Millions of older adults in the United States rely on prescription sleep medications to manage insomnia. These drugs include benzodiazepines and popular “Z-drugs” like Ambien. Even though they can help people fall asleep, they also carry serious risks—such as falls, broken bones, thinking problems, and dependence. Many medical organizations warn against long-term use, but prescriptions remain common.

A new study from the USC Schaeffer Center for Health Policy & Economics suggests that cutting back on these medications could significantly improve both health and longevity for older adults. Using a large simulation model, researchers compared what life looks like with current prescribing habits versus a scenario where older adults avoid these sleep medications entirely.

Their findings were striking:

• Falls would drop by 8.5%

• Cognitive impairment would drop by 2.1%

• Life expectancy would increase by about 1.3 months, adding up to 1.7 million extra life-years across the U.S. population

• Most additional years would be spent in good health

• Lifetime savings per person would be around $6,600, totaling $101 billion nationally

Adults ages 65–74 would gain the most in terms of memory, thinking ability, and physical health if they avoided long-term sleep drug use.

Although insomnia itself can be harmful—raising risks for depression, heart disease, and cognitive decline—the study shows that long-term sleep medication often does more harm than good. For many people, the “benefit” comes from escaping withdrawal symptoms, not improved sleep quality.

Experts recommend cognitive behavioral therapy for insomnia (CBT-I) as the safest and most effective long-term treatment. It can be delivered in person, online, or through apps such as the VA’s CBT-I Coach.

The authors note that healthcare systems could help by adding alerts to electronic health records, prompting doctors to justify sleep-aid prescriptions and highlighting non-drug treatments. They also suggest that physicians could receive periodic feedback on their prescribing habits to encourage safer practices.

The message is clear: helping seniors avoid sleep medications can lead to longer, healthier, more independent lives.

Sleep is important, but drugging yourself to get it, may be counter-productive. Try these less drug dependent approaches:

1. Cognitive Behavioral Therapy for Insomnia (CBT-I)

The gold standard, proven as effective—or more effective—than sleep medication.

What it does:
CBT-I targets the thought patterns, habits, and behaviors that keep insomnia going.

Key components:

• Fixing sleep schedules

• Reducing time spent awake in bed

• Challenging anxious thoughts about sleep

• Building strong sleep habits

Why it works:
Multiple large studies show that CBT-I improves sleep quality, reduces time to fall asleep, decreases nighttime awakenings, and keeps benefits long-term—unlike pills.

2. Strategic Light Exposure (Morning Light Therapy)

One of the strongest natural ways to reset your body’s clock.

What it does:
Morning light—sun or a lightbox—signals your brain to set the right circadian rhythm.

Benefits:

• Helps you fall asleep earlier

• Regulates melatonin release

• Improves sleep quality

• Helpful for insomnia, winter depression, and irregular sleep schedules

The science:
Clinical trials show that 20–30 minutes of morning light is highly effective for improving both sleep quality and daytime alertness.

3. Sleep Restriction Therapy (SRT)

Counterintuitive—but extremely effective for chronic insomnia.

What it does:
Temporarily reduces the hours you spend in bed to strengthen sleep drive.
Over time, increases sleep efficiency and consolidates sleep.

Example:
If you only sleep 5 hours but stay in bed 8, SRT narrows your sleep window to match the 5 hours, then gradually expands it as your sleep improves.

Evidence:
Repeated trials show remarkable long-term improvement, often matching or beating sleeping pills.

4. Stimulus Control Therapy

Retrains your brain to associate your bed with sleep—not anxiety or wakefulness.

Rules based on decades of research:

• Go to bed only when sleepy

• Get out of bed if awake more than ~15–20 minutes

• Use the bed only for sleep and sex

• Wake up at the same time daily

Why it works:
It breaks the cycle of lying awake, worrying, or “trying” to sleep—one of the core drivers of chronic insomnia.

5. Relaxation Training & Slow Breathing Techniques

Reduces the body’s arousal level so sleep comes naturally.

Methods with strong evidence:

• Progressive muscle relaxation

• Diaphragmatic breathing (slow belly breathing)

• 4–7–8 breathing

• Guided imagery

• Meditation and mindfulness

Effects shown in studies:

• Lower heart rate

• Reduced cortisol

• Calmer nervous system

• Faster sleep onset

• Fewer nighttime awakenings

Even brief daily practice can improve sleep within 2–4 weeks.

Behavioral strategies with strong evidence

(These strengthen the five primary treatments above.)

Keep a consistent wake time, even on weekends
Avoid screens 1–2 hours before bed
Reduce caffeine after noon
Keep the bedroom cool (60–67°F)
Exercise regularly (but not right before bed)

Finally, write down what you need to take care of the next day or what’s bothering you on a pad or journal next to your bed before you go to sleep.