By Serena McNiff
HealthDay reporter
WEDNESDAY, May 12, 2021 (HealthDay News) – An estimated 9 million Americans turn to prescription pills when they cannot sleep. However, a new study of middle-aged women shows that taking the medication for a year or more is of little use.
Researchers at Brigham and Boston Women’s Hospital compared a group of about 200 women who were being treated for sleep problems with over 400 women who had sleep problems but were not taking any medication. They found that sleeping pills don’t seem to be beneficial in the long run. After a year or two of sleep medication, the women in the drug group slept no better or longer than those who were not.
“The simple conclusion is that long-term use of sleep medication has no clear benefit in terms of chronic sleep problems,” said study author Dr. Daniel Solomon, rheumatologist and epidemiologist at Brigham and Women’s.
Although Solomon does not typically focus on sleep problems, he was inspired by longstanding patients struggling with insomnia. “I usually give a patient medication to sleep for a week, and sometimes they come back long-term and still have trouble sleeping,” he noted.
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The results come from a US National Institutes of Health database that examined thousands of women about how middle age and menopause affected their mental and physical health.
Menopause, when women stop producing certain female hormones and lose monthly periods, are known to cause insomnia. Many women have trouble sleeping in the pre-menopausal and menopausal years.
Solomon’s research team identified women in this database who reported sleep problems such as waking too early and having difficulty falling and falling asleep.
“All of the women in our study had reported insomnia. Some of them started taking a drug, some didn’t, and then we followed them lengthways a year later and two years later,” said Solomon. “We asked them about their regular medication use at each annual visit, and we also asked them about sleep disorders using a well-described sleep disorder scale.”
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Since the study mainly consists of annual check-ins with the participants, it can only be shown how these drugs work in the long term. However, clinical studies show that these drugs help people sleep for short periods of time.
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“There are good randomized controlled trials that say that sleeping pills work for a few weeks or months,” said Solomon. ‘However, it turns out that around 35% to 40% of people who start using them use them a year later, so the typical way they are used – that is, chronically – hasn’t been well explored in studies. “
The new report was published online on May 11th in the magazine BMJ Open.
Commonly prescribed sleeping pills include benzodiazepines and “Z-drugs” like zolpidem (Ambien) and eszopiclone (Lunesta), some of which are used to induce sleepiness while others are primarily used to relieve anxiety.
These drugs are thought to work by changing the levels of brain chemicals called neurotransmitters that keep you awake during the day and relaxed at night, said Dr. Fariha Abbasi-Feinberg, sleep doctor and member of the American Academy of Sleep Medicine board.
Like most medications, sleeping pills are not without their risks. According to Solomon, the most common problems cited are daytime sleepiness and imbalance or falls, especially when a medical person gets up to go to the bathroom in the middle of the night. Addiction is a problem as people can be dependent on their sleeping pills. There may also be a link between sleep medication and memory problems later in life.
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“If you’re going to use sleeping pills, you really have to think of them as short-term or very intermittent drugs,” said Solomon. “Use them here and there for a week or a couple of nights. But once you start using them long-term, it’s not as if they are curative for your sleeping problems.”
While Solomon is not a sleep expert, his local colleagues recommend “improving sleep hygiene” to address persistent sleep problems.
“It’s about making sure that you are tired when you go to sleep, that you have limited your daytime caffeine consumption, and that you have limited your use of screens during your bedtime,” Solomon said. “Occasional use of sleeping pills or supplements can be beneficial, but it shouldn’t be a chronic treatment for your sleep problems.”
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When changing sleeping habits isn’t enough, Abbasi-Feinberg says cognitive behavioral therapy is a potentially effective option for people with insomnia.
“Cognitive behavioral therapy for insomnia helps us to redefine our sleep problems,” said Abbasi-Feinberg. “It addresses all of the thoughts and behaviors that keep you from sleeping well. It helps you learn new strategies to sleep better, and it can also help with stress relief, relaxation, and schedule management.”
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Abbasi-Feinberg said she treats sleep problems like a mystery. “You have to solve the problem and see what is going on with each person and then make a long-term decision,” she said.
More information
The US Centers for Disease Control and Prevention has tips for better sleep.
SOURCES: Daniel Solomon, MD, Chief, Department of Clinical Sciences, Department of Rheumatology, Brigham and Women’s Hospital, Boston; Fariha Abbasi-Feinberg, MD, Member of the Board of Directors of the American Academy of Sleep Medicine, Sleep Medicine Specialist, Millennium Physician Group, Fort Myers, Florida; BMJ Open, May 11, 2021, online
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