About 12% of Americans have been diagnosed with chronic insomnia. But whether it’s one restless night or many, tossing and turning or staring at the wall for hours can leave anyone looking for an easy fix.
Not only is it frustrating, but lack of sleep can lead to a host of health problems — including heart disease, kidney disease, high blood pressure, diabetes, stroke, obesity and depression.
For many, the solution may be over-the-counter or prescribed sleep-aid medication.
According to the Centers for Disease Control and Prevention, in 2020, over 8% of adults reported using sleeping medications every day or most days in the past month.
However, research shows that even just occasional use of sleeping medications can have health consequences. So, daily use is not without risk — but can be a hard habit to break.
Using sleeping pills can lead to physical and emotional dependence, according to licensed experts at WebMD. They encourage patients to speak to their doctors about potentially weaning off the medication.
But why would that be important? Here’s what science says.
1. Higher risk of disability
For a study published in the journal Sleep, researchers reviewed five years of data on more than 6,700 people over the age of 65.
Researchers connected higher levels of both insomnia symptoms and sleep medication use with a higher risk of disability a year later.
Participants’ risk for becoming disabled in some form in their daily life increased by 20% for every year they experienced an incremental increase in insomnia symptoms and sleep medication use.
“When we evaluated the relationships between disability, insomnia and sleep medication use, we found that as older people used more sleep medication or experienced more insomnia symptoms, they moved more rapidly towards greater disability,” said study co-author Orfeu Buxton, a professor of biobehavioral health at Penn State.
2. Higher risk of dementia
A study from the Group Health Research Institute looked at medications with an anticholinergic effect. These drugs “essentially jam, limit or block” communication in the brain, according to the Cleveland Clinic.
Medications with anticholinergic effects are often prescribed for anxiety, pain or depression. They also include some over-the-counter sleep aids and over-the-counter drugs for allergies, such as diphenhydramine, also called Benadryl, which some people also use to help them sleep.
The researchers concluded that taking drugs with anticholinergic effects is associated with an increased risk of developing Alzheimer’s disease or other dementia. This risk is cumulative, meaning it’s greater for people who take such drugs longer-term.
What’s more, the study was the first to find that the damage caused by these drugs may not be reversible even years after patients stop taking them.
If you are or might be on such a medication, talk to your doctor about your medications’ ingredients and to see if other treatment options might be suitable for you.
“Older adults should be aware that many medications — including some available without a prescription, such as over-the-counter sleep aids — have strong anticholinergic effects,” study co-author Shelly Gray said. “But of course, no one should stop taking any therapy without consulting their health care provider.”
3. Higher risk of death
Research from the team at Scripps Clinic linked regular use of certain types of sleeping pills to a 4.6 times higher risk of death.
The study involved more than 10,000 participants who were prescribed such medications for an average of 2.5 years. But even among participants who took between just one and 18 sleeping pills a year, the risk of death was 3.6 times higher than it was for people who took none.
“What our study shows is that sleeping pills are hazardous to your health and might cause death by contributing to the occurrence of cancer, heart disease and other ailments,” study author Dr. Daniel F. Kripke said.
The study looked at the eight most commonly used hypnotic drugs, which include zolpidem (also known as Ambien) and temazepam (also known as Restoril).
4. Higher risk of cancer
The Scripps Clinic study narrowed down its findings to consider cancer risk as well.
Participants who were prescribed at least 132 doses of hypnotic drugs a year developed cancer at a 35% higher rate than people who did not take such drugs.
5. Next-day impairment
The U.S. Food and Drug Administration (FDA) has a webpage dedicated to the dangers of next-day impairment from insomnia drugs — specifically zolpidem products, like Ambien, Ambien CR, Edluar and Zolpimist.
A study led by researchers at the University of Washington found that once a patient starts zolpidem (Ambien, Ambien CR), temazepam (Restoril) or trazodone, their risk of getting in a car crash nearly doubles.
The FDA warns that these types of medications can leave people too impaired to engage in activities that require a lot of alertness, like driving, even the morning after use. The highest risk for next-morning impairment is associated with the extended-release forms of the drugs.
The risk is greater for women, as their bodies don’t eliminate zolpidem as quickly as men’s bodies.
The FDA states it has recommended manufacturers lower the zolpidem dose for women from 10 mg to 5 mg for immediate-release drugs and from 12.5 mg to 6.25 mg for extended-release. It advised that men may also be prescribed these lower doses.
6. Higher risk of falling
Researchers from a study published in the scientific journal Sleep note that prescribed insomnia medications (not exclusively sedative hypnotics) can cause issues with balance, memory and situational awareness.
They say the probability of a fall rises from 28% for older adults with no symptoms of insomnia to 40% for older adults reporting four different symptoms of insomnia — trouble falling asleep, trouble staying asleep, waking too early and not feeling rested.
Researchers also say that the risk of falls for older adults with insomnia who take prescribed sleep medication is higher, even compared with those who have all four symptoms of insomnia.
“The more likely a person has difficulty sleeping, the more likely they are going to be up and walking around in the dark at night,” said study co-author Orfeu Buxton, a professor of biobehavioral health at Penn State. “You might think that if they have a physician-prescribed sleep medication that risk of falling might go down because they would stay in bed, but it doesn’t. It worsens.”
7. Increased risk of pancreatitis
For a study published in the scientific journal Psychopharmacology, researchers analyzed data on more than 22,000 people between the ages of 20 and 84.
The study concluded that those who took zolpidem (Ambien) were seven times more likely to develop acute pancreatitis compared with those who had never taken it.
Alternatives to sleep medications
Quitting sleeping medications is no easy task. There are, however, alternatives that people can turn to. So if you take a sleep medication and are concerned about the risks, it’s important that you talk to your health care provider.
The main non-drug treatment is called cognitive behavioral therapy for insomnia (CBTI).
Harvard University reports that CBTI and hypnotic medications are initially equally effective, and CBTI has longer-lasting effects. Using a combination of the two hasn’t proven to be more effective than CBTI on its own.
CBTI focuses on restructuring the thoughts, feelings and behaviors that may be contributing to a lack of sleep. It also teaches techniques involving stimulus control, sleep restriction and relaxation training.
The Mayo Clinic also provides some basic “sleep hygiene” tips that may be helpful. For example:
- Keep a sleep schedule: This can help your body maintain a rhythm, making it easier to fall asleep.
- Limit naps: Napping for more than an hour or later in the day can interfere with your ability to sleep at night.
- Evaluate your daytime activities: Exercising can help tire you out, but avoid working out close to bedtime. You should also avoid eating, alcohol and caffeine too close to bedtime.
Learn more about how to get a good night of shut-eye in “7 Sleep Tricks That Actually Work.”
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