; hypnotics; Hip fracture; osteoporosis; zolpidem
• ISSN: 0161-8105; 1550-9109; 1550-9109
• DOI: 10.5665/sleep.3566

Few studies have evaluated the hip fracture risk for zolpidem users. We assessed the risk for subjects taking zolpidem. Population-based retrospective cohort study using claims data of a universal insurance system. We identified 6,978 patients newly prescribed for zolpidem in 2000-2001 age 18 y and older, and 27,848 nonusers frequency matched with sex, age, and date visiting a clinic. Both cohorts were followed up to the end of 2008 to measure the hip fracture incidence and risk, which considered factors such as sex, age, occupation, days of drug use, and osteoporosis status. The zolpidem users had a 2.23-fold higher hip fracture incidence than nonusers (3.10 versus 1.39 per 1,000 person-y). The risk increased with age for both cohorts. The elderly users had a 21-fold higher incidence than the younger users, or twofold higher than the elderly nonusers. Among 33 patients (20.4%) with hip fracture occurring during presumed medication days, which was accountable for an incidence of 1,083.0 per 1,000 person-y. Those taking the medicine for 8 days or longer had a moderately higher fracture rate than those taking it for less days (6.02 versus 4.48 per 100 person-times) with a ratio of 1.34 (95% confidence interval 0.42-4.56). Subjects with blue collar occupations were at a higher fracture risk. The hip fracture risk of zolpidem users is higher than that of nonusers. Fracture prevention awareness should be disseminated to the users.