Sleeping pills DON'T work as a long-term cure for insomnia

Sleeping pills fail to work as a long-term cure for insomnia, a study reveals.

Clinical trials have previously indicated the drugs may aid sleep difficulties for up to six months.

But researchers say doctors and patients should reconsider their extended use after finding they make no difference after one or two years.

They assessed data on 685 women suffering from sleep problems, such as difficulty nodding off, frequently waking or rising too early.

Researchers at Brigham and Women’s Hospital, in Boston, US, have said doctors and patients should reconsider their extended use of sleeping pills. (Stock image)

Some 238 were given sleeping tablets and 447 were not.

After one and two years, neither group reported any significant improvement in sleep quality nor duration and there was no difference between them.

Participants in the study, led by Brigham and Women’s Hospital, in Boston, United States, had an average age of 49.5 years.

All initially reported difficulty falling asleep on one night in every three, waking frequently on two nights out of three, and waking up early one night in three.

Study lead author Dr Daniel Solomon said there is ‘scant evidence’ of the drugs’ long-term effectiveness despite their widespread use.

He wrote: ‘Sleep difficulties are common. Not surprisingly, the use of sleep medications has also grown over the last two decades.

The study found that sleeping pills failed to work as a long-term cure for insomnia. (Stock image)

People with insomnia regularly have problems sleeping.

Sufferers of insomnia regularly find it hard to go to sleep, wake up several times during the night, lie awake at night, wake up early and cannot go back to sleep and still feel tired after waking up.

Those who suffer from insomnia also find it hard to nap during the day (even if they feel tired) and find it difficult to concentrate during the day because they are tired.

The most common causes of the condition are stress, anxiety or depression, noise, a room that’s too hot or cold, alcohol, caffeine or nicotine and recreational drugs.

In order to treat insomnia, GPs will try to find the cause of the patient’s insomnia.

Sometimes a patient may be referred to a therapist for cognitive behavioural therapy (CBT).

GPs now rarely prescribe sleeping pills to treat insomnia.

The NHS recommends that adults get between seven to nine hours of sleep a night.

Source: NHS

‘These agents have a range of safety concerns and recent reports describe substantial driving impairments.

‘Most data regarding their efficacy derive from short-term studies (ie, 2-12 weeks), but these agents appear to be used over the long-term by many patients.

‘In this analysis of the long-term impact of sleep medications…sleep medication use was not associated with reduced sleep disturbances.

‘When physicians or other clinicians prescribe these medicines, they often begin with short-term prescriptions, but many patients receiving these prescriptions become long-term users.

‘While there are good data from randomised control trials that these medications improve sleep disturbances in the short term, the results we present here represent some of the only data on these medications’ long-term impact on sleep.

‘The lack of benefit observed in the current study suggests that when physicians begin prescribing these medicines they should discuss with patients that many patients continue them long-term, and that there is scant evidence demonstrating benefit to using these medicines beyond several months.’

Poor quality sleep is associated with ill health, including diabetes, high blood pressure, pain and depression.

Around one in three people suffer sleep problems at least once a week and doctors prescribe a variety of drugs to help people doze.

These include benzodiazepines, Z-drugs such as zolpidem, zaleplon and eszopiclone, and others intended for anxiety and depression.

The researchers accept the drugs may work well in some ‘small percentage of patients’ with sleep disturbances over several years.

But they say their findings should make doctors and patients ‘pause for thought’ before reaching for a prescription.

The NHS says GPs now rarely prescribe sleeping pills to treat insomnia because of their side-effects and potential for addiction.

Go to bed and wake up at the same time every day.

Relax at least 1 hour before bed, for example, take a bath or read a book.

Make sure your bedroom is dark and quiet – use curtains, blinds, an eye mask or ear plugs if needed.

Exercise regularly during the day.

Make sure your mattress, pillows and covers are comfortable.

They are typically prescribed for a few days or weeks at the most if insomnia is very bad or other treatments have not worked.

Milder sleeping pills are available from pharmacists.

The most common causes of insomnia are stress, anxiety or depression; noise; a room that is too hot or cold; an uncomfortable bed; or alcohol, caffeine or nicotine.

Professor Martin Marshall, Chair of the Royal College of GPs, said: ‘Sleep problems can have a serious and negative impact on a patient’s physical and mental health and wellbeing.

‘Whilst sleep medication can be effective for some patients in the short term, it does not come without risk, so GPs will only prescribe it to patients when alternative treatment options have been explored.

‘Stress, anxiety and lifestyle factors, such as drinking alcohol or caffeine, can all contribute to sleep problems and can often be addressed without medication.

‘If medication is prescribed, it will be after a frank conversation with the patient about the potential risks and benefits – and GPs will generally prescribe the lowest possible amount for the shortest possible time.

‘This is an interesting study and it’s important that it is taken into account as clinical guidelines are developed and updated.’

The findings are published in the journal BMJ Open.