There are many reasons that people struggle to fall asleep. Often times, stress keeps people up at night. But sometimes the culprit is a disorder like insomnia or obstructive sleep apnea.
Sleeping pills often are prescribed to help people who consistently struggle to fall asleep, but they also are known to cause potentially dangerous side effects.
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A newly-released survey of more than 30,000 adults, conducted by the U.S. Centers for Disease Control and Prevention in 2020, found that 8.4% of adults were taking sleep medication at least most nights, with women more likely to use them than men. The use of sleeping pills generally increased with age. Nearly 12% of seniors reported using a sleeping aid on at least most nights.
The higher percentage of seniors using sleeping pills is of particular concern, experts say.
"Sleeping pills have a lot of side effects, and older adults are more prone to experiencing the negative effects of these medications," Dr. Nishi Bhopal, a psychiatrist and sleep medicine doctor who was not involved in the survey, told CNN. "These include things like confusion, the risk of falling, breaking bones, and (they) even are at a higher risk of cognitive issues like dementia. And so to see that the highest rate of use (is) in this population is concerning."
Still, a study published last year found that the use of sleeping pills dropped by 31% between 2013 and 2018. That decline followed decades of increased usage. Benzodiazepine prescription jumped by 69% between 1993 and 2010; those for zolpidem, sold under the brand Ambien, rose by 140%.
"There are several possible reasons for this decline; for example, there's a greater awareness of the potential dangers in the use of these medications," lead researcher Christopher Kaufmann, a professor in the Department of Health Outcomes and Biomedical Informatics at the University of Florida, told U.S. News & World Report. "Also, there's been a recent upsurge in behavioral treatments for improving sleep that don't have the potential adverse outcomes that some medications might have."
The Sleep Foundation lists many possible serious side effects of common sleeping pills. They include a burning or tingling sensation in the extremities, changes in appetite, constipation, diarrhea, dizziness, daytime drowsiness, dry mouth, gas, headaches, heartburn and nausea. Some people also experience mental impairment the following day, difficulties with concentration and memory, stomach pain, impaired balance, weakness, uncontrollable shaking and frequent weird dreams or nightmares.
Eighty percent of people who take prescription sleeping pills, like benzodiazepine hypnotics and zopiclone, experience at least one of the following side effects the next day: drowsiness, mental impairment and difficulty with balance or motor coordination. These side effects, referred to as "hangover effects," can impact a person's driving abilities, work performance and social relationships.
Prolonged use of these drugs only worsens the side effects, experts say. People who take sleep medications also may be a risk for parasomnia – unusual behaviors while sleeping, like sleepwalking, bed wetting, allergic reactions and pill dependency.
Most sleeping pills are meant only for short-term use. As the body becomes dependent on sleep medications, progressively larger doses are to needed to produce the same effect. People who mix the pills with alcohol, also a sedative, increase their risk of death, because the combination causes breathing to slow down.
When people are ready to stop taking sleeping pills, they are advised to follow the instructions on the label or those given to them by their health care providers or pharmacists. Some pills must be stopped gradually. Short-term rebound insomnia is common in the first few days after stopping the pills.
Before people consider taking sleeping pills, they are advised to get evaluated by a physician to ensure that they don't have an underlying medical condition, like a sleeping disorder, experts say. Any medical condition should be addressed and behavioral changes made for long-lasting improvements in sleep health.
The Sleep Foundation and Cleveland Clinic offer several alternatives to help improve sleep:
• Get at least 7 hours of sleep every night
• Manage stress levels
• Limit caffeine and alcohol consumption
• Exercise regularly
• Unwind for at least a 30 minutes before climbing into bed
• Keep the bedroom temperature between 60-67 degrees