Prescription sleeping pills may help you get some much needed rest
at night, but using them routinely might also make it more likely that
you will die or develop certain types of cancer, research suggests.
A new study suggests that those who take these medications are four times more likely to die than people who don't take them. What's more, the research shows that sleeping pill use is also associated with a raised risk for certain cancers. The findings appear online Feb. 27 in the journal BMJ Open.
Sleeping pills linked to these risks included benzodiazepines such as temazepam; non-benzodiazepines such as Ambien (zolpidem), Lunesta (eszopiclone) and Sonata (zaleplon); barbiturates; and sedative antihistamines.
The new study only shows an association between the sleeping aids and death risk, not cause-and-effect, and many experts are urging caution in jumping to any conclusions from the findings.
The study author, however, was less reticent.
"Popular sleeping pills are associated with a shocking excess of deaths and a horrible increase in new cancers," said Dr. Daniel Kripke, of the Scripps Clinic Viterbi Family Sleep Center, in La Jolla, Calif.
Many Americans use sleeping pills. During 2010, between one in 20 and one in 10 adults took a sleeping pill in the United States.
In the new study, Kripke's team tracked more than 10,500 people averaging 54 years of age. These patients had a range of underlying health conditions and were prescribed sleeping pills for an average of about 2.5 years between 2002 and 2007. The researchers compared these patients' risks for death and cancer against those of people who did not take sleeping pills.
Those who were prescribed up to 18 doses a year were 3.6 times more likely to die than their counterparts who were prescribed none, while those prescribed between 18 and 132 doses were more than four times as likely to die, the study showed. Those taking more than 132 doses a year had five times the risk of dying compared to those prescribed none. This was true regardless of age, but risks were highest among those individuals aged 18 to 55.
Specifically, there were 265 deaths among 4,336 people taking Ambien, compared with 295 deaths among the 23,671 people who had not taken sedatives or sleeping pills.
Those taking the highest doses were also at greater risk of developing several types of cancer, including esophagus, lymphoma, lung, colon and prostate cancers. Interestingly, the risks of leukemia, breast cancer, uterine cancer, bladder cancer, leukemia and melanoma were not elevated. This association was not explained away by preexisting health problems, the researchers added.
There are many known mechanisms that may explain these increased risks, Kripke stressed. For example, esophageal regurgitation may lead to esophageal cancer. These medications may also make sleep apnea worse, and they may make people more susceptible to falls and automobile crashes.
"For the particular sleeping pills studied, I do not see any time I would prescribe them," Kripke said.
However, other experts weren't ringing alarm bells.
Dr. Victor Fornari, director of child and adolescent psychiatry at the Zucker Hillside Hospital of the North Shore-Long Island Jewish Health System in Manhasset, N.Y., said that people who take sleeping pills should not panic. There could be many reasons for this increased risk of death that have little to do with the pills and more to do with the reasons why people take them, he explained.
"Sleep is the first thing affected when someone is under distress due to medical illness or psychological problems," he pointed out. "These are safe and effective medications when prescribed by a physician as part of a comprehensive treatment plan."
"Don't stop taking these medications if you feel that you need them and are taking them with a doctor's prescription, but be mindful that they shouldn't be taken frivolously and there are alternatives such as avoiding napping, getting proper exercise, eliminating caffeine and doing other the kinds of things that improve sleep hygiene," Fornari said.
But Dr. Bryan Bruno, acting chairman of the department of psychiatry at Lenox Hill Hospital in New York City, cautioned against the chronic use of sleeping pills.
"They can be dangerous and are ideally used on a temporary or short-term basis," he said. "Chronic use should be avoided if possible, particularly because there are risks involved, including dependence. They are not benign or without risk, and should be used cautiously."
More information
Daniel F. Kripke, M.D., Scripps Clinic Viterbi Family Sleep Center, La Jolla, Calif.; Bryan Bruno, M.D., acting chairman, department of psychiatry, Lenox Hill Hospital, New York City; Victor Fornari, M.D., director, child and adolescent psychiatry, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Manhasset, N.Y.; Feb. 27, 2012, BMJ
http://www.sleepfoundation.org/article/sleep-topics/healthy-sleep-tips
A new study suggests that those who take these medications are four times more likely to die than people who don't take them. What's more, the research shows that sleeping pill use is also associated with a raised risk for certain cancers. The findings appear online Feb. 27 in the journal BMJ Open.
Sleeping pills linked to these risks included benzodiazepines such as temazepam; non-benzodiazepines such as Ambien (zolpidem), Lunesta (eszopiclone) and Sonata (zaleplon); barbiturates; and sedative antihistamines.
The new study only shows an association between the sleeping aids and death risk, not cause-and-effect, and many experts are urging caution in jumping to any conclusions from the findings.
The study author, however, was less reticent.
"Popular sleeping pills are associated with a shocking excess of deaths and a horrible increase in new cancers," said Dr. Daniel Kripke, of the Scripps Clinic Viterbi Family Sleep Center, in La Jolla, Calif.
Many Americans use sleeping pills. During 2010, between one in 20 and one in 10 adults took a sleeping pill in the United States.
In the new study, Kripke's team tracked more than 10,500 people averaging 54 years of age. These patients had a range of underlying health conditions and were prescribed sleeping pills for an average of about 2.5 years between 2002 and 2007. The researchers compared these patients' risks for death and cancer against those of people who did not take sleeping pills.
Those who were prescribed up to 18 doses a year were 3.6 times more likely to die than their counterparts who were prescribed none, while those prescribed between 18 and 132 doses were more than four times as likely to die, the study showed. Those taking more than 132 doses a year had five times the risk of dying compared to those prescribed none. This was true regardless of age, but risks were highest among those individuals aged 18 to 55.
Specifically, there were 265 deaths among 4,336 people taking Ambien, compared with 295 deaths among the 23,671 people who had not taken sedatives or sleeping pills.
Those taking the highest doses were also at greater risk of developing several types of cancer, including esophagus, lymphoma, lung, colon and prostate cancers. Interestingly, the risks of leukemia, breast cancer, uterine cancer, bladder cancer, leukemia and melanoma were not elevated. This association was not explained away by preexisting health problems, the researchers added.
There are many known mechanisms that may explain these increased risks, Kripke stressed. For example, esophageal regurgitation may lead to esophageal cancer. These medications may also make sleep apnea worse, and they may make people more susceptible to falls and automobile crashes.
"For the particular sleeping pills studied, I do not see any time I would prescribe them," Kripke said.
However, other experts weren't ringing alarm bells.
Dr. Victor Fornari, director of child and adolescent psychiatry at the Zucker Hillside Hospital of the North Shore-Long Island Jewish Health System in Manhasset, N.Y., said that people who take sleeping pills should not panic. There could be many reasons for this increased risk of death that have little to do with the pills and more to do with the reasons why people take them, he explained.
"Sleep is the first thing affected when someone is under distress due to medical illness or psychological problems," he pointed out. "These are safe and effective medications when prescribed by a physician as part of a comprehensive treatment plan."
"Don't stop taking these medications if you feel that you need them and are taking them with a doctor's prescription, but be mindful that they shouldn't be taken frivolously and there are alternatives such as avoiding napping, getting proper exercise, eliminating caffeine and doing other the kinds of things that improve sleep hygiene," Fornari said.
But Dr. Bryan Bruno, acting chairman of the department of psychiatry at Lenox Hill Hospital in New York City, cautioned against the chronic use of sleeping pills.
"They can be dangerous and are ideally used on a temporary or short-term basis," he said. "Chronic use should be avoided if possible, particularly because there are risks involved, including dependence. They are not benign or without risk, and should be used cautiously."
More information
Daniel F. Kripke, M.D., Scripps Clinic Viterbi Family Sleep Center, La Jolla, Calif.; Bryan Bruno, M.D., acting chairman, department of psychiatry, Lenox Hill Hospital, New York City; Victor Fornari, M.D., director, child and adolescent psychiatry, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Manhasset, N.Y.; Feb. 27, 2012, BMJ
http://www.sleepfoundation.org/article/sleep-topics/healthy-sleep-tips
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