Do Sleep Aids Cause Memory Loss? What You Need to Know About Dementia Risk

Nearly all my patients struggle with sleep, and you probably do too. According to the New England Journal of Medicine, 1 in 5 Americans use sleep aids. But while these medications promise restful nights, many come with a hidden cost: potential brain damage that may impair memory and lead to dementia.

Sleep aids typically don't promote natural sleep, which is why many people feel groggy or unrefreshed in the morning. But some medications go much further, potentially causing lasting cognitive damage. Let me walk you through the most common sleep aids, their risks, and safer alternatives that most doctors don't discuss.

The High-Risk Sleep Aids

1. Gabapentin: The Hidden Danger

Gabapentin was once thought to be ideal for sleep because it facilitates deep sleep. However, research reveals a serious cost. In non-elderly patients with chronic low back pain, being prescribed gabapentin showed over twice the risk of dementia (RR: 2.10) and 2.5 times the risk of mild cognitive impairment (RR: 2.50) compared to those not prescribed the medication.

The data shows a dose-dependent relationship, meaning higher prescription frequency correlates with higher risk. Gabapentin also carries a risk of difficult withdrawals, making it challenging for patients to taper off the medication.

2. Benzodiazepines: Xanax, Ativan, and Valium

Classic benzodiazepines present concerning risks. Research shows 78% higher odds of dementia in benzodiazepine users, with even more alarming findings in Asian populations where the risk jumps to 240% higher.

Short-acting benzodiazepines like Xanax (alprazolam) and Ativan (lorazepam) carry the highest risk, especially in women, showing a clear dose-response relationship. While some studies show little evidence of a causal relationship, a concerning 2024 study found that current benzodiazepine use was associated with smaller brain volumes, particularly in the hippocampus (the memory storage area), with accelerated volume loss over time.

Beyond dementia risk, benzodiazepines carry risks of dependence, withdrawals, depression, falls, and fractures.

3. Z-Drugs: Ambien, Lunesta, and Zolpidem

Z-drugs show mixed data, but patterns emerge. Like benzodiazepines, women are more affected than men, particularly at higher doses. A Taiwanese study found that high cumulative doses of zolpidem were associated with increased Alzheimer's disease risk in older adults.

FDA Warning: The FDA specifically warns about "Complex Sleep Behaviors" with Z-drugs, including dangerous incidents like falls, burns, self-harm, and wandering outside in extreme weather—all while having no memory of these actions.

4. Benadryl (Diphenhydramine): The Most Common and Most Concerning

Despite being available over-the-counter, Benadryl may pose the most significant risk. Higher cumulative anticholinergic use is strongly associated with increased dementia risk, with risk increasing based on cumulative dosing.

Given how commonly Benadryl is used for sleep, this risk should absolutely be discussed with your doctor before starting or continuing use.

The Safer Alternatives

Trazodone

Often prescribed as an antidepressant for nighttime use, trazodone fortunately doesn't appear to increase dementia risk. While it doesn't improve cognition in dementia patients, it also doesn't cause harm in this regard.

Melatonin

This naturally occurring hormone doesn't appear to increase dementia risk. In fact, research suggests melatonin may provide symptomatic improvement in mild-stage Alzheimer's disease.

Natural Supplements

Several supplements show promise without dementia links:

• L-Theanine - supports cognitive function
• Valerian root - may help with cognitive disorders
• Glycine - supports physiological systems
• Ashwagandha - may improve memory in mild cognitive impairment
• Passionflower

The Hormone Connection Women Need to Know

The most important sleep disruptor may be hiding in your hypothalamus where hormones are controlled. This is especially critical for women, whose hormones are more prone to imbalance, particularly during menopause.

It's not just hot flashes and depression affecting sleep. Research shows hormone changes independently disrupt sleep during perimenopause, separate from other symptoms. Younger women experience this throughout their menstrual cycles, especially during the luteal phase when hormones rapidly change.

The good news: progesterone is often the key hormone that needs restoration. Micronized progesterone has been shown to improve various sleep parameters with a good safety profile when prescribed as part of a holistic health plan.

Since women face higher dementia risk from sleep aids to begin with, hormone balancing should be a top priority. Yet most women struggling with sleep have never had this conversation with their doctor. Younger women are especially likely to be offered antidepressants instead.

Ask yourself: Is it a Prozac deficiency or a progesterone deficiency we're treating?

The Bottom Line

For patients with additional dementia risk factors—like the ApoE4 gene, heart disease, or stroke history—these considerations become even more critical. The goal isn't to fear-monger, but to avoid long-term use of potentially dangerous sleep aids whenever safer alternatives exist.

You deserve to know the risks before starting any sleep medication, and you deserve access to natural, hormone-based solutions that address the root cause of sleep disruption rather than masking symptoms with medications that may harm your brain. Schedule an appointment with Clarus Health today to improve your sleep and discuss your longevity goals.