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Sleeping Pills and Death Risk
Sleeping Pills Linked to Almost Fourfold Increase in Death Risk
By LARA SALAHI Feb. 27, 2012

Sleeping pills prescribed by your physician are supposed to ward off the myriad health problems that come with lack of sleep.

But adults who take sleeping pills in even small numbers over their lifetimes may be nearly four times more likely to die earlier compared to those who are not prescribed sleeping pills, according to new findings published Monday in the British Medical Journal. And those prescribed sleeping pills may also be more likely to be diagnosed with cancer, the study found.

Researchers looked at electronic medical records of nearly 35,000 patients, fewer than half of whom took such FDA-approved sleep medications as Ambien, Restoril, Lunesta, and Sonata. They found that even those who look fewer than 18 sleeping pills a year were at greater risk of death, compared to those who were not prescribed sleeping aids.

An estimated 50 to 70 million Americans suffer from insomnia and other sleep disorders, which can keep them from functioning normally during the day. Untreated sleep disorders can lead to conditions like obesity, diabetes, heart disease and stroke.

Such consequences from sleep disorders leave many doctors asking whether the findings from this study really suggest that sleeping pills are to blame, or whether those who take sleeping pills are at higher risk because of health conditions that potentially brought on the sleeping problems.

The study did not say why the patients were prescribed the sleeping medications, whether the patients were evaluated by a sleep specialist, or whether they were also undergoing other types of treatment for any underlying health conditions -- all important factors when weighing an increased risk of death, said Dr. Steven Scharf, professor of medicine at the University of Maryland in Baltimore.

"Most chronic conditions, including cancer, are associated with insomnia and mortality," said Scharf. "Who knows what the cause here was?"

Six to 10 percent of Americans were prescribed sleeping pills in 2010, according to the study.

Sleep disorders can also be considered symptoms of underlying mental and physical conditions.

In fact, those in the study who were prescribed sleeping medications had higher rates of heart disease, diabetes and other conditions which may contribute to sleeplessness.

"I think the underlying conditions which may require sedative-hypnotics are the culprits, not the medicines themselves," said Dr. Scott Nelson, a family practice physician at Cleveland Family Medicine.

Many experts said these findings should not prompt patients to stop taking their medications.

"I think sleeping pills are helpful when there are short term stressors," said Dr. Richard Colgan, associate professor in the department of family and community medicine at the University of Maryland School of Medicine.

Sleeping pills can be helpful for those who work unusual shifts, and for those who travel across time zones, said Colgan.

But the medications are not without side effects -- including drowsiness, impaired judgment, depression and heart problems. Misuse can be fatal. And, according to Dr. Lee Green, a professor in the department of family medicine at the University of Michigan, the risks outweigh the benefits.

Medication to treat sleeplessness is not as important as treating the underlying condition, he said.

"Sedation worsens sleep apnea, for example, and we know sleep apnea is associated with risk of death," said Green. "We tend to think that a sleeping pill once in a while is harmless, but there's no such thing as a medication free of risk."

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(05-05-2012, 10:51 PM)zonk Wrote: ..."Sedation worsens sleep apnea, for example, and we know sleep apnea is associated with risk of death," said Green. "We tend to think that a sleeping pill once in a while is harmless, but there's no such thing as a medication free of risk."

I am glad that this information is becoming more widely known. I especially like the last quote about no such thing as a medication free of risk.

Our society has grown accustomed to having a pill to fix anything, and occasionally a pill IS the only answer. However, 9 times out of 10, a pill should be a last resort, or at most a stop gap measure. Far better to fix the underlying problem if possible (some medical problems are not fixable, and therefore we have to make due with drugs, all of which have side effects).

As most everyone here probably already knows, sleep disorders are only inadequately addressed, even in the medical profession. Sleep impaired driving or machine operation is a major public health issue on par with alcoholism and drug abuse.

Assuming no major sleep pathology (such as sleep apnea) sleep hygiene is critical for good sleep (dark, quiet, regular time, etc)

As for shift work, I wish I could waive a wand and make all night shifts illegal. However, until that happens, sleep scheduling is very important, and should not be random. Ideally, it should not change too frequently and when it does, it should be in a fall back mode (moving from day shift to late shift to nights in steady progression, not the other way around). Lights and other external cues can help, but even after all this, there are documented unavoidable health risks to night shift working. And it doesn't help that other family members are seldom on the same shift, thus temping the employee to stay up longer than normal or try to participate in daytime activities as well.

Short term cognitive behavioral therapy can help in some cases (for example depression or support in dealing with sleep hygiene issues) and is at least as effective as medication in the long term, although it can be combined with sedative hypnotic sleeping pills in the short term.

Pills are a last resort, and as the article shows have many serious side effects not highlighted by most TV commercials (sleep driving, sleep sex, amnesia, etc etc). Think Tiger Woods and others like him. And none of them really induce truly normal sleep. Even the short acting ones which address the issue of delayed onset sleep insomnia have more effect than we would like.

The amnesia part is doubly important if it allows someone to forget they have already taken a pill and they take it again, especially when combined with pain relievers they can be deadly. Think Heath Ledger or others -- for example probably unintentionally overdosing due to a combination of back pain medication and a sleeping pill.

The medical profession does not really understand why we sleep. It's more than just resting. Forcibly preventing sleep (as in torture chambers) can induce insanity, but we really don't understand why. We're getting better and better theories about it, but until we know more, it's safer not to mess with mother nature by adding to the confusion with pills in my opinion, and definitely not using pills that are just new to the market. I usually wait 5 years before prescribing any non-life-saving medication, and rarely would recommend even short term use of a sedative hypnotic in any case. Let other doctors treat their patients like guinea pigs. I won't take sleeping pills myself. Far rather go without sleep.
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i have been taking Ambien for several years and in no way like taking them but not taking means i dont sleep,there are times even when taking these i cant go to sleep and i have to take a Ambien and something else with it such as pm type medication,i wish i never had to use but went years feeling tired all the time and sleep only 2 or 3 hours a night on a lucky night sometimes on the 3rd or 4th night get a little more than that.
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I just wonder what they are calling "sleeping pills". Does this study include antidepressants and antihistamines?
Many people take them for sleep.

The cancer association is interesting, but you have to wonder if you already have cancer making your sleep problem so bad that you need a sleeping pill in order to fall asleep. Obviously, not all patients with sleep problems have cancer. But I would bet a lot of cancer patients, have pain and trouble sleeping enough to seek out a sleeping pill.
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Or maybe the study just shows that healthy people who don't need sleeping pills live longer than unhealthy people who need sleeping pills.

I guess I should wade through the actual study and see if they adequately addressed that question.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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Thirteen years ago I was prescribed a sleeping medication to help me get used to Cpap (In hindsight where was the logic in that?)
I do sometimes suffer with insomnia and take 5-htp which I purchase from a local Health Food Supplier (As I understand it, it's a suppliment that 'Assist's' the conditions for restful sleep, sort of a sleep food!)
Some very serious issues raised though guys!
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(08-15-2012, 02:33 AM)Podd Wrote: Thirteen years ago I was prescribed a sleeping medication to help me get used to Cpap (In hindsight where was the logic in that?)

As a temporary measure to let your body adjust to CPAP therapy? Yes, I see a lot of sense in that.
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