Sleeping Pills: A Risky Night’s Sleep

by Candace Rowell on March 5, 2012

My family loves sleeping pills. At least the women do. My mom, my grandma, and I’m pretty sure at least one of my aunts [the other one is secretive about her medication usage] all take a sleeping pill several nights a week before they hit the sack. Ambien is their drug of choice.

Until now, I’ve never thought about the health consequences of taking prescription sleeping pills. I’ve watched my family get “loopy” [which is actually very funny] as the drug starts to take effect but I’ve never considered that these pills could be causing my family any harm. Research suggests that I should.And so should the other 6 to 10% of Americans who use prescription sleep medications.

The Study

The study involved 224,757 patients over the age of 18 [the average patient age was 54]. The study specifically focused on 2 common sleep medicines certified by the U.S. Food and Drug Administration (FDA): zolpidem (Ambien) and temazepam (Restoril). The case-control study followed patients who used prescription sleeping pills and compared their health outcomes [cancer/death] to patients who did not use sleeping pills. For each prescription pill user, two individuals who did not use sleeping pills were also followed [controls were chosen based on similarities in age, sex, height, weight, smoking status, and health status-including presence of certain chronic diseases].  To account for confounding factors that are often associated with increased risk of cancer, the study controlled for age, sex, BMI, marital status, ethnicity, and self-reported alcohol use and smoking status. Patients with any previous or current cancer diagnosis were excluded from the study. Patients receiving the prescription sleeping medicines for purposes other than sleep aid were also excluded.

The Results

The results indicate that even at low levels of use [as little as 1 to 18 pills per year] there is an increased risk of death.  Deaths during the 2.5 years of the study were 3 times greater in those who did receive sleeping pill prescriptions versus those who did not.  As the amount of pills per year increased [the highest amount recorded was greater than 132 pills per year], so did the risk of death; indicating a dose-response relationship.  For those who took more than 132 pills per year, the risk of death was 5 times more than those who took no prescription sleep aids.

The study also directly correlated prescription sleeping pill usage with increased cancer incidence. Those who reported more than 132 doses per year were at 35% more likely to be diagnosed with cancer during the study period.

The Limitations

The limitations of this study should be noted: the study could not establish a causal relationship between prescription sleeping pill use and death and cancer. The study can only associate usage with increased risk. To establish a causal relationship between prescription pills and death or cancer a randomized control trial comparing subjects taking sleep medicines with individuals taking placebo pills would be necessary. This is noted by the authors.

The short follow-up period [2.5 years] has been critiqued as being insufficient to accurately determine if cancers are newly developed as a result of sleep medication usage since most cancers take many years to develop after exposure.

The Take Home Message

Millions of Americans depend on prescription sleeping pills in order to get their nightly beauty sleep. Research suggests these medicines are associated with increased risk of death and cancer. More research is needed to determine a definite causal relationship between prescription sleeping pill use and death and/or cancer.

I’m not going to tell my family to stop taking their medicines. But I will tell them to be aware of the risk [every medication comes with some risks]. And I am going to suggest some non-medication techniques that may help reduce their need for sleeping medicine. According to this study- lower your usage of prescription sleeping pills, lower your risk.

Tips for battling sleepless nights:
http://helpguide.org/life/sleep_apnea.htm
http://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea/names.html
http://www.wisegeek.com/what-can-i-do-to-reduce-insomnia.htm

Image: By Entheta (Own work) [Public domain], via Wikimedia Commons

http://commons.wikimedia.org/wiki/File%3AStilnoct2.JPG

http://upload.wikimedia.org/wikipedia/commons/b/b3/Stilnoct2.JPG

Patricia March 7, 2012 at 8:42 am

Nice post. Well written and with the exact amout of information to understand the problem but not becoming alarmistic. Your final line is good.

Candace Rowell March 8, 2012 at 1:19 pm

Thanks Patricia!

Angela March 8, 2012 at 10:56 am

Really interesting – and worrying, considering the numbers of people affected. My only experience with sleeping aids is valerian and hops tea, which does not seem to work for me, but completely knocked out my former housemate (she has now upgraded to ‘hops only’ in the form of beer). Therefore, the dangers of prescription variants have completely gone under my radar. Thanks for writing about this!

Candace Rowell March 8, 2012 at 1:21 pm

Hey Angela, I also don’t have much personal experience with sleeping aids, but as I mentioned, my family is well experienced! This topic seemed really interesting just based on the amount of people who use prescription pills to sleep. Glad you enjoyed the read.

Rick March 21, 2012 at 8:52 am

Found a small typo:
I should.And so [add a space before "And"]

I used to suffer from insufficient sleep: If I just tried to go to sleep I’d lie awake for hours; if I read a novel I’d get engrossed in the novel and read for a few hours, leaving not enough time for sleep. I hit upon a solution by accident: listening to podcasts. I figure the reason is that I find them interesting enough to keep my attention and thus stop me thinking about work, but not as engrossing as reading.

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