Insomnia is often dismissed as a nuisance or an inevitable part of aging. But it’s far more than that. It’s a condition that robs you of your ability to function — physically, emotionally, and mentally. When left unaddressed, chronic insomnia doesn’t just hurt your quality of life, it dismantles it. As a result, many people turn to pharmaceutical interventions — sleeping pills — to be able to get their much-needed slumber.
However, these medications are causing even more damage. According to a recent large-scale analysis, both the symptoms of insomnia and the medications typically prescribed to treat it are strongly tied to future disability, and the damage stacks up over time.
Sleep Meds and Sleepless Nights Drive Faster Decline in Function
In a recent study published in the journal Sleep,1 researchers from Penn State College of Health and Human Development and Taipei Medical University tracked 6,722 American adults aged 65 and older to investigate how insomnia and the use of sleeping pills influence the risk of disability.
The researchers used five years of data, from 2011 to 2015, from the National Health and Aging Trends Study (NHATS) to predict who would lose the ability to care for themselves or move independently in the years ahead.2
• Researchers investigated the link between sleep quality and factors related to disability — Through questionnaires, the research team looked at how frequently each person reported experiencing insomnia symptoms and how often they used sleep medication.
• To measure insomnia and use of sleeping pills, the data included five frequency levels — These were “never,” “once a week,” “some nights,” “most nights,” and “every night.” A point was given for “never,” and each succeeding level was given one more point, so “every night” gets 5 points.
• The participants’ ability to carry out daily tasks was also measured — These include eating, dressing, bathing, and using the toilet. Activities involving mobility like walking, getting out of bed, and going outdoors, were also evaluated.
• A simple scoring system was used to quantify these variables — An article in News-Medical.net explains: “For each self-care activity, participants were classified as ‘fully able’ to complete the activity on their own; ‘vulnerable’ to disability if they used accommodations, reduced their participation in the activity, or had difficulty with tasks; or ‘assistance’ if they could not complete an activity without help.”
• Participants who have higher scores represented higher levels of disability — One point was given for a classification of “fully able,” while “vulnerable” received 2 points. Classifications of “assistance” were given a score of 4.
• The findings were clear — People who used more sleep medications or had more frequent insomnia symptoms were significantly more likely to become disabled over time. The researchers found that for every step up in the severity of insomnia, disability scores rose an average of 0.2 points the following year.
• The same went for sleeping pills — With every increase in how often someone used them, their disability score ticked up another 0.19 points. When combined — chronic insomnia and regular medication use — the risk of losing independence became especially high.
While it might not seem like much, this adds up quickly over a few years. For example, someone moving from “never” to “every night” over five years would end up with a full point or more increase on the disability scale — enough to shift someone from independence to needing help.
Sleep Meds Are Linked to a Higher Risk of Falls and Injuries in Older Adults
Digging deeper, Orfeu Buxton, a professor at Penn State and co-author of the study, suggested a key reason sleep medications may contribute to disability is the increased risk of falls.3
• Sleeping pills work as sedatives — They don’t just knock you out, they impair coordination, slow your reflexes, and make it harder to balance. “As older people used more sleep medication or experienced more insomnia symptoms, they moved more rapidly towards greater disability,” Buxton said.
• For older adults, falls are a major threat — A single fall can mean a broken hip or spinal cord injuries, which could lead to loss of mobility and a fast track to needing round-the-clock care. “Seniors often turn to benzodiazepines or other sedatives that can result in delayed reaction time, dizziness, and impaired balance. Considering that older adults are already susceptible to injuries and falls, using these medications might only exacerbate the problems,” an article in the Hearty Soul notes.4
• The paper didn’t dive deep into how insomnia itself physically contributes to disability — However, from what we know from sleep science, chronic insomnia disrupts the brain’s ability to repair and regenerate. Previous studies have shown how it impairs memory, decision-making, and muscle recovery.5,6,7
• The researchers highlight the need for safer and more effective treatments for insomnia — One option they recommend is Cognitive Behavioral Therapy for Insomnia (CBT-I), which aims to change people’s behavior and pessimistic mindsets toward sleep. Trials have shown that the effectiveness of this treatment, however, it is not yet easily accessible for most individuals.8
The older you get, the more restorative sleep matters, and the more dangerous it is to go without it night after night. The good news is, there are several easy lifestyle changes that will help improve your sleep (we’ll discuss them later). Soomi Lee, an associate professor of human development and family studies at Penn State and one of the co-authors of the study, said:
“Many older adults think sleep disruptions are a natural part of aging, but they are a real problem that must be addressed. And that problem is unlikely to improve unless people talk to their doctors. There are not enough sleep clinics, especially in rural areas, so older people may need to advocate for themselves to get proper treatment.”9
Sleeping Pills Disrupt Your Brain’s Self-Cleaning System
Today, the number of Americans struggling with sleep disorders stands at around 50 to 70 million — 1 in 3 adults are now failing to get the restful, uninterrupted sleep they need for optimal health.10 And while sleeping pills seem like the quickest way to address this problem, many are unaware that these medications are forcing your brain into an unnatural, sedated state that’s nothing like the sleep you need.11
• Sleeping pills affect your brain’s glymphatic system — This is a built-in cleaning system that removes waste while you sleep. The glymphatic system uses cerebrospinal fluid (CSF) to flush out harmful toxins, including beta-amyloid and tau proteins, which are associated with neurodegenerative diseases. As long as this process functions properly, your brain will be free of any toxic buildup that causes memory loss and cognitive decline.
• The glymphatic system is most active during deep sleep — It’s particularly busy during the non-REM (NREM) phase. During this time, your brain cells shrink slightly, creating more space for CSF to flow and wash away waste products that build up throughout the day.
• Norepinephrine, a key chemical in the brain, controls CSF flow — During deep sleep, norepinephrine levels rise and fall in slow waves, helping fluid move through brain tissue. If norepinephrine is not functioning properly, the glymphatic system slows down.
• However, sleep meds disrupt norepinephrine activity — A recent study revealed how sleep meds affect synchronized oscillations of norepinephrine in your brain. Published in the journal Cell,12 the study focused on zolpidem, a common sleep aid, and how it affects these oscillations and CSF flow.
“[C]orrelation analysis in naturally sleeping mice showed that the frequency of NE oscillations, reflected by the frequency of micro-arousals during NREM sleep, displayed a stronger correlation with glymphatic flow than all other measures analyzed, including total NREM and REM sleep duration and NREM delta power,” the researchers noted.
“Conversely, although the sleep aid zolpidem promoted sleep, it impaired the infraslow oscillations in NE (norepinephrine), blood and CSF, reducing both vascular and neuronal oscillatory dynamics and ultimately decreasing glymphatic flow.”13
What’s more, the study also confirmed what’s been known for years: sleeping pills do not create real sleep; instead, they cause sedation. When you take sleeping pills, your brain gets stuck in an artificial sleep state that lacks deep sleep and REM sleep — important cycles that are necessary for memory and repair. As a result, brain function declines and your risk of neurodegenerative diseases rises.
Sleep Meds Have Long-Term Health Consequences
Many studies have already shown that taking sleeping pills significantly hampers your cognitive function. For elderly people who are at higher risk of neurodegenerative illnesses, relying on these pharmaceutical interventions nightly is a risky move that speeds up your decline.
• Sleeping pills increase your risk of dementia — A 2023 study followed nearly 3,000 older adults over nine years and found that white participants who frequently used sleep medications had a 79% higher chance of developing dementia compared to those who rarely or never used them.14
An earlier meta-analysis, published in the Journal of Clinical Neurology, specifically looked at the effects of benzodiazepines, and found that it significantly increases the risk of dementia in the elderly.15
• These pills create a dependency — Using these drugs on a long-term basis causes many users to develop a tolerance; hence, they need to take higher doses over time to achieve the same effect. And when they attempt to stop taking these pills, they experience withdrawal symptoms, such as severe insomnia and anxiety. As a result, they continue using the drugs, despite their long-term risks.
• Many people assume sleep meds are safe — This is because they’re FDA-approved and are widely prescribed by healthcare providers. But the truth is that the research about these drugs — as well as their safety and risks — is still ongoing. Unfortunately, the results are not favorable — studies have linked long-term use of these pills to an increased risk of death and cancer.16
Turn to Natural Sleep Solutions Instead
If you’re dealing with insomnia, or you’ve been relying on sleep medications to get through the night, I recommend trying these practical steps to improve your sleep quality. Implementing these changes will support your body’s natural sleep rhythms and help protect your cognitive and physical health — especially as you age.
1. Stop relying on sleep medication and start asking why you’re not sleeping — If you’re taking pills to sleep every night, it’s time to stop and reevaluate. Ask yourself: What’s keeping you up? Is it pain? Anxiety? Poor sleep habits? Once you know, you’ll be able to start fixing the actual issue rather than masking it.
2. Shift your bedtime habits to match your body’s natural sleep-wake cycles — Your body needs signals to know when it’s time to wind down. This means no screens for at least an hour before bed, as the blue light shuts down your melatonin. Dim the lights in your home after sunset. Keep your bedroom cool and pitch dark. And try to wake up at the same time every day — even on weekends. The more consistent your rhythm, the easier it becomes to fall and stay asleep.
3. Rebuild your sleep drive naturally with sunlight and movement — One of the simplest and most overlooked remedies is getting early morning sun exposure. Get outside as soon as you wake up. Ten to 15 minutes of morning light resets your circadian rhythm and tells your brain when to be alert and when to rest.
4. Be physically active during the day — Walking, moderate exercises, or strength training will help your body feel ready for rest when night comes. If you’re someone who sits most of the day, this alone could change your nights. Strength training, in particular, is said to help prevent insomnia among seniors. For more tips on how to exercise your way to better sleep, read “The Impact of Exercise on Sleep and Sleep Disorders.”
5. Support your brain chemistry with real food — not supplements or sedatives — You need the right nutrients to make sleep hormones like serotonin and melatonin. That means eating enough carbs to fuel your metabolism, not starving yourself with low-carb diets. Focus on whole fruits, root vegetables, and easy-to-digest starches, especially in the evening.
Don’t settle for medications that do more harm than good. Take back control by addressing the real reasons behind your insomnia and building a foundation for sleep that lasts. For more useful strategies to boost your sleep quality, read “Top 33 Tips to Optimize Your Sleep Routine.”
Frequently Asked Questions (FAQs) About Insomnia and Sleep Meds
Q: How does insomnia affect older adults over time?
A: Chronic insomnia doesn’t just make you tired — it steadily increases your risk of losing independence. A large study found that each year of worsening sleep raised disability risk by 20%, affecting your ability to dress, walk, and care for yourself.
Q: Are sleep medications a safe way to manage insomnia?
A: No. While they may provide short-term relief, sleep medications increase your chances of disability, falls, and even neurodegenerative conditions like dementia. These drugs sedate rather than support real sleep and interfere with the brain’s natural repair systems.
Q: What daily tasks are most affected by poor sleep and medication use?
A: Basic activities like eating, dressing, bathing, using the toilet, and walking are the first to decline. The more you rely on sleep meds or suffer from insomnia, the more likely you are to need help with these essential functions.
Q: What are safer alternatives to sleep medications for older adults?
A: Cognitive Behavioral Therapy for Insomnia (CBT-I) is a safer, effective option. It retrains your brain for better sleep without side effects. Pairing it with daily sunlight, consistent routines, movement, and nourishing whole foods also supports restorative sleep.
Q: Why do sleep medications increase the risk of disability and cognitive decline?
A: These drugs interfere with deep sleep cycles and the glymphatic system, which your brain uses to remove toxins. When this system is impaired, waste builds up, increasing the risk of cognitive decline, memory loss, and physical disability.
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