If you’re very stressed and need help nodding off the night before an important work or social event, these pills can be a big help. There’s still a time and place for prescription and OTC sleep aids. Other experts agree that cognitive behavioral therapy for insomnia-which can include strategies like establishing a consistent sleep routine, purposely restricting time spent in bed or practicing mindfulness-based meditation-is the best way to cure insomnia. “Cognitive behavioral therapy should always be the first line of treatment,” she says. For these people, a sleeping pill is standing in the way of them finding a true remedy for the ailment.Įven for younger adults who can’t sleep because of stress, financial concerns or other sources of anxiety that are more difficult to treat, sleeping pills are a poor solution, she says. Many older adults may take sleeping pills because pain, nerve problems or other health issues are keeping them up at night, she says. “The real question is, why aren’t you sleeping?” Schroeck says. Both drugmakers define “long-term” use as anything beyond 28 days.Įven setting aside the potential risks and side effects, sleeping pills aren’t an effective long-term solution for insomnia. The prescribing inf ormation for Ambien notes that the drug’s use should be “re-evaluated” if a patient’s insomnia persists after seven to 10 days of treatment-guidelines echoed by the makers of Lunesta. The drugs are only meant to be used sparingly. More recent research, in both people and animals, has turned up more preliminary links to cancer. The authors also found associations between the use of hypnotics and specific types of cancer-notably, lymphomas and cancers of the lungs, colon and prostate-but they did not offer any cause-and-effect mechanisms that might explain the links. The drugs were also associated with car accidents, falls and depression-all of which could explain the elevated mortality risks. The authors of the study tried to control for pre-existing medical conditions and other factors that could explain why people taking these drugs died or developed cancer at higher rates than non-users. Even people who took these drugs sparingly-like once every few weeks-were more likely to die than those who did not take them at all. The researchers found that those who were prescribed more than 132 doses of these hypnotic drugs per year-meaning those patients taking them at least every two or three days-had a 35% increase in cancer risk and a five-fold jump in risk of death compared to those not prescribed these drugs. One observational study published in 2012 in the BMJ looked at electronic medical records data from more than 30,000 adults and the usage of common hypnotics, including zolpidem (sold under the brand name Ambien and others), temazepam (Restoril), eszopiclone (Lunesta), zaleplon (Sonata) and other barbiturates, benzodiazepines and sedative antihistamines. Mergenhagen says it’s very difficult for researchers to nail down the long-term risks associated with regular use of these drugs. (Mergenhagen was also a co-author on the Veterans Affairs sleep-aid study.) Headaches, dizziness, nausea, vomiting and hallucinations are a few of the short-term concerns associated with hypnotics-a class of prescription drugs designed to induce sleep that includes Ambien, Lunesta, Sonata and other popular meds, she says. “There are new reports of side effects coming out on a yearly basis,” says Kari Mergenhagen, a clinical pharmacist and adjunct instructor at the University of Buffalo. Prescription sleep aids carry their own risks. (To his knowledge, these studies are not being done.) “But the only way to 100% attribute a health issue to any specific treatment is through a randomized trial,” Maust says, referring to an experiment in which one group of people is given a drug and another is not. A more recent study from the UK turned up only “tentative” links, and its authors stated that more research is needed. The links between these OTC drugs and dementia are far from certain. For individuals who took these drugs about once every three days (or more), their dementia risks rose by 54% compared to people who did not take these types of medications. One 2015 study published in JAMA Internal Medicine found that over a 10-year period, people who regularly took the amount of diphenhydramine found in two Benadryl or two Extra Strength Tylenol PM pills roughly once every week or two were at significantly increased risk for dementia. “Another concern for which evidence is growing is that long-term use appears to increase the risk of dementia-and the more use, the greater the risk,” Maust says. There is also growing worry about another more-serious risk associated with these OTC drugs.
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