Sleep Drugs May Not Help Much

Are you worried about lying awake at night—unable to quickly fall asleep?  Sleeping pills help you much less than you might think.

Researchers recently took another look at laboratory studies on the new class of sleeping pills called "Z" drugs. They found that, on average, people who took one of these drugs fell asleep 12.8 minutes sooner than those who took a placebo. They only slept an average of 11.4 minutes longer—for the entire night. The "Z" drugs include Ambien, Lunesta, and Sonata.

Older drugs, known as the benzodiazepine class did a little better. The average time to falling asleep was 10 minutes faster than with dummy pills, and sleep time was extended by 32 minutes.

The benzodiazepine drugs include Halcion, Restoril and Dalmane. They have fallen out of favor during the last decade. Reports of side effects, especially in the elderly, have scared doctors and patients away from these drugs. However, now that the "Z" drugs are not so new, some of the same side effects are being reported.

The actual lab results on sleeping pills are not impressive. But people's perception of how easily they fall asleep and stay asleep with these drugs is much more positive than the reality. Most people believe they are very helpful.

Why should perception be so much better than reality? There are at least two good reasons. First, the drugs relieve anxiety. So you are most likely going to feel more relaxed when you wake up, even if you haven't slept any longer. Also, sleeping pills can make you forget how difficult it may have been for you to fall asleep.

There's no question that getting adequate sleep is important for good health. But before you reach for a sleeping pill, make sure you are already practicing good sleep habits:

·         Get exercise during the day.

·         Avoid alcohol in the evening and caffeine after noon.

·         Don't use alcohol to help you fall asleep.

·         Avoid arguments or stressful conversations near bedtime.

·         Don't go to bed too hungry, but don't overeat before you lie down.

·         Put aside the work of the day at least half an hour before you want to sleep.

·         Establish a bedtime ritual that you can follow regularly.

·         Get into bed for the night only when you are sleepy.

·         If it takes you more than 10 to 15 minutes to fall asleep, get out of bed. Go to another room and read. Try to sleep again later.

 Sleeping pills can be very helpful for occasional, short-term use. You may find that a generic anti-anxiety medicine for a few nights can put you back on track. If your problem is just falling asleep, then a short-acting medicine such as lorazepam may help.

Some people prefer something longer-acting, such as low-dose diazepam or temazepam. Be careful — these can cause you to be drowsy in the daytime. In older people, they can stay in the body for a long time.

If you have persistent insomnia, it may be caused by a medical condition like asthma, sleep apnea, restless legs syndrome, depression, anxiety and heart failure. Treating the medical problem might be the cure for your insomnia.

What are your thoughts on sleeping pills? Have you tried any? Did they work? What other strategies work for you?

Julie K. Silver, M.D., is an assistant professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School. She is also the Chief Editor of Books for Harvard Health Publications.

Good Night’s Sleep

Sleep can be as important to your health as diet and exercise, but for many people, falling and staying asleep isn’t easy. The Harvard Medical School Guide to a Good Night’s Sleep lays out a six-step plan to improve sleep and deal with common issues like insomnia, disrupted sleep, sleepwalking, and the many other chronic sleep conditions that affect more than 70 million Americans. Through lifestyle and environment changes, you can finally sleep soundly—without necessarily having to take a pill.

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