Problems sleeping? Go to a therapist, try melatonin or magnesium or tryptophan. If at all possible try to avoid pharmacological sleeping aids. Researchers at the American Scripps Clinic Viterbi Family Sleep Center discovered that even among people who only occasionally take a sleeping pill the mortality risk is four times higher than among non-users.
More and more studies are showing that sleep is crucial to health. People who get enough good quality sleep synthesise larger amounts of anabolic hormones and they are fitter, more attractive and live longer.
If you sleep badly, but believe the pharmacological studies that say sleeping pills will make you healthier, you could be making a serious mistake, according to the study that Daniel Kripke, Robert Langer and Lawrence Kline published in BMJ Open. The researchers’ interest was piqued by 24 previous studies on the relationship between death and sleeping pills. Of these 18 concluded that sleeping pills increase risk of death.
The researchers collected data on over 10,000 users of sleeping pills from the medical databank of Pennsylvania state. The average age of the users was 54, and they were monitored for over two years. The researchers compared the sleeping pill users with 20,000 non-users.
Even people who only occasionally used sleeping pills – up to 18 times a year – were 3.6 times more likely to die than the non-users, the researchers discovered. The higher the use of sleeping pills, the greater the chance of death.
One risk factor was age. The older the users, the more likely they were to die, as the figure above shows. There was little difference between the different sleeping pills that the researchers studied: zolpidem, temazepam, eszopiclone, saleplon, barbiturates or anti-histamines were all equally unhealthy.
The researchers were unable to work out from their results how sleeping pills increase mortality risk. They did discover that sleeping pills double the risk of cancer, but that effect was too small to explain the total effect. The researchers suspect that sleeping pills increase the frequency of sleep apnoea, which as a result increases the risk of cardiovascular disease. On top of that sleeping pills make people drowsy, as a result of which people are more likely to have accidents, and users suffer more from stress, suggesting their immune system becomes weakened.
On the basis of their study the researchers estimate that in the US alone 300,000 to 500,000 people die as a result of taking sleeping pills.
They suggest that doctors and consumers need to start reducing the use of hypnotics as they are called. In the long term their effect has been shown to be negligible. [BMJ. 2005 Nov 19;331(7526):1169.] [J Gen Intern Med. 2007 Sep;22(9):1335-50.]
“The meagre benefits of hypnotics, as critically reviewed by groups without financial interest, would not justify substantial risks”, the researchers write. “A consensus is developing that cognitive-behavioural therapy of chronic insomnia may be more successful than hypnotics.” [Arch Intern Med. 2004 Sep 27;164(17):1888-96]
Hypnotics’ association with mortality or cancer: a matched cohort study.
An estimated 6%-10% of US adults took a hypnotic drug for poor sleep in 2010. This study extends previous reports associating hypnotics with excess mortality.
A large integrated health system in the USA.
Longitudinal electronic medical records were extracted for a one-to-two matched cohort survival analysis.
Subjects (mean age 54?years) were 10?529 patients who received hypnotic prescriptions and 23?676 matched controls with no hypnotic prescriptions, followed for an average of 2.5?years between January 2002 and January 2007.
MAIN OUTCOME MEASURES:
Data were adjusted for age, gender, smoking, body mass index, ethnicity, marital status, alcohol use and prior cancer. Hazard ratios (HRs) for death were computed from Cox proportional hazards models controlled for risk factors and using up to 116 strata, which exactly matched cases and controls by 12 classes of comorbidity.
As predicted, patients prescribed any hypnotic had substantially elevated hazards of dying compared to those prescribed no hypnotics. For groups prescribed 0.4-18, 18-132 and >132 doses/year, HRs (95% CIs) were 3.60 (2.92 to 4.44), 4.43 (3.67 to 5.36) and 5.32 (4.50 to 6.30), respectively, demonstrating a dose-response association. HRs were elevated in separate analyses for several common hypnotics, including zolpidem, temazepam, eszopiclone, zaleplon, other benzodiazepines, barbiturates and sedative antihistamines. Hypnotic use in the upper third was associated with a significant elevation of incident cancer; HR=1.35 (95% CI 1.18 to 1.55). Results were robust within groups suffering each comorbidity, indicating that the death and cancer hazards associated with hypnotic drugs were not attributable to pre-existing disease.
Receiving hypnotic prescriptions was associated with greater than threefold increased hazards of death even when prescribed <18 pills/year. This association held in separate analyses for several commonly used hypnotics and for newer shorter-acting drugs. Control of selective prescription of hypnotics for patients in poor health did not explain the observed excess mortality.
PMID: 22371848 [PubMed] PMCID: PMC3293137