Pros and cons of sleeping pills
Are sleeping pills safe? Find out about the myths of using sleeping pills to get better sleep, side-effects and how to stop your sleeping pills safely.
Talk to your doctor, nurse or pharmacist about sleeping pills so together you can weigh the pros (benefits) of what the medication will do for you versus the cons (harms) that could come from taking it. This can help you to decide if the medication is right for you or whether you should look for other safer and more effective options.
History of Sleeping Pills
For centuries, people have tried different things to help them sleep better, including herbal remedies, opium, alcohol, and barbiturates. In the 1960’s, sleeping pills (benzodiazepines) arrived on the scene and we mistakenly thought they were safe and effective. Being heavily marketed as the safest option for getting a good night’s sleep, by the 1970’s they were the most widely prescribed medication in the United States. However, we soon learned that benzodiazepines weren’t completely safe or effective.
Skip to the 2000’s, a new generation of sleeping pills arrived. These sleeping pills, called “z-drugs”, flooded the market with the hope that they were a safe option to get better sleep. Unfortunately, they work in a similar way to benzodiazepines so the harms for the user were the same.
These days the message about sleeping pills is quite different, with researchers exposing their ineffectiveness and harms. Sleeping pills only provide a small amount of extra sleep and increase the risk of falls and injury. For these reasons, sleeping pills may not be your safest option for getting a good night’s sleep.
If the history of sleeping pills interests you, there is a timeline of the development of sleeping pills to date, compiled by health researchers at Dalhousie University, which can be found at mysleepwell.ca.
The Pros: Benefits of sleeping pills
Sleeping pills may work for you for a short time but after a few weeks, the brain gets used to the effects of sleeping pills and they may not work as well as when you started taking them. Canadian guidelines recommend sleeping pills should not be taken for longer than four weeks as research has shown that there are better long-term treatments for people who have trouble sleeping (insomnia).
Would you believe that for every 6 people who take a sleeping pill, one person will have a harmful side effect? With this level of harm in mind, test your knowledge on what a sleeping pill can do for you with the following questions.
Q1. How much extra sleep can a sleeping pill give me per night?
A. 5 hours
B. 2-3 hours
C. 1 hour
D. 35 minutes
Answer: D. On average, people can get about 35 minutes of extra sleep when they start taking sleeping pills
Q2. How much faster can I get to sleep when I take a sleeping pill?
A. less than 15 minutes
B. about half an hour
C. about an hour
D. over 2 hours
Answer: A. On average, people get to sleep about 14 minutes faster with some types of sleeping pills and some, like Z-drugs, may not make help fall asleep any faster at all.
Q3. Do sleeping pills work for everyone?
A. yes
B. no
Answer: No. Research shows that only 1 in 13 people who take a sleeping pill will get one of the above benefits, but 1 in 6 will experience one of the harms below
The cons: Harms of sleeping pills
Over the last few decades, the harms of sleeping pills have been researched widely. Did you know that people who take sleeping pills are:
5 times more likely to have memory and concentration problems
4 times more likely to feel very tired during the day
2 times more likely to experience falls and fractures (hip, wrist)
2 times more likely to have a motor vehicle accident
At risk of developing problems holding their urine
Professor Cara Tannenbaum, from the University of Montreal, gave a brochure explaining the pros and cons of sleeping pills to seniors who had been using sleeping pills regularly for years. After reading the brochure and talking to their doctor or pharmacist, more than 1 in 4 seniors were able to safely stop their sleeping pills and regain control of their sleep.
Read this brochure and talk to your doctor, nurse or pharmacist about how you can safely stop sleeping pills.
Sleeping pills don’t work for everyone
Sleeping pills don’t work for everyone and, in fact, for those who use regularly they may stop working as your body becomes accustomed to the drug. This means you may need higher and higher doses overtime to achieve the same effect. This is known as tolerance. Professor David Gardner, from Dalhousie University (and creator of mysleepwell.ca), writes that sleeping pills may lose their sedating effect with nightly use. When this happens, some people try to stop their sleeping pills which can lead to withdrawal effects. One common withdrawal effect is trouble sleeping, called insomnia. This insomnia gets better for a short while when they restart the sleeping pill. This starts an endless cycle of increasing the dose of sleeping pills, stopping them and then restarting. Meanwhile, you’re still at risk of harms from the sleeping pills.
You can prevent withdrawal effects by talking with your doctor, nurse or pharmacist about slowly lowering the dose over time. This is called tapering. Learn more about tapering in this brochure.
Driving the day after
“Driving the day after you take a sleeping pill puts you at the same risk of having a car crash as if you are driving over the blood alcohol limit,” said Dr Justin Turner from the University of Montreal.
Researchers studied the cause of car accidents and found that your risk of having an accident while driving the day after you take a sleeping pill is the same as a person who has a blood alcohol level of 0.06-0.11%. This is a blood-alcohol level that is over the legal limit in Newfoundland and Labrador. Dr. Turner commented, “None of us would recommend that we drive drunk, but how many of us consider that risk when we or a loved one takes a sleeping pill?”
Falls and fractures
Taking a sleeping pill doubles your risk of having a fall or a fracture. Dr Cara Tannenbaum, from the University of Montreal, writes about the risks of falls and fractures when you take a sleeping pill in her article Hips don’t lie: What you should know about medications and falls. Because the risk is worse for older adults, Dr Tannenbaum suggests that people should talk to their parents or grandparents about the medications they are taking.
Seniors have a higher risk of harm
Almost 1 in 3 Canadians over the age of 65 years are prescribed a sleeping pill. Yet, older adults are at the greatest risk of harm from sleeping pills. As you get older, changes take place in your body that affect the way your body processes sleeping pills. The medication stays in your body for longer and your risk of harm increases. These medications can lead to memory problems. Unfortunately, many seniors who take sleeping pills aren’t aware of this risk.
Because the risk of side effects is worse for older adults, Dr Tannenbaum suggests that people should talk to their parents or grandparents about the medications they are taking. “you can give them a brochure so they can talk to their doctor, nurse or pharmacist and weigh the potential benefits and harms of sleeping pills for them.
