Insomnia drugs are among the most common class of prescription medications, with about 4% of U.S. adults taking them in a given month. We all know how important sleep is, and that lack of it can be deadly. But given how complex human sleep is, it's likely that there are several different causes for insomnia, even among people who take the same drugs.
A recent study published in The BMJ highlights some of the issues with sleep meds, namely benzodiazepines, which are also used to treat anxiety. It was a prospective study following more than 1,000 subjects for 15 years.
The results are startling; compared with those who never took benzodiazepines, those who started taking them three years into the study were 50% more likely to develop dementia. This research is unique in that it had a much longer follow-up period than other studies on benzodiazepines, followed patients forward in time, and controlled for variables (such as depression) which are known to be early symptoms of dementia.
In 2012 another study in the same journal was published looked at hypnotic sleep medications (including benzodiazepines), and concluded that people taking them were about three times more likely to die during the two-and-a-half-year study. Although this study was a retrospective analysis of medical records, the results warrant attention because researchers controlled for 12 external causes of early death, such as asthma, coronary disease, obesity, hypertension, and diabetes.
What's more, a dose-effect response was found: The longer people took sleep meds, the more likely they were to die.
Human sleep is very complex and scientists still do not fully understand it. Granted, prescription sleep medications are life savers for many people. However, for many, the benefits may not outweigh the risks especially in light of our expanding knowledge of the underlying biology and alternative remedies.
Before resorting to medications here are some of the alternatives you should explore (in addition to proper diet, exercise and sleep hygiene which are no-brainers):
1. Try cognitive behavioral therapy (CBT).
Anxiety is one of the most common causes of insomnia, and cognitive behavior therapy is as effective as medication in treating it ... without the side effects. Moreover, it can increase deep, restorative sleep, which many medications cannot. Other psychological disorders, such as depression, can also cause insomnia and be treated with CBT.
2. Check your Circadian alignment.
Some types of insomnia involve inability to fall asleep while others involve waking too early. Both are likely the result of circadian misalignment.
While this is still a developing area of research, there's strong evidence that light is the most powerful circadian regulator. If you have trouble falling asleep, not enough natural early morning blue light or too much blue light at night may be to blame. If you tend to become sleepy too early at night, you may require blue light therapy in the late afternoon or evening.
3. Reduce pain medication and other pharmaceuticals.
Drowsiness is a common side effect of many medications, especially pain medications and even over-the-counter medications. Taking naps during the day may seem like the right thing to do intuitively when you feel drowsy, but they may reduce your physiological drive for sleep at night. Additionally, many medications contain caffeine and other stimulants. Many other prescription medications can interfere with sleep, including heart and blood pressure medications and antidepressants.
4. Look for underlying medical conditions.
Some common conditions that can cause sleep problems are nasal and sinus allergies, gastrointestinal disorders, endocrine problems like hyperthyroidism, arthritis, and asthma. These should be thoroughly investigated and treated before considering sleep medication.