DO YOU TAKE SLEEPING PILLS?

In a study just published, ‘Hypnotics’ association with mortality or cancer: a matched cohort study’ 27.2.12, it was established that medications commonly prescribed for insomnia, such as zolpidem, temazepam, eszopiclone, zaleplon, and other benzodiazepines, barbiturates and sedative antihistamines, significantly increased the risk of premature death and cancer.

The key messages from the study include:

* Patients receiving prescriptions for zolpidem, temazepam and other hypnotics suffered over four times the mortality as the matched hypnotic-free control patients.

* Even patients prescribed fewer than 18 hypnotic doses per year experienced increased mortality, with greater mortality associated with greater dosage prescribed.

* Among patients prescribed hypnotics, cancer incidence was increased for several specific types of cancer, with an overall cancer increase of 35% among those prescribed high doses.

The study also highlighted the evidence from controlled trials, which show that hypnotics, “Impair motor and cognitive skills, such as driving”. Therefore there is an increased risk of automobile crashes and an increase in falls, due to hangover sedation. In some patients, hypnotics increase sleep apnoea, prolong apnoeas or suppress respiratory drive, though among other patients, there may be mild improvement. Sleep apnoeas, in turn, may lead to motor vehicle crashes, hypertension, heart failure, arrhythmias, cardiovascular diseases and death. Hypnotics may cause somnambulistic night-eating syndromes resulting in poor diet and obesity as well as other automaton-like behaviours, which can be dangerous.”

The research team conducting the study concluded by saying that, “Receiving hypnotic prescriptions was associated with greater than threefold increased hazards of death even when prescribed less  than 18 pills per year”. They added “The meagre benefits of hypnotics, as critically reviewed by groups without financial interest, would not justify substantial risks.”

Sar Rooney’s Comment:  When I am treating a patient for insomnia, I will often prescribe medical-strength hypericum (St. John’s Wort) and/or high-strength Valerian, Skullcap, or other herbal medicines (I usually make up an individual herbal complex to suit the patient’s unique requirements) and, although these herbs are not without potential side-effects (e.g. Hypericum can interact with certain medications including the contraceptive pill), the side effects from herbal medicines are generally far less severe than those of pharmaceutical drugs, especially when prescribed correctly. More importantly, though when a patient is suffering from insomnia, I will try to determine the underlying cause of their sleeplessness, while providing them with symptomatic relief. I’ve found the causes of insomnia can vary quite a lot from stress and an overactive mind (which herbs are great for!) through to parasitic infestations, elevated blood sugar levels, hormone imbalances and the list goes on. If you or a loved one suffers from insomnia, consult your trusted naturopathic physician for advice. Don’t suffer in silence as sleep deprivation can have a huge affect on your short-term and long-term health and wellness.

Reference: BMJ Open2012;2:e000850 doi:10.1136/bmjopen-2012-000850