Sleeping Pills May Carry High Risks

Sleeping medications linked to a higher risk of death and slightly higher risk of cancer

(RxWiki News) When counting sheep and hot herbal tea doesn't work, people may turn to sleeping pills to help get a good night's rest. But the long-term risks of these medications may not be worth it.

A recent study found that patients taking sleeping pills had a higher risk of death than those not prescribed sleeping pills.

The study could not show that the sleeping pills caused death. Rather, it showed a strong link between the sleeping medications and a higher risk of death.

Even patients who were prescribed fewer than 18 sleeping pills a year had a risk of dying that was about three times higher than individuals not taking any sleeping pills.

The researchers could not find other factors among the study participants that explained the higher risk of death among those who took sleeping pills.

"Ask your doctor about options for insomnia."

The study, led by Daniel F. Kripke, MD, of the Scripps Clinic Viterbi Family Sleep Center in La Jolla, California, aimed to see whether there was a link between a higher risk of death and being prescribed hypnotic medications.

Hypnotics are medications used to help individuals sleep. Most people commonly call hypnotics 'sleeping pills.'

Among the different sleeping medications included in this study were zolpidem (Ambien), temazepam (Restoril), eszopiclone (Lunesta), zaleplon (Sonata), other benzodiazepines, barbiturates and sedative antihistamines.

The researchers gathered data from the medical records of 10,529 patients (average age 54) who received sleeping pill prescriptions and 23,676 individuals who did not receive sleeping pill prescriptions.

Each of the patients who received a prescription for a sleeping pill was "matched" in terms of their characteristics to at least two of the individuals who did not receive a hypnotic prescription.

Each participant was tracked for an average of 2.5 years between January 2002 and January 2007.

Then the researchers compared the death rates and causes of death among both groups.

The researchers adjusted their analysis to account for all the study participants' age, gender, weight, ethnicity and marital status. The researchers also factored in whether the individuals smoked, drank alcohol or had previously had cancer.

The results showed that having been prescribed any sleeping medication increased a person's risk of death, depending on how many doses they had been prescribed.

Individuals prescribed between 0.4 and 18 doses had a risk of dying about 3.6 times greater than those not prescribed any sleeping medications.

Those prescribed between 18 and 132 doses of sleeping medications had a risk of dying that was 4.4 times greater than those not prescribed sleeping medications.

Furthermore, those prescribed more than 132 doses of sleeping medications had a risk of dying that was 5.3 times greater than those who were not prescribed a sleeping medication.

In addition, those prescribed more than 132 doses were also at a 35 percent greater risk of developing cancer than those not prescribed any sleeping medications.

The researchers concluded that receiving hypnotic medications was linked to a triple increase in a person's risk of death – even if they were prescribed fewer than 18 pills a year.

Even when the researchers took into account the individuals who were in poor health, their findings did not change.

However, the researchers did not distinguish between the benzodiazepines and other types of sleeping medications, said William Kohler, MD, the director of the Florida Sleep Institute in Spring Hill, Florida, and a dailyRx expert. It's difficult to differentiate the different risk factors for different categories of medication, he said.

Dr. Kohler also noted that this study offers a reminder that individuals should consider both the risks and benefits of any medication they take and to look at all the treatment options for a condition.

"For people with sleeping problems, cognitive behavioral therapy is better than utilizing a hypnotic and should be emphasized as far as the preferred treatment choice rather than going to a hypnotic," Dr. Kohler said.

The study was published February 27 in the journal BMJ Open. The research was funded by Scripps Clinic Academic Funds. One author reported that he has long criticized hypnotic drugs on his nonprofit website. Another author's family has an investment in a corporation that has some of its assets in Sanofi-Aventis and Johnson & Johnson stock. The other authors declared no conflicts of interest.

Review Date: 
March 7, 2013