Insomnia is one of the most common symptoms affecting us. Almost daily, my patients complain they cannot sleep, and the request is invariably the same — "Please, doctor, I must have a sleeping pill." And most of us take the path of least resistance and prescribe something — a mistake!
Many people have tried Tylenol PM. The active ingredient is the antihistamine Benadryl. Both over-the-counter sleep aids and prescription sleeping pills can have side effects, including daytime drowsiness, shorter reaction times that increase risk of motor vehicle wrecks, depression, gastrointestinal upsets and blood pressure abnormalities.
In older people, sedatives can cause memory loss. Sadly, the disadvantages of these drugs outweigh any perceived benefit.
And if these side effects are not enough, new research published in the British Medical Journal shows that taking the most common prescription sleeping pills, such as Ambien, Sonata and Restoril, can shorten life expectancy. Remarkably, taking as few as 18 sleeping pills annually was associated with an increased risk of death, and those taking them daily were five times more likely to die than those who were not, according to the study.
This information is preliminary, and many other factors could contribute to death rates in insomniacs taking sleeping pills. Nevertheless, if the information is true, sleeping pills are more dangerous than cigarettes.
Medication treatment for insomnia must be the last resort. First, attempt to identify and resolve the cause. Most commonly, lifestyle and stress precipitate the problem. Too much caffeine, alcohol, job or family-related stress, burning the candle at both ends and worrying about sleep difficulties all contribute to insomnia. Many medications, including antidepressants, cholesterol-lowering drugs and decongestants can cause poor sleep.
Sometimes a sleep disorder can be the culprit. The most common include sleep apnea, in which breathing stops for short periods of time during sleep, and restless leg syndrome, in which excessive leg movement affects sleep quality.
The key to preventing insomnia is improving sleep habits. Avoid anything that interferes with quality sleep.
Limit caffeine after noon, avoid too much alcohol, and stop drinking fluids of any kind three hours before bedtime. Sometimes merely switching medications to the morning makes a difference.
Good sleep habits occur in happy and healthy people. Depression and stress, which can manifest with severe insomnia, are readily improved by therapy.