Why It’s Time to Ditch the Sleeping Pills

Featured Article, Mental Health & Sleep Center, Sleep
on March 12, 2014
why it's time to ditch the sleeping pills

We all want a good night’s rest. But no matter how much you crave quality shut-eye, if you’re stressed out, in pain or dogged by night sweats, sleep can elude you. As you get older, it may take longer to nod off and you may have trouble staying asleep. But because the amount of sleep you need—seven to nine hours per night—stays the same throughout your life, fitful nights can leave you tired, cranky and down.

No wonder so many of us rely on sleeping pills—both over-the-counter and prescription. Overall, three percent of nearly 1000 people questioned said they had used prescription sleep aids during the previous month, according to the 1999-2010 National Health and Education Survey (NHANES). The findings were published in the February 2014 issue of Sleep.

A 2011 study in the American Journal of Public Health reported that from 1993 to 2007 use of prescription meds for non-benzopdiazepine sleep aids—such as zolpidem—soared 30-fold. That may be because diagnoses of insomnia increased seven-fold to 6.1 million in 2007.

Sure, sleeping pills will help you nod off. But while they’re generally safe, you shouldn’t make a habit of using them.

A 2012 study out of the Viterbi Family Sleep Center in San Diego reported that eight of the most commonly used sleep aids, including zolpidem and temazepam, were associated with an increased risk of cancer and death.

Rates of cancer were 35 percent higher in people who took at least 132 sleeping pills per year compared to people who didn’t use them. People who took 18 to 132 pills were more than four times as likely to die. Even downing as few as one to 18 pills per year wasn’t a good idea. These people had a risk of death 3.6 times higher than people who didn’t use sleep aids.

“Part of the human condition is to have an occasional night of poor sleep,” says Lois E. Krahn, M.D., a specialist in sleep medicine and psychiatry and psychology at the Mayo Clinic in Arizona. Indeed, most people can manage just fine after one bad night in bed. But when tossing and turning persist, you need help breaking the cycle of insomnia. “If those single nights string together and become two or three in a row, reaching for an OTC sleep aid makes sense,” says Dr. Krahn.

But if an OTC sleep aid doesn’t work or you use it regularly, ask your doctor whether or not you need a prescription sleep aid. “If you have three sleepless nights, maybe a single pill will solve your problem,” says Dr. Krahn. “If you’ve had three bad weeks, it may take a week of prescription sleeping pills to get back on track,” she adds. “There is no hard and fast rule.”

What you don’t want to do is use sleeping pills routinely. Most OTC sleep aids contain an antihistamine to make you drowsy, and stop working if you keep taking them. Older sleep aids, known as benzodiazepines, can be habit forming. While the newer non-benzopdiazepines aren’t, insomnia can recur when you stop using them–the so-called rebound effect.

What’s more, OTC sleep aids can cause next-day drowsiness or dizziness, and make you less alert. Prescription pills can cause confusion and “complex behaviors” such as sleepwalking, sleep driving and even raiding the fridge. In rare instances you could have a serious allergic reaction. What’s more, the costs add up.

What to do? Rather than rely on sleep aids, try these seven natural sleep-promoting strategies. They just may help you sleep like a baby again.If they don’t do the trick, consult a sleep specialist.

Exercise. When insomniacs 55 and older did aerobic exercise four times per week for 16 weeks, their sleep was transformed, say Northwestern University researchers. The exercisers fell asleep faster and slept longer and better than people who didn’t work out. What it took:Either two 20-minute sessions or one 30- to 40-minute session per day of walking, riding a stationary bike, or hitting the treadmill at 75 percent of their maximum heart rate. Best time to exercise: Late afternoon or early evening. “Your body temperature rises when you exercise,” says Dr. Krahn. And it’ll stay elevated for about four to five hours after you stop. As it drops, ”it‘s one of the natural cues to the brain that it’s time to slow down and fall asleep,” she adds.

Cool Down. Open the window or turn down the thermostat. “Because a reduction in core body temperature is a cue to sleep, being in a cooler room is a good idea,” says Dr. Krahn. Lightening up on the bed covers helps, too.

Block Noise and Light. Who hasn’t been awakened by a pesky car alarm or a neighbor’s porch light? If noise is an issue, “try a white noise machine,” advises Dr. Krahn.Or play soothing music to mitigate annoying sounds. (Bonus: One study found that older people who listened to soft, calming music for three weeks fell asleep faster and slept longer). As for light? Try room-darkening shades or an eye mask.

Get More Day Light. The more natural light you’re exposed to during the day, the better you’ll sleep. The reason: Daylight may help with the production of melatonin, a hormone that controls your sleep-wake cycle. Researchers at Northwestern University found that people with a window in their offices were exposed to 173 percent more natural white light during the day and, as a result, slept about 46 minutes more per night.If you don’t have a window, spend some time outside during the day.

Meditate. When you meditate, you achieve a state of sleep-inducing relaxation. In a small study, Northwestern University, researchers found that women who practiced Kriya yoga 15 to 20 minutes twice a day for two months saw the overall quality of their sleep improve by 50 percent. And time spent awake in the middle of the night dropped by nearly an hour.

Try Hypnotherapy. This uses imagery and deep breathing to help you relax and fall asleep, explains Gary Elkins, Ph.D., of Baylor University in Waco, Texas, who is author of the book Hypnotic Relaxation Therapy. Hypnotherapy also eases hot flashes, which sabotage many women’s sleep. Dr. Elkins has found that the frequency of hot flashes decreased by 68 percent in breast cancer survivors after just five weekly 50-minute sessions of hypnotherapy, improving sleep. Once you learn hypnotherapy techniques from a certified hypnotherapist, you can use them whenever you have trouble drifting off or awaken in the middle of the night.

Consider CBT. Cognitive behavioral therapy for Insomnia (CBT-I) has been hailed as the gold standard for treating insomnia. A CBT-I therapist will give you tools to help you reclaim a good night’s sleep, and use when sleep doesn’t come. Among them: relearning good sleep strategies—called sleep hygiene; re-setting your wake-sleep cycle; and coping with anxiety.Expect to see results after five to six sessions. You don’t have to visit a therapist’s office to benefit. Two online CBT-I programs, developed by sleep experts, may help: SHUTi ™ (Sleep Healthy Using the Internet) costs $129 for eight weeks of access. Currently, Somnio costs $149 for an eight-week program.