Do Prescription Sleep Medicines Even Work?

By Serena McNiff
HealthDay reporter

WEDNESDAY, May 12, 2021 (HealthDay News) – An estimated 9 million Americans turn to prescription pills when they can’t sleep, but a new study of middle-aged women finds that taking the drugs for a year or more can do little good.

Comparing a group of about 200 women who took medication for sleep problems with more than 400 women who had problems sleeping but weren’t taking medication, researchers at Brigham and Women’s Hospital in Boston found that sleeping pills do not appear to be of long-term benefit. use. After a year or two of sleeping pills, women in the drug group did not sleep better or longer than those who weren’t on medication.

“The simple conclusion is that long-term use of sleeping pills does not have a clear benefit when it comes to chronic sleep problems,” said study author Dr Daniel Solomon, rheumatologist and epidemiologist. at Brigham and Women’s.

Although Solomon doesn’t usually focus on sleep-related issues, he was inspired by years of seeing patients with insomnia. “Usually I could give a patient a week’s worth of sleeping medication, and sometimes they end up coming back with long-term use, and they still complain of sleep issues,” he noted.

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The findings come from a U.S. National Institutes of Health database that has followed thousands of women to examine how middle age and menopause affect their mental and physical health.

Menopause, when women stop producing certain female hormones and stop having monthly periods, is well known to cause insomnia. Many women experience problems sleeping in the years leading up to menopause and menopause itself.

Solomon’s research team identified women in this database who reported sleeping problems, such as waking up too early and having difficulty falling asleep and staying asleep.

“All of the women in our study had reported trouble sleeping. Some of them started medication and some didn’t, and then we followed them longitudinally a year later and two years later,” Solomon said. “We asked them about their regular medication use at each annual visit, and we also asked them about sleep disturbances using a well-described sleep disturbance scale.”

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Since the study mainly consists of annual checks with participants, it can only show how these drugs work in the long term. However, clinical trials support that for a short time these drugs help people sleep.

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“There are good randomized controlled trials that say sleeping pills help over a few weeks or months,” Solomon said. “But, it turns out that around 35% to 40% of people who start using them use them a year later. So the typical way they are used – that is, chronically – n ‘has not been well studied in the trials. “

The new report was published online on May 11 in the journal BMJ open.

Commonly prescribed sleeping pills include benzodiazepines and “Z drugs” such as zolpidem (Ambien) and eszopiclone (Lunesta), some of which are intended to promote drowsiness while others are primarily used to calm anxiety.

These drugs are believed to work by altering the levels of chemicals in the brain, called neurotransmitters, which keep you alert during the day and relaxed at night, said sleep medicine specialist and member Dr Fariha Abbasi-Feinberg. American Academy of Sleep Medicine. Board of Directors.

Like most medications, sleeping pills are not without risks. According to Solomon, the most commonly cited problems are daytime sleepiness and problems with balance or falling, especially when a medicated person gets up in the middle of the night to use the bathroom. Addiction is a problem because people can become addicted to their sleeping pills. There may also be a link between sleeping pills and memory problems later in life.

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“If you’re going to use sleeping pills, you really have to think of them as short-term or very intermittent medications,” Solomon said. “Use them for a week, or a few nights here and there. But once you start using them long-term, it’s not like they cure your sleep problems.”

Although Solomon is not a sleep expert, he said his colleagues in the field recommended “improving sleep hygiene” to address persistent sleep problems.

“It’s about making sure you’re tired when you fall asleep, have limited your caffeine intake during the day, and restricted screen use at bedtime,” Solomon said. “Occasional use of sleeping pills or supplements can help, but they should not become chronic treatment for your sleep problems.”

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When changing sleep patterns isn’t enough, Abbasi-Feinberg said cognitive behavioral therapy is a potentially effective option for people with insomnia.

“Cognitive behavioral therapy for insomnia helps us reframe our sleep problems,” Abbasi-Feinberg said. “It addresses all the thoughts and behaviors that keep you from sleeping well. It helps you learn new strategies to sleep better, and it can also help you reduce stress, relax, manage your schedule.”

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Abbasi-Feinberg said she is approaching the treatment of sleep problems as a mystery. “You have to fix the problem and see what’s going on with each person, and then make a long-term decision,” she said.

More information

The US Centers for Disease Control and Prevention has tips for better sleep.

SOURCES: Daniel Solomon, MD, chief, clinical sciences section, division of rheumatology, Brigham and Women’s Hospital, Boston; Fariha Abbasi-Feinberg, MD, Member, Board of Directors, American Academy of Sleep Medicine, Sleep Medicine Specialist, Millennium Physician Group, Fort Myers, Florida; BMJ open, May 11, 2021, online

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