Cognitive and Mental Impairment Risks Associated with Eszopiclone

Introduction to Risks

The American College of Physicians notes that hypnotics used regularly and long-term are associated with dementia, fractures, major injuries, and possibly cancer 2
High-quality data to support the use of newer nonbenzodiazepine hypnotics like eszopiclone in demented older adults are nonexistent, according to the American Academy of Sleep Medicine 3

Eszopiclone causes CNS depression with documented adverse effects including dizziness, confusion, and cognitive impairment, as reported by Praxis Medical Insights 1
Benzodiazepines, a related class, are specifically associated with confusion, impaired motor performance, anterograde amnesia, and cognitive impairment, as noted by the American Academy of Family Physicians and Praxis Medical Insights 4, 1

Older adults face particularly severe risks including cognitive impairment, falls, and unsafe mobility, according to the American Academy of Sleep Medicine and Praxis Medical Insights 3, 1
The American College of Physicians advises dose reduction in older/debilitated adults due to drugs remaining at levels high enough to interfere with morning function 2
The American Academy of Family Physicians recommends using the lowest effective dose (1 mg for sleep onset in elderly, 2 mg for most adults) to minimize cognitive and behavioral risks 4
The American Academy of Sleep Medicine suggests avoiding or using extreme caution in elderly patients with existing cognitive impairment 3, 1