If you’re going through a crisis or a lot of stress, and have been prescribed sleeping pills, don’t be alarmed by this article. Just try not to take them for too long. That seems the key conclusion if you read what Neuroscientist Professor Matthew Walker, an expert on sleep, says in his recent and highly acclaimed book Why We Sleep: The New Science of Sleep and Dreams. He doesn’t think taking sleeping pills is a good idea at all. (To be clear – the following points refer to prescription medication like zolpiden/Ambien, eszopiclone/Lunesta, not herbal pills, or over-the-counter pills just using antihistamine like Nytol). Here’s why:
1. 65 studies covering almost 4,500 patients found no difference in how soundly people slept whether they took a sleeping pill or a placebo. When you are given a sleeping pill you do go to sleep quicker, but you also go to sleep quicker if you think you have been given a sleeping pill! The team of leading doctors that researched this concluded that the effect of current sleeping medications was ‘rather small and of questionable clinical importance.’
2. Despite the above, the drugs in these pills do affect your physiology. Pills such as zolpidem (brand name Ambien) and eszopiclone (brand name Lunesta) seem to produce sleep that is lacking in the largest, deepest brainwaves when compared with naturally occurring sleep.
3. Side effects can include next-day grogginess, forgetfulness, and slowed reaction times in motor skills such as driving.
4. When individuals stop taking pills they may suffer from even worse sleep – known as rebound insomnia. The brain has tried to alter its balance of receptors as a reaction to the drug. It has tried to ‘become somewhat less sensitive as a way of countering the foreign chemical within the brain’ as Prof. Walker puts it. This creates drug tolerance, and when the drug is stopped, as part of the withdrawal process there is a spike in insomnia severity. Rebound insomnia often results in patients reverting to the drug.
5. One of the functions of sleep is to ‘lay down’ your memories – to strengthen the neural connections between synapses that make up a memory circuit.That is why it is good to nap when you revise for an exam rather than staying up all night ‘swatting’. When you sleep you are storing memories. Studies in animals given sleeping medication showed a 50% weakening (unwiring) of neural connections formed during learning. As Walker puts it: ‘Ambien-laced sleep became a memory eraser, rather than engraver.’
If it is has this effect on humans (we do not know yet, but it seems likely) this is unfortunate for anyone taking these pills, but particularly for the older, whose memories need strengthening not weakening, and for the increasingly younger population who are being prescribed and who need to learn in school or college.
6. Most worrying of all are the findings of Dr Daniel Kripke, who has discovered that ‘individuals using sleep medications are significantly more likely to die and to develop cancer than those who do not.’ In 2012 Kripke compared 10,000 patients taking pills with 20,000 matched individuals not taking them. Those taking more than 132 pills per year were 5.3 times more likely to die. Even those taking just 18 pills a year were still 3.6 times more likely to die. Since Kripke’s work, more than 15 other studies have been carried out with similar findings. The stats linking pill-taking with cancer are equally depressing: within a two and a half year period people taking pills were 30-40% more likely to develop cancer. I have summarised these findings, but if you are concerned do look at Walker’s book (Chapter 14) which of course goes into much greater detail, and gives references to the research literature, and have a look at this article here, which gives good advice if you are taking them regularly.
Six reasons not to take sleeping pills – or only very sparingly indeed – but perhaps give a thought to how much you might be hurting the pharmaceutical industry if too many people deprive them of revenue. Walker gives a good comparison: one of the highest grossing movies of all times, Star Wars, took 40 years to amass $3 billion in revenue. The leading brand of sleeping pill, Ambien, amassed $4 billion in sales profits in 2 years. (How come? In the USA alone 10 million people will have taken a sleeping pill in the last month).
But don’t despair – Walker makes a strong case for instead trying CBT-I (Cognitive Behavioral Therapy for Insomnia) which can be highly effective. See the CBT-I programs offered by The Sleep School here. Or try a combination of approaches that draws on Neuroscience and the mind-body system of Sophrology, that I’ve developed. It really does seem effective in helping people free themselves of insomnia. You can find it here: The Sleep Clinic: How to Sleep Better.