1: In the past month, nearly 10 million Americans have swallowed some type of sleeping aid.

This reality is unfortunate and dangerous, writes sleep expert Matthew Walker in Why We Sleep: Unlocking the Power of Sleep and Dreams: “Sleeping pills do not provide natural sleep, can damage health, and increase the risk of life-threatening diseases,” he writes.

Sleeping pills like Ambien and Lunesta “target the same system in the brain that alcohol does—the receptors that stop [our] brain cells from firing—and are thus part of the same general class of drugs: sedatives,” notes Matthew.  “Sleeping pills effectively knock out the higher regions of [our] brains cortex.”

The biggest problem with these types of drugs?  “Sedation” is not the same as “sleep.”  

“Don’t get me wrong,” he writes, “No one would claim that [we] are awake after taking prescription sleeping pills.  But to suggest that [we] are experiencing natural sleep would not be a true assertion,” writes Matthew.  “No past or current sleeping medications on the legal (or illegal) market induce natural sleep,” writes Matthew.  The type of sleep these drugs bring about lacks “the largest, deepest brainwaves.”  

2: The research on sleeping pills is not promising.  A team of leading medical doctors and researchers examined all published studies on these drugs, considering sixty-five separate drug-placebo studies involving 4,500 individuals.  While participants reported falling asleep faster and sleeping more soundly relative to the placebo, “that’s not what the actual sleep recordings showed,” Matthew writes.  “There was no difference in how soundly the individuals slept.  Both the placebo and the sleeping pills reduced the time it took people to fall asleep (between ten and thirty minutes), but the change was not statistically different between the two.  

“In other words, there was no objective benefit of these sleeping pills beyond that which a placebo offered,” Matthew notes.  “The committee concluded the report by stating that the effect of current sleeping medications was ‘rather small and of questionable clinical importance.'”

3: More alarmingly, studies by Dr. Daniel Kripke, a physician at the University of California, San Diego, show individuals who use prescription sleep medications are “significantly more likely to die and to develop cancer than those who do not,” Matthew writes.  Dr. Kripke analyzed data from more than 10,000 patients taking sleeping pills and contrasted them with 20,000 very well-matched individuals of similar age, race, gender, and background, who were not taking sleeping pills.

“Those taking sleeping pills were 4.6 times more likely to die over this short two-and-a-half-year period than those who were not using sleeping pills,” Matthew reports.  “Those individuals classified as heavy users, defined as taking more than 132 pills per year, were 5.3 times more likely to die over the study period than matched control participants who were not using sleeping pills.”

But even the infrequent users, defined as those taking eighteen pills per year, “were still 3.6 times more likely to die at some point across the assessment window than non-users,” notes Matthew.  “There are now more than fifteen such studies from different groups around the world showing higher rates of mortality in those who use sleeping pills.”

Reasons for these results include “increased risk for fatal car accidents,” Matthew writes.  “This could be due to the non-restorative sleep such drugs induce and/or the groggy hangover that some suffer, both of which may leave individuals drowsy while driving the next day.”

Other potential causes for the higher mortality rates include “higher-than-normal rates of infection,” higher risk of falling, especially among the elderly, and being “30 to 40 percent more likely to develop cancer within the two-and-a-half-year period of the study than those who were not,” notes Matthew.

Now, do these findings prove that sleeping pills cause cancer?  “No.  Absolutely not,” he writes.  “There are alternative explanations.  For example, it could be that the poor sleep that individuals were suffering prior to taking these drugs—that which motivated the prescription to begin with—and not the sleeping pills themselves predisposed them to ill health.  Moreover, the more problematic an individual’s prior sleep, perhaps the more sleeping pills they later consumed, thus accounting for the dose-dependent mortality and dose-carcinogen relationships Dr. Kripke and others observed.

“But it is equally possible that sleeping pills do cause death and cancer,” writes Matthew.  “To obtain a definitive answer we would need a dedicated clinical trial expressly designed to examine these particular morbidity and mortality risks.”

Matthew concludes with his “scientific, though non-medical, opinion: I believe that the existing evidence warrants more transparent medical education of any patient who is considering taking a sleeping pill, at the very least.  This way, individuals can appreciate the risks and make informed choices.”

He emphasizes that he is not “anti-medication.  On the contrary, I desperately want there to be a drug that helps people obtain truly naturalistic sleep. . . As a researcher, I am keen to help science explore new medications in carefully controlled, independent studies.  If such a drug—one with sound scientific data demonstrating benefits that far outweigh any health risks—is ultimately developed, I would support it,” he writes.  “It is simply that no such medications currently exists.”

More tomorrow.

__________________

Reflection: Are there people I know who are taking sleeping pills?

Action: Share this information with them.

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