New findings link commonly prescribed drugs to certain health risks—prompting experts to urge caution for older adults.
According to the National Sleep Foundation’s 2025 “Sleep in America” poll results, four out of every 10 American adults say they have trouble falling asleep at least three nights a week. When sleep is hard to come by (and counting sheep just isn’t bringing on the desired drowsiness), you may find yourself reaching for melatonin or another sleep aid in the desperate search for shut-eye.
But for roughly 12% of older adults, sleep medications are necessary to manage insomnia, a condition that affects millions as they age. But a new study citing that statistic suggests it may be time to rethink your nightly prescription pill for the sake of your cognitive health and safety.
“Prescription sleep medications, including z-drugs, benzodiazepines, and trazodone, are commonly used treatments in older adults for insomnia, but have negative consequences related to injuries, cognitive impairment, and quality of life,” the study explains. The findings were published in the peer-reviewed journal The Lancet in October 2025.
To understand the burden of those consequences, the team used the Future Elderly Model to project how seniors might fare with and without the use of prescription sleep drugs. Developed in collaboration with the Centers for Medicare and Medicaid Services, the National Institute on Aging, the Department of Labor, and the MacArthur Foundation—as well as educational partners—the Future Elderly Model is a microsimulation often used to explore and inform policy decisions.
Using data collected between 1998 and 2018 via the Health and Retirement Study, the model allows researchers to predict the health and economic outcomes of various inputs—in this case, the remaining lifetime burden in U.S. adults over 50 of regularly using prescription medications to sleep.
When they compared two scenarios—a future in which 15.3 million Americans over 50 continue to use prescription sleep meds versus a future in which those individuals discontinue use—they found that avoiding sleep meds decreased lifetime incidence of falls by 8.5% and cognitive impairment by 2.1%. Discontinuing meds also increased life expectancy by 1.3 months. While this number may seem small, the researchers emphasize the broader public health impact: for people 65 and older, falls can contribute to premature death risk. “Collectively,” the researchers note, “eliminating future use could save 1.7 million life years and 1.3 million quality-adjusted life years in this cohort.”
Those between the ages of 65 and 75 saw the greatest benefits, according to a statement from the University of Southern California’s Schaeffer Center for Health Policy & Economics.
They also noted a staggering economic savings when they projected drug discontinuation, with “the largest share… attributed to improved quality of life.” Each person who stopped taking prescription sleep meds could reduce their net lifetime health spending by $6,600, totaling $101 billion in savings across the entire cohort.
The researchers acknowledge that stopping sleep medications can result in “short-term rebound insomnia” lasting about two weeks, but add that doing so “likely has longer-term health benefits.” As one of the study’s co-authors suggests, physicians can also play a role by reducing prescriptions and promoting safer, proven alternatives.
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