(RxWiki News) If your good night's sleep is only achieved with a prescription, you may want to explore other ways to address your insomnia.
The results of a new large-scale study found associations between increasing use of various prescription sleeping pills and a higher risk of death or cancer diagnosis.
The researchers did not establish causation.
The associations between taking sleeping medications and dying or being diagnosed with cancer does not mean taking the sleeping pills caused the death or cancer diagnosis.
"Ask your doctor about alternatives to sleeping medications for insomnia."
Dr. Daniel Kripke, M.D., of the Viterbi Family Sleep Center in San Diego, led the study investigating the long-term disease and mortality associations with being prescribed sleeping medications.
The researchers tracked 10,531 adults who had been prescribed various sleeping pills for an average of 2.5 years between 2002 and 2007.
The pills included medications in multiple classes, including barbiturates, sedative antihistamines like Benadryl, and both benzodiazepines like Restoril (temazepam) and non-benzodiazepines, like Ambien (zolpidem), Lunesta (eszopiclone) and Sonata (zaleplon).
The patients, whose average age was 54, had a range of underlying conditions. However, the researchers matched them with 23,674 people with similar age, sex and lifestyle demographics who also had underlying health conditions but had not been prescribed sleeping pills over the same time period.
The researchers found that patients prescribed up to 18 doses of sleeping pills a year were 3.5 times more likely to die than those who were not prescribed any medications for sleep.
Those prescribed between 18 and 132 doses had quadruple the risk - and these rates held true even after accounting for age, gender, weight, lifestyle, ethnicity and previously diagnosed cancer.
The authors said the risk rose with the number of doses a person was prescribed: those prescribed more than 132 doses a year were at five times greater risk of death than those prescribed none.
An association with cancer diagnosis, unrelated to pre-existing poor health, was also found among those prescribed sleeping meds. Patients taking the highest doses were more than a third more likely to be diagnosed with some form of cancer,
"We tried every practical strategy to make these associations go away, thinking that they could be due to use by people with more health problems, but no matter what we did the associations with higher mortality held," said co-author Robert Langer, M.D., M.P.H., of the Jackson Hole Center for Preventive Medicine in Jackson, Wyoming.
The age range in which the associations were strongest included those between 18 and 55 years old.
But the authors said these results, combined with similar evidence from other studies, should give clinicians a reason to consider alternative ways to treat insomnia than just a prescription.
Dr. Kripke said one way to do this is to be sure doctors are treating the underlying condition that may be causing insomnia, such as depression rather than treating only the insomnia.
"Understanding how to use the circadian rhythm is a very powerful tool that doesn't require a prescription," he added.
"Although the authors have not been able to prove that sleeping pills cause premature death, their analyses have ruled out a wide range of other possible causative factors," said Dr. Trish Groves, editor in chief of BMJ Open.
"So these findings raise important concerns and questions about the safety of sedatives and sleeping pills," Groves said.
No information was available regarding potential conflicts of interest. The research was funded by Scripps Health Foundation and other additional philanthropy organizations. It was published online February 27 in the online journal BMJ Open.
