Q: I’ve heard that sleeping pills are dangerous. Are there any “safe” sleeping pills you can take?
Nearly 1 in 3 Americans will have trouble sleeping tonight, and 1 out of every 10 of us will take something to help us sleep. The older we get, the more trouble we have sleeping: insomnia is twice as common in elderly people. People who travel across time zones or work at night face the disruption of their sleeping and waking cycles.
There are 3 ways people experience problems with sleep: not being able to fall asleep, not being able to stay asleep, and not feeling rested after sleeping.
People experiencing physical discomfort such as pain, shortness of breath, heartburn or bladder problems have more trouble getting good sleep. Emotional upset also has an impact, especially anxiety or depression. In addition, many medicines have side effects that can interfere with sleep.
Concern about taking sleeping pills is not new. There have been several studies in the past showing that those who take a prescription medicine for sleep are more likely to die than those who don’t.
One recent study published a couple of months ago in the British Medical Journal concluded that those who were prescribed sleeping pills were more likely to die than those who didn’t take them, and the more doses they received, the higher their chances of dying. The study kept track of how many doses were dispensed to each participant; those who averaged more than 11 doses of a sleeping pill per month were 5 times more likely to die during the 2.5 years of the study than those who didn’t receive any.
Sixty per cent of the sleeping medicine in this study was either zolpidem, a popular fast-acting medicine also known by its brand name, Ambien®, or temazepam, an older sleeping medicine related to Valium®. The other 40% included a variety of other prescription medicines.
How would taking a prescription to help you sleep increase your chances of dying? One possiblity is that those who ask for something to help them sleep are sicker; they have more serious health problems than others. Another possibility is related to the side effects of these medicines, especially in older people: they can suppress breathing, especially dangerous if you have breathing problems, heart problems or sleep apnea. These medicines also cause problems with balance, contributing to falls resulting in head injury or hip fractures.
Most medicines for sleep should never, ever be taken with alcohol. This combination is a deadly one! Alcohol plus a sleeping pill can slow down your breathing enough to kill you.
Are there any safe sleeping medicines that you can take? It’s best if you avoid prescription sleeping medicine completely. Most prescription medicines for sleep were only studied for 6 months, yet people take them for years.
If you are trying to cut down on your medicine for sleep, try this: take only half the dose of a sleeping pill to start and put the other half out where it is easy to find. If you are still awake after 30-45 minutes, go ahead and take the other half.
Ask your medical provider or pharmacist if occasional use of a non-prescription sleeping aid would be safe for you to use. Diphenhydramine and doxylamine are antihistamines commonly used for sleep and are not prescriptions. Tylenol PM® has diphenhydramine in it to encourage sleep in addition to acetaminophen for minor aches.
Here are some suggestions to help you sleep better without adding a sleeping pill to your life or to your pillbox:
1. If physical or emotional discomfort is keeping you awake, getting treatment will improve your sleep. As the underlying cause of it improves, your sleep should improve as well. A mild pain medicine such as acetaminophen in the evening may also help.
2. Avoid drinking caffeinated beverages or taking medicines that have a stimulant effect in the evening or at night. Prescription medicine such as bupropion, prednisone, or decongestant tablets like Sudafed® can cause also sleeplessness.
3. If you take a water pill for blood pressure or swelling, take it in the morning. If you have to take it twice a day, avoid taking it after 3 pm if possible.
4. Physical exercise is a wonderful stress reliever and can help you rest better, that is, if you avoid activity binges like moving large boxes all day or strenuous physical activities.
