Non-Benzo Sedatives May Contribute to AMD

When consumed, Z-meds bind to GABA-A receptors, causing a sense of sedation. Photo: Sanofi. Click image to enlarge. Consistent, prolonged use of hypnotic “Z-med” sedative drugs (a colloquial term for non-benzodiazepine hypnotic drugs such as zolpidem (Ambien) and zopiclone (Imovane), may increase the risk of developing age-related macular degeneration (AMD), says a recent study. Most drug names in this class begin with the letter Z, hence the moniker.Surveying 11,061 participants’ data obtained from the UK Biobank database, a team of Chinese researchers wrote in their paper that they found “the prolonged use of Z-meds was associated with an elevated AMD risk” but also noted that “no significant association was observed for the regular use of benzodiazepines.” Their findings were published in the journal Advances in Ophthalmology Practice and Research.The team examined data on both benzodiazepine and Z-med users as well as non-users: 1,899 benzodiazepine users and 7,557 non-users, as well as 321 Z-med users and 1,284 non-users. Additional factors were considered, including age, sex, ethnicity, smoking status and other conditions, such as epilepsy and diabetes. The authors wrote that “no interaction effect was identified in the association between benzodiazepine use and AMD” or between Z-med use and AMD.Benzodiazepines were concluded not to contribute to AMD risk, though the researchers found that the same did not apply to Z-meds. The authors speculated that AMD cases occurring from hypnotic drugs are “complex and multifactorial,” with significant involvement of the GABA-A receptors. Activation of these receptors is “known to induce relaxation of arterial smooth muscle, leading to vasodilation and a subsequent reduction in blood pressure,” which, they speculate, “could theoretically influence ocular perfusion.” In addition, they discussed the role of oxidative stress—“a central component of AMD pathogenesis,” though not a direct factor in GABA-A receptor activation; instead, the researchers proposed that “GABAergic alterations may interact with excitotoxic and inflammatory pathways, which themselves are closely intertwined with oxidative stress.” The imbalanced number of participants per drug user group spells a noticeable limitation, with only 321 Z-med users compared to the 1,899 in the benzodiazepine user group. While the results state that prolonged Z-med use was associated with AMD risk in contrast to benzodiazepine use, this difference in drug-user ratios skews the results so that the number of AMD-developing users in each group is not adequately represented. As such, the proportion of those who developed it while using Z-meds may appear greater than what it would be in a non-study population. Despite this, the study provided a useful baseline for optometrists and other practitioners to monitor patients who use Z-meds for warning signs of AMD and related ocular conditions.Click here for the journal source. Chen J, Tu S, Zhu Y, et al. Association between regular hypnotic use and age-related macular degeneration. Adv Ophthalmol Pract Res. March 1, 2026. [Epub ahead of print].  This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.