Table 3

HRs for deaths and for cancers with dose–response analyses

HypnoticDeathsCancers
p ValueHR (95% CI)p ValueHR (95% CI)
Any hypnotic: doses/year<0.001<0.001
 No hypnotics, N=23 676ReferenceReference
 0.4–18 pills/year, mean 8, N=3491<0.0013.60 (2.92 to 4.44)0.0860.86 (0.72 to 1.02)
 18–132 pills/year, mean 57, N=3548<0.0014.43 (3.67 to 5.36)0.0221.20 (1.03 to 1.40)
 >132 pills/year, mean 469, N=3490<0.0015.32 (4.50 to 6.30)<0.0011.35 (1.18 to 1.55)
Zolpidem only: mg/year<0.0010.035
 No zolpidem or other hypnotics, N=23 671ReferenceReference
 Zolpidem 5–130 mg/year, mean 60, N=1453<0.0013.93 (2.98 to 5.17)0.0950.79 (0.60 to 1.04)
 Zolpidem 130–800 mg/year, mean 360, N=1456<0.0014.54 (3.46 to 5.95)0.5851.07 (0.83 to 1.39)
 Zolpidem >800 mg/year, mean 3600, N=1427<0.0015.69 (4.58 to 7.07)0.0231.28 (1.03 to 1.59)
Temazepam only: mg/year<0.001<0.001
 NO temazepam or other hypnotics, N=23 674ReferenceReference
 Temazepam 1–240 mg/year, mean 98, N=798<0.0013.71 (2.55 to 5.38)0.0030.48 (0.30 to 0.77)
 Temazepam 240–1640 mg/year, mean 683, N=613<0.0014.15 (2.88 to 5.99)0.0241.44 (1.05 to 1.98)
 Temazepam >1640 mg/year, mean 7777, N=665<0.0016.56 (5.03 to 8.55)<0.0011.99 (1.57 to 2.52)
  • HRs associated with levels of hypnotic consumption from Cox proportional hazards survival analyses, controlled for age, gender, ethnicity, smoking status, body mass index, marital status and alcohol use and stratified by diagnoses in 12 classes of comorbidity. N: number of patients in each dose group for deaths. Restrictions of stratification produced small differences in N for the cancer analyses. p: probability that HR=1 from Cox proportional hazards models. For each drug, the top p level is for the overall contrast among dosage categories (including the no medication or reference category), and the lower p values are for the significance of each HR referenced to no hypnotic use. HR: hazard ratio for death or cancer (95% CI). Models for zolpidem and temazepam excluded patients receiving other hypnotics. See the supplemental files for additional HRs.