Sleep aids may not be the answer

I recently asked a group of 40-something women if they had ever taken or currently do take sleeping pills. The answers I received mirrored a report from the National Center for Health Statistics published in August. According to the report, about 9 million American adults had taken sleeping pills in the past month. While the highest use — 7 percent in the past month — is among people 80 and up, the runner-up in usage is adult women, at 5 percent. Sleep aid usage increased with age and education. The NCHS, part of the Centers for Disease Control and Prevention, says this analysis is the first one based on systematic first-person accounts rather than insurance claims data or sales data.

Sleeping pills may bring some relief, but not without risk
Prescription sleep aids are one treatment option for people who have trouble falling or staying asleep. The medications work by suppressing activities in the nervous system. Experts say the percentage of the population using sleep medication may be too high, especially because long-term use of sleep aids has been linked to negative health effects. “We know [sleep aids] make sleep apnea worse. We know they cause automobile accidents, depression and infection,” says Dr. Daniel Kripke, professor emeritus of psychiatry at the University of California, San Diego. “But the most important effects are controversial — increased mortality and increased cancer.” In a 2012 study of about 33,000 people, Kripke and his colleagues found that people who use common prescription sleep medications had higher risks of dying prematurely and higher rates of cancer, even after controlling for their underlying health problems. “The cancer effect was associated to a high dose of sleep medication, but the mortality effect was associated to a low-dose group, taking as little as 18 doses a year,” Kripke said. Earlier this year, the Food and Drug Administration required the manufacturers of drugs containing zolpidem (with brand names such as Ambien, Edluar and Zolpimist) to reduce the recommended dosage to half after studies suggested people taking them faced a higher risk of injury because of morning drowsiness.

Sleep aid alternatives
Kripke says there’s no objective evidence sleep medications help people perform better the next day. The majority of studies show they impair the performance the next day. So what is a woman (or man) desperate for a good night’s sleep to do? “I’ve battled insomnia my entire life and have finally realized I have to order my life in a certain way to get enough sleep,” says 35-year-old Jessica Baker of San Antonio. She avoids taking sleep aids by exercising daily and spending a lot of time outside. “I have a regular-ish bedtime and don’t use my phone in bed at night. I also eat my biggest meal at lunch and almost never drink.” With trial and error, Baker found a lifestyle prescription that works to prevent her stress-induced insomnia. Many of her self-taught strategies mirror the advice of sleep experts.

Engineer a healthy sleep environment
Make your bedroom a haven. Remove any non-sleep related furniture or objects (like computers or exercise equipment) from your bedroom. Treat yourself to some luxurious sheets and pillows. Add dark curtains to block out any light. Turn off those screens; turn down lights. Your optic nerve signals your brain when it’s light and dark. When the hypothalamus receives the message that it’s dark, it responds by releasing sleep-inducing hormones such as melatonin and reducing body temperature. So that well-lit Kindle may not be such a good idea at bedtime. Turn down the heat. Your bedroom thermostat should be at a comfortably cool 60 to 68 degrees. Stick to a schedule. Go to bed and set your alarm to wake up the same time every day — even on the weekends and during vacations. Additionally, if you struggle with worries and feel anxious when your head hits the pillow, it may be wise to consult a mental health professional to ensure you’re not masking depression or other health issues with sleep aids.

by Kelly A. Goff