睡眠薬と死亡・発がんリスク，Hypnotics' association with mortality or cancer: a matched cohort study
Hypnotics' association with mortality or cancer: a matched cohort studyご参照
Patients with prescriptions for hypnotics had approximately 4.6 times the hazard of dying over an average observation period of 2.5 years as compared to non-users. These findings were robust with adjustment for multiple potential confounders and consistent using multiple strategies to address confounding by health status. A dose–response effect was seen. Among users in the highest tertiles of annualised dosages, the HRs for death were 5.3, 5.7 and 6.6, respectively, for all hypnotics, zolpidem alone and temazepam alone. This top third of users were prescribed 92.8% of all the prescription doses of hypnotics (supplemental figure 2). Those in the top third were also 35% more likely to develop a new major cancer.
Perhaps the most striking finding was that an increased hazard for death was present even in the lowest tertile of hypnotic use, such that hypnotic drugs were associated with a 3.6-fold increased risk of dying for patients using <18 hypnotic pills per year. Several strategies to discover biases that could account for this hazard, even at low levels of use, revealed none. Nonetheless, some residual confounding is inevitable in our results as a consequence of factors that were inadequately assessed. However, considering the minimal impact of the major confounders for which we did control upon the HRs, we think it unlikely that confounding explains the high mortality that we found associated with hypnotics.・・・・