Do Even Prescription Sleep Medications Work?

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By Serena McNiff
HealthDay Reporter

WEDNESDAY, May 12, 2021 (HealthDay News) – An estimated 9 million Americans use prescription pills when they can’t to sleep, but a new study on middle-aged women finds that taking drugs for a year or more may be of little use.

Comparing a group of about 200 women who received medication for sleep problems with more than 400 women who had sleep problems but did not take medication, researchers at Boston’s Brigham and Women’s Hospital found that medications for sleep problems Sleep does not seem to be beneficial in long term use. After a year or two of taking sleep medications, the women in the medication group slept neither better nor more than those who were not on medication.

“The simple conclusion is that long-term use of sleep medications does not have a clear benefit with respect to chronic sleep problems,” said study author Dr. rheumatologist and Brigham and Women epidemiologist.

Although Solomon does not usually focus on sleep-related issues, he was inspired by years of seeing patients struggling with him. insomnia. “Normally, I could give a patient a week of sleeping pills and sometimes they end up coming back with long-term use and still complaining of sleep problems,” he noted.

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The results were derived from a database of U.S. National Institutes of Health that has tracked thousands of women to see how middle age and menopause affect their mental and physical health.

Menopause, when women stop producing certain female hormones and stop having a monthly period, is well known to cause insomnia. Many women experience sleep problems during the years before menopause and the menopause itself.

The Solomon research team identified in this database women who reported sleep problems, such as waking up too early and having difficulty falling asleep and falling asleep.

“All the women in our study had reported sleep disorders. Some of them started a medication and some didn’t, and then we followed them longitudinally a year later and two years later,” Solomon said. “We asked them about their regular use of medications at each annual visit and we also asked them about sleep disorders using a well-described sleep disorder scale.”

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Since the study consists mainly of annual records with participants, it can only show how these drugs work in the long term. Despite this, clinical trials support that for a short time, these drugs help to sleep.

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“There are good randomized controlled trials that say sleep medications help for a few weeks or months,” Solomon said. “But it turns out that between 35% and 40% of people who start using them use them a year later. Therefore, the typical way to use them – that is, chronic – has not been well studied. in the essays “.

The new report was published online in the journal on May 11th BMJ Open.

Usually prescribed sleep medications include benzodiazepines and “Z medications” such as zolpidem (Ambien) and esopiclone (Lunesta), some of which are intended to promote sleep, while others are used primarily to relieve anxiety.

These drugs are believed to work by altering the levels of brain chemicals, called neurotransmitters, that keep you alert during the day and relaxed at night, said Dr. Fariha Abbasi-Feinberg, a sleep medicine specialist and member of the American Academy of Sleep Medicine Board of Directors.

Like most medications, sleep medications are not without risks. According to Solomon, the most frequently cited concerns are daytime sleepiness and balance or fall problems, especially when a medicated person gets up in the middle of the night to go to the bathroom. Dependence is a problem as people can depend on their sleeping pills. There may also be a link between sleep medications and later life problems.

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“If you’re using sleep medications, you really have to think of them as short-term or very intermittent medications,” Solomon said. “Use them for a week or a couple of nights here and there. But once you start using them long-term, it’s not like they’re healing for your sleep problems.”

Although Solomon is not a sleep expert, he said his colleagues in the field recommend “improving sleep hygiene” to solve ongoing sleep problems.

“It’s about making sure you’re tired when you go to bed, that caffeine use has been restricted during the day, and screen use has been restricted during bedtime.” , said Solomon. “Occasional use of medications or sleep supplements may be helpful, but they should not become a chronic treatment for your sleep problems.”

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When changing sleep habits is not enough, Abbasi-Feinberg said cognitive behavioral therapy is a potentially effective option for people with insomnia.

“Cognitive-behavioral therapy for insomnia helps us rethink our sleep problems,” Abbasi-Feinberg said. “It addresses all the thoughts and behaviors that keep you from sleeping well. It helps you learn new strategies for better sleep and can also help reduce stress, relax, and manage your schedule.”

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Abbasi-Feinberg said he addresses the treatment of sleep problems as a mystery. “You have to solve the problem and see what happens to each person and then make a long-term decision,” he said.

More information

The U.S. Centers for Disease Control and Prevention has done just that tips for better sleep.

SOURCES: Daniel Solomon, MD, Head of Clinical Science Section, Rheumatology Division, Brigham and Women’s Hospital, Boston; Fariha Abbasi-Feinberg, MD, member, board of directors of the American Academy of Sleep Medicine, sleep medicine specialist, Millennium Physician Group, Fort Myers, Florida; BMJ Open, May 11, 2021, online



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