Saturday, March 17, 2012

Maryl swallows: The hard truth about sleeping pills

We just closed our unscientific poll on the sleep habits of second lifers and reported that we are a very, very tired demographic. And now we learn this week from the British Medical Journal (BMJ) that sleeping pills present more risks than rewards. They went online with a study that concluded patients using prescription sleep aids on a regular basis were nearly five times as likely to die over a period of two and a half years than non-users. Those using drugs periodically were at some risk too but heavy pill takers were even more likely to develop cancer. Yikes!

To be clear the research that comes out of the Viterbi Family Sleep Center at the Scripps Clinic in San Diego does not prove that these medications were the exact cause of these risks but that at the very least there’s a correlation between the two. Patients with sleep problems tend to have other health issues, such as cancer, heart disease, depression, to begin with or may develop them as a result of sleeplessness.

The study involved the use of benzodiazepine and barbiturate drugs and the more popular non-benzodiazepines, such as Ambien, Lunesta and Sonata. I’m often faced with the quandary at 2:30 in the morning whether to give in and take a pill and risk feeling groggy the next morning or to continue plumping my pillows and pretend sleep is imminent. I guess this study will help with that dilemma.

So where does that leave us? We’ve already had to rule out Hormone Replacement Therapy, which quelled night sweats and anxiety that can keep women awake at night. Over the years my doctor has prescribed several antidepressants, such as Zoloft and Effexor, the anti anxiety drug Xanax and Gabapentin, a drug used for seizures that also treats hot flashes. None of these were worth the morning after dizziness and drowsiness and they shouldn’t be used long term. Basically I’m not a comfortable pill taker. So at my last visit, my doctor tossed out “just take some Benadryl,” which targets allergic reactions and has quieted many a small child on those long car and plane trips.

Benadryl….I can do. It’ll work on my sinuses too. It’s also the PM component of Tylenol PM and other sedative antihistamines that several friends swear by. But then I read about the danger of anticholinergic drugs, which antihistamines as well as many other popular painkillers and antidepressants are classified as. The cumulative effect can be cognitive impairment and memory loss and heavy users had an increased death rate in a recent study conducted by the Norwich Medical School at the University of East Anglia in England. Oh no!

You can’t avoid some of these medications but you can be sure to make your doctor aware of all that you are or have been taking so that you don’t experience an anticholinergic overload. And they probably shouldn’t be prescribed to older patients who have likely been taking them regularly for many years already. If you would like to know which drugs fall under this classification (and sometimes ignorance is bliss), you can acquaint yourself with the Anticholinergic Burden Scale here. A score of three is the most serious.

So now where are we? Drugs are not bad unto themselves. It’s the frequency with which we take them and how we balance the variety of medicines that are now available for whatever ails us. But sleeplessness can be chronic. Maybe we should take those healthy sleep habit tips (no daytime napping, darkened room, etc.) we’ve often skimmed past more seriously? Learn from our rare friends who sleep like a baby? My 94 year old aunt told me at lunch today that the only time she remembers not being able to sleep was when she was a toddler. Her mother made her a cup of Ovaltine and tucked her in. Hm. Could be the Ovaltine that worked. Or just maybe it’s the being tucked in we all miss?


  1. I have recently taken up a breathing meditation technique that has helped a lot with sleeping better. You can buy the "mindfulness meditation" tape on amazon.

    1. Wait sounds familiar....and the CD is sitting on my stack of books. I'll dust it off and give it a try tonight. Thanks for the reminder.

  2. Oh, phooey. You know what else increases your risk of dying? Breathing! Oh, and taking all these studies to heart.

    I'm just as eager as the next person to live well and long, but the all of these studies really only benefit the researchers who get the grant money and the news media who get the publicity from promoting them. It's become an industry like any other.

    1. These studies can even contradict themselves. I'm trying the Tylenol PM anyway after the meditation CD or maybe both together...rough night last night!