Millions of Americans take millions of sleeping pills every year — a sign, many experts say, that human beings weren’t designed to live in a wired world of constant stimulation.
All those highly addictive pills, meanwhile, have potentially serious side effects. So this week the Food and Drug Administration stepped up with a warning.
“Rare but serious injuries have happened with certain common prescription insomnia medicines,” the agency said, including while people are “sleepwalking, sleep driving, and engaging in other activities while not fully awake.”
The FDA is now requiring that the most commonly prescribed sleeping pills carry a notice that these meds may be more dangerous than people realize. It singled out Ambien, Lunesta and Sonata as being particularly worrisome.
How serious is the problem? Government researchers found 66 cases of “complex sleep behaviors occurring with these medicines over the past 26 years that resulted in serious injuries, including death,” the agency said.
“These cases included accidental overdoses, falls, burns, near drowning, exposure to extreme cold temperatures leading to loss of limb, carbon monoxide poisoning, drowning, hypothermia, motor vehicle collisions with the patient driving, and self-injuries such as gunshot wounds and apparent suicide attempts,” it said.
“Patients usually did not remember these events.”
We’re becoming a nation of Jason Bournes, but without all the cool stuff.
All because we can’t get enough shut-eye.
Jerome Siegel, a sleep researcher at UCLA, told me there’s no question we’re overdoing it with use of powerful chemicals to knock ourselves into a stupor.
“There are situations where short-term use of sleeping pills might be helpful,” he said. “But even that’s debatable. If you ask me, no one should be taking sleeping pills.”
Every sleep expert I spoke with said pretty much the same.
“There is evidence that sleep medications are over-prescribed, and that not enough attention is paid to the side effects in many cases or alternative approaches,” said Bryce Mander, an assistant professor of psychiatry and human behavior at UC Irvine.
According to the Centers for Disease Control and Prevention, as many as 70 million Americans “suffer from sleep disorders or deprivation.”
An estimated 4% of U.S. adults are taking prescription meds to help them sleep at any given time, the CDC says. That’s 10 million people.
They’re spending roughly $2 billion a year, with millions of dollars more going toward over-the-counter drugs and dietary supplements such as melatonin.
Needless to say, this is a golden opportunity for drug companies, which have built multimillion-dollar marketing campaigns around the notion that everyone deserves a decent night’s rest.
“Sleep is big business in the United States,” said Raj Dasgupta, a USC sleep researcher. TV ads for sleeping pills are effective, he said, because “people are always looking for a shortcut.”
A spokeswoman for the Pharmaceutical Research and Manufacturers of America, the drug industry’s main trade group, declined to comment.
The dirty little secret of the sleeping-pill business is that the drugs don’t in fact fix anything. If you have chronic sleep issues, they’ll likely return as soon as you stop taking the meds.
If you can stop.
“Although people successfully treat short-term insomnia with sleeping pills, many become dependent on them,” says the Addiction Center website. “As tolerance increases, many find that they need to take larger dosages to obtain the desired effect.”
Those larger doses, in turn, can result in devastating withdrawal symptoms when you try to go cold turkey.
“For acute or short-term insomnia, prescription sleeping medications taken for a week or two can be helpful in breaking the cycle of poor sleep but should not be used for chronically poor sleep,” said Clete A. Kushida, a Stanford University neurologist who specializes in sleep disorders.
And get this: A 2007 study financed by the National Institutes of Health found that sleeping pills helped people nod off just 13 minutes faster than patients who took placebos, and they increased total sleep time by only about 11 minutes.
A much smarter move, experts say, is to practice what’s called good “sleep hygiene.”
To a large extent, that simply means using common sense. Limit daytime naps to no more than 30 minutes. Get some exercise. Avoid stimulants such as caffeine or nicotine before bedtime.
UCLA’s Siegel advised taking control of your sleep pattern by getting up at the same time every day, even on weekends.
Yes, that can leave you a little groggy if you went to bed late, or had trouble falling asleep, the night before. Over the long haul, however, your body will adjust to the regular schedule and will develop a cycle that delivers seven or eight hours of downtime.
I’ve used this technique for years, and it’s helped. Not always, of course — I’m a light sleeper and still suffer from occasional bouts of insomnia — but generally I sleep better with a fixed rise-and-shine.
I also switch my Kindle tablet to “night mode” when I read or check email before bed to minimize exposure to bright light, which can disrupt circadian rhythms. Just swipe down from the top of the screen and tap “blue shade.”
Most importantly, I don’t agonize if I can’t find my way to dreamland. Stress doesn’t help. Sometimes I’ll return to the living room and read some more, or put on headphones and listen to music. Then I’ll give it another go.
“You have to make sleep a priority,” said USC’s Dasgupta. “It takes work.”
As for sleeping pills, the FDA says you should contact your doctor right away “if you do not remember activities you have done while taking the medicine.”
Sure, Matt Damon pulls it off in the Bourne movies.
The rest of us should just muddle through as best we can.