The University of Nottingham

There has been a call for more research into the effects of a class of commonly used sleeping pills after researchers at The University of Nottingham found that patients taking benzodiazepines were at an increased risk of contracting and dying from pneumonia.

The research, led by Eneanya Obiora – an MSc Epidemiology student in the School of Community Health Sciences under the supervision of Richard Hubbard, a professor of respiratory epidemiology and Dr Puja Myles, an expert in infectious disease epidemiology – has been published in the journal Thorax, an international journal of respiratory medicine.

Professor Hubbard said: “These drugs are commonly prescribed medications that have significant immune effects. Deep sleep induced by these drugs may mean that secretions can build up in the lungs. Our results suggest that they may increase both the risk of and mortality from pneumonia.

Benzodiazepines are a class of commonly prescribed sleeping pills used as sedatives for anxiety, epilepsy, muscle spasm, alcohol withdrawal, palliative care, insomnia and to provide sedation. Their use is prevalent in elderly patients. However, the drugs have been associated with an increased incidence of infections and death from sepsis in the critically ill.

The research team in the Division of Epidemiology and Public Health looked at just under 5,000 patients of all ages who had been diagnosed with pneumonia. They compared each of them with six similar people, matched by age and sex and drawn from the same GP practice that had not contracted the condition.

The study found that taking benzodiazepine was associated with a 54% increased risk of pneumonia and those who did contract it were a fifth more likely to die within a month and a third more like to die within three years.

Current users of the drugs were 90% more likely to contract pneumonia whereas past users were 40% more likely to contract the lung condition.

Dr Myles said: “Our results are consistent with data from previous clinical trials which have raised concerns over the effects of these drugs in critically ill patients admitted to intensive care units. These concerns have led to a move away from the use of benzodiazepine sedation. Our findings indicate a significant risk of benzodiazepine exposure on infectious lung disease and given the widespread use of benzodiazepine drugs, further studies are required to evaluate their safety in the context of infection.”