Not getting enough sleep can impact several areas of a person’s life — so it’s really no surprise that people are looking for solutions to what can become a chronic and debilitating problem.
But before you pop a sleeping pill, there are a few things you need to know.
Sleeping pills in America
According to a new survey from Consumer Reports, more than one-third of U.S. adults who complained of sleep problems at least once per week said they turned to over-the-counter or prescription sleep drugs in the past year.
And it’s not like these were drugs bought on the black market or anything — the Food and Drug Administration has approved them to treat sleeping problems, meaning it was determined that the benefits of the drugs outweigh the risks. But do they?
“Those benefits aren’t as great as many people assume, and the drugs have important harms,” said Lisa Schwartz, M.D., a drug-safety expert at Dartmouth College’s Geisel School of Medicine, who has worked with Consumer Reports Best Buy Drugs on investigating sleeping-pill effectiveness and safety.
The misuse of sleeping pills is considered one of these potentially harmful effects. Consumer Reports’ survey found that about 50% of the people who take sleeping aids use them in potentially harmful ways. This may mean taking more than they should, taking the drugs longer than recommended or mixing them with other drugs or supplements that could create a dangerous combination.
How well do sleeping pills really work?
One study on the effectiveness of a new insomnia drug called Belsomra found the following results:
- People who took a 15- or 20-milligram dose of Belsomra every night for three months fell asleep just 6 minutes faster on average than those who took a placebo. Those on Belsomra slept on average only 16 minutes longer than people given a placebo.
- Instead, more people who took Belsomra reported that they felt drowsy the next day than those who took a placebo.
A previous study on the effect other sleeping medications found similar results:
- After studying the effect of other prescription sleep drugs — including eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien)—researchers found that they, too, provided modest benefits.
- People who took these drugs fell asleep, generally, between 8 and 20 minutes faster than when a placebo was taken.
And according to Consumer Reports’ research and analysis, over-the-counter sleep aids, such as Advil PM, Nytol, Sominex, Tylenol PM, and ZzzQuil, aren’t really any better at helping people fall asleep — or stay asleep — than newer, prescription drugs.
Potential risks of sleeping pills
Sleeping pills can pose a variety of dangers and can also come with some unpleasant side effects.
“These drugs are known to have a hangover effect that impairs coordination and balance into the next day, especially in older adults,” says Ariel Green, M.D., a geriatrician at the Johns Hopkins University School of Medicine in Baltimore.
Even when taken as directed, in the recommended dose, sleeping pills can still cause next-day drowsiness.
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“People take sleeping pills hoping that they will function better the next day,” Schwartz says. “But some people actually end up functioning worse—so drowsy, in fact, that driving can be dangerous—because the effects of the drug can linger.”
A recent study published by the American Journal of Public Health found that people prescribed sleeping pills were around twice as likely to be in car crashes as other people. On top of that, people taking sleeping pills were also just as likely to have a car crash as those driving with a blood alcohol level above the legal limit.
And to address these potentially dangerous side effects, the FDA’s recommended doses for Ambien and Lunesta are now half what they used to be.
Research shows that over-the-counter sleep aids can also pose risks, including daytime drowsiness, confusion, constipation, dry mouth, and problems urinating.
The recommended uses for sleeping pills
According to Nathaniel Watson, M.D., president of the American Academy of Sleep Medicine, sleeping pills should really just be used to treat certain conditions or in specific situations. Watson says these drugs should be reserved for short-term insomnia — which may be caused by jet lag, anxiety after the death of a loved one or anxiety caused by job loss.
Even in these situations, Consumer Reports suggests following these precautions when taking prescription or over-the-counter sleep medications:
- Tell your doctor about all of the medications you take, including supplements. Many common drugs, such as certain antibiotics and antidepressants, can interact dangerously with sleep drugs.
- Take the drugs only if you have time for at least 7 or 8 hours of sleep. Even if you’ve had that much sleep, don’t drive if you feel drowsy.
- Do not take an extra dose if you wake up in the middle of the night.
- Never mix sleeping pills with alcohol, recreational drugs, or other sleep drugs or supplements, including over-the-counter nighttime pain relievers and antihistamines, such as Benadryl Allergy, that contain the sedative diphenhydramine.
- Start with the lowest recommended dose, especially until you know how the drug affects you.
- Be cautious about frequent use. Taking sleep drugs regularly can breed dependence and raise the risk of adverse effects.