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Benzodiazepine use for over 3 months correlates with higher anxiety and depression in chronic insomniaLong term benzodiazepine use for insomnia linked to higher anxiety

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Key Takeaway
Note that benzodiazepine use exceeding 3 months is associated with higher anxiety and depression in chronic insomnia.

This meta-analysis evaluates the impact of benzodiazepine medications used for more than 3 months on adults with chronic insomnia. The study compares these patients to healthy sleepers and individuals not taking any medication. The primary outcome of insomnia severity was found to be more severe in those on benzodiazepines than healthy sleepers, but less severe than those not taking any medication.

Secondary outcomes revealed that patients on benzodiazepines for over 3 months had significantly higher levels of anxiety and depression compared to healthy sleepers. Regarding safety, the incidence of falls was similar between those using benzodiazepine medications and those who were not.

A primary limitation noted by the authors is the lack of studies regarding the long-term use of benzodiazepine medications. These findings suggest that extended benzodiazepine use may worsen sleep quality, mental health, and quality of life. The results support clinical guidelines that recommend limited use of benzodiazepines while prioritizing behavioral therapy and safer pharmacotherapies.

How this fits prior evidence

This meta-analysis addresses a gap in the understanding of long-term benzodiazepine use for chronic insomnia. It provides a contrast to the finding that DORAs have the strongest evidence for insomnia, as it highlights the potential mental health risks associated with extended benzodiazepine use. While tVNS and integrated TCM with Western medicine are noted as other options for insomnia, this evidence specifically highlights the risks of prolonged benzodiazepine use.

Living with chronic insomnia can feel like a constant battle for rest. While benzodiazepines are often used to manage sleep, staying on these medications for more than three months may come with hidden costs for your mental health.

Researchers looked at the data for adults using these medications long-term. They found that while these patients had less severe insomnia than those taking no medication at all, they still struggled significantly more than healthy sleepers. Most importantly, those on long-term benzodiazepines showed much higher levels of anxiety and depression compared to people without insomnia.

While the risk of falling was similar between those taking the medication and those who were not, the findings suggest that extended use might hurt your overall quality of life. Because of these risks, experts suggest using these drugs for a limited time and looking into behavioral therapy or safer alternatives.

What this means for you:
Long-term benzodiazepine use for insomnia is linked to higher anxiety and depression compared to healthy sleepers.

Common questions

Does taking benzodiazepines for insomnia cause anxiety?

The data shows that adults who used benzodiazepine medications for more than three months had significantly higher levels of anxiety compared to healthy sleepers. Because of these findings, experts suggest prioritizing behavioral therapy or safer medications for long-term sleep issues.

Are there mental health risks with long-term benzodiazepine use?

Yes, the study found that people using these medications for more than three months had significantly higher levels of depression than healthy sleepers. This suggests that extended use may negatively impact your overall mental health and quality of life.

Is it safe to use benzodiazepines for more than three months?

The evidence suggests that extended use may worsen sleep quality and mental health. Because of these risks, medical guidelines recommend limiting the use of these drugs and switching to safer alternatives or behavioral therapies.

Study Details

Study typeMeta analysis
EvidenceLevel 1
Follow-up3.0 mo
PublishedOct 2026
View Original Abstract ↓
This systematic literature review evaluated the risks of using benzodiazepine medications for more than 3 months in adults with chronic insomnia. Chronic insomnia is defined as ongoing dissatisfaction with sleep quantity or quality, causing significant distress and impaired functioning during the day. Although benzodiazepine medications are often prescribed to treat insomnia, using them longer than 4 weeks raises concerns about dependence, negative side effects, and long-term health risks for patients. This review included 27 studies published between 1987 and 2023, focusing on adults with insomnia symptoms lasting at least 3 months. The main outcomes examined were sleep quality, safety issues such as risk of falls, mental health concerns including depression and anxiety, and overall quality of life. Five outcomes were deemed suitable for meta-analysis: severity of insomnia, sleep quality, incidence of falls, depression, and anxiety. The results showed that people taking benzodiazepine medications had more severe insomnia than healthy sleepers, but less severe than those who were not taking any medication. The risk of falls was similar between those using benzodiazepine medications and those who were not. However, people using these medications experienced significantly higher levels of depression and anxiety compared to healthy sleepers. This review highlights a lack of studies on the long-term use of benzodiazepine medications, but suggests that extended use may worsen sleep quality, mental health, and quality of life. The findings support guidelines recommending limited use and prioritizing behavioural therapy and alternative safer pharmacotherapies for insomnia.
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