Dangers of sleeping pills and how to avoid them

Taking sleeping pills can also be deadly. According to a 2010 study, as many as half a million “excess deaths” in the United States were due to the use of sleep aids called sedative-hypnotics.

People with prescriptions for these sleep aids, which include zolpidem and temazepam, were over four years old the likelihood of dying from accidents and health problems due to use is higher than those who have not used such drugs, said the study. Even people who took less than two sleeping pills a month were three times more likely to die than those who didn’t.
If you are using or considering using a prescription or over-the-counter sleep aid, what do you need to know to do so safely? We asked dr Jin WangAssistant Professor of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai in New York City.

This conversation has been edited slightly for clarity.

CNN: When someone with insomnia or another sleep disorder comes to you asking for help falling asleep, do you first give them a sleeping pill for immediate relief?

dr Jin Wang: No, definitely not. We’re trying really, really hard not to do that. When someone comes to us with insomnia, we do a really thorough medical and sleep history. It is very important that the person provides personal information so that we can identify the cause of the insomnia. Is it behavioral or is it due to medication or medical conditions?

I will ask her: “What is your daily routine like? What do you do at night?” trying to find her physical and emotional stressors. Is this person in front of a screen at work and at home all the time?

Then we go into how this person gets ready for bed: “Do you have routines? Do you have a regular bedtime?” Frequently, insomnia is perpetuated by what we do in response to not being able to sleep. People get very creative, which may not help: they make phone calls, read email or reply to business messages, or sleep with the TV on. Both expose you to blue light, which sends a signal to the brain to wake up. Occasionally people will say I get up and work out which is definitely not what you want to do!

CNN: When is a sleeping pill advisable?

Wang: Our first-line approach is to introduce patients to a form of cognitive behavioral therapy called CBTI, designed specifically for insomnia. It educates patients about healthy sleep habits, such as: For example, keeping regular bedtimes and wake-up times, keeping screens and blue lights out of the bedroom, doing relaxing things before bed, and so on. It’s all about the associations our brain makes with our sleeping environment and how our behavior or activities affect that.

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If we have someone who is clearly struggling with very acute insomnia and there is an identifiable factor or change in their life, then we could have a discussion about trying a sleep aid for a short term for a few weeks or a few months or something, and only with regular check-ups.

And we have clear expectations for short-term use because we don’t just prescribe a sleep aid and want the person on it for the next 30 years. We want to get to the root of the problem in a healthier way by addressing what’s causing insomnia.

CNN: Why isn’t taking a sleeping pill long-term healthy?

Consult a doctor before taking any type of sleep aid.

Wang: It depends on how people react differently and can be vulnerable in different ways. Some of these sleep aids can be addictive, leaving the person feeling unable to sleep without them. They can be dangerous when mixed with alcohol or certain pain relievers. Some cause daytime sleepiness and can interfere with driving and other motor activities.

Sedative sleep aids have been linked to hallucinations and dissociative behavior. People drove cars, cooked food, sleepwalked and on the phone, all with no memory when they woke up. Upon waking, people can be prone to drowsiness and confusion, like a hangover effect.

CNN: Let’s talk about over-the-counter drugs. Is this a problem?

Wang: Every drug is a double-edged sword: it has its benefits, but always side effects.

One of the strongest pieces of advice I always give patients is to tell them to really try to avoid over-the-counter sleep aids. You may have unforeseen side effects, e.g. B. that they make you hyper instead of sleepy. There is a possibility of an interaction with prescription tranquilizers patients may also be taking. And there’s always a chance of abuse or overuse because they’re like, “Oh, it’s over-the-counter, so it’s safe.”

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Take melatonin. Some people have reported taking 30 or even 60 milligrams of melatonin and that could be dangerous; we just don’t know yet. It’s not really regulated, so non-melatonin substances can be mixed into the pill or tablet. You could get a headache, one of the known side effects of melatonin. Or you could take it at the wrong time and upset your circadian rhythm.

Antihistamines, for example, cause dry mouth, dizziness and a kind of hangover the next day. They can also have anticholinergic effects, such as urinary retention, blurred vision, constipation, and nausea. Chronic, regular use of these agents has been linked to an increased risk of dementia in some studies.

Finally, using over-the-counter sleep aids can potentially delay acknowledging their sleep issues as a concern and seeking help: “There is no reason for me to see the sleep medicine specialist or talk to my doctor about my sleep issues. I can just keep using an over-the-counter agent.”

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