Which sleep aids are listed among inappropriate medications for delirium due to CNS effects?

• A. Z-drugs (eszopiclone, zaleplon, zolpidem)
• B. Anticholinergics
• C. Corticosteroids
• D. Opioids

Answer: (A)

The main idea is that delirium in older adults is often worsened by drugs that depress the central nervous system. In the Beers Criteria, sleep aids that can exacerbate delirium due to their CNS effects are specifically discouraged. The nonbenzodiazepine hypnotics—the Z-drugs (eszopiclone, zaleplon, zolpidem)—are listed as inappropriate when delirium risk is present because they can cause confusional states, excessive sedation, and increase fall risk.

Other options may contribute to delirium (anticholinergics, corticosteroids, opioids), but they are not sleep aids, so the focus here—sleep-inducing meds flagged for delirium risk—points to the Z-drugs as the best answer. In practice, for delirium risk, nonpharmacologic sleep strategies are preferred, and if meds are needed, they should be avoided or used with great caution.