November 8, 2010
Sleeping Pills Not Easy Answer
When sleep doesn't come easily, some people turn to what they think is an easy solution "“ sleeping pills. But according to a Baylor College of Medicine sleep expert, sleep medications "“ whether prescription or over-the-counter "“ shouldn't be taken lightly.
"All medications have side effects that need to be weighed whenever you take them," cautioned Dr. Phil Alapat, assistant professor of pulmonary, critical care and sleep medicine at BCM and medical director of the BCM Sleep Center.
Some of the most common prescription sleep medications are non-benzodiazepine hypnotics, like Ambien and Lunesta. These medications are not physically addictive and will not cause withdrawal symptoms when a person stops taking them. However, many people depend on them because they believe they cannot sleep without them, Alapat said.
"The difficult point here is determining what is an addiction," Alapat said. "Many patients do tend to become attached to the idea that the medication is required for them to fall asleep."
There are some medications that people use to help them sleep that can become addictive. Often, these were prescribed for some other reason, but patients also use them as a sleep aid.
"Many medications have been prescribed and used as a sleep aid, from antidepressants to antipsychotics to muscle relaxers. Anything outside of FDA approved sleep aids such as the melatonin receptor agonist, Rozerem, and non-benzodiazepine medications, such as Ambien, really has no place as a sleep aid," Alapat said.
One of the most common over-the-counter sleep aids is the nutritional supplement melatonin, which does help to promote sleep for some people, he said. It is more commonly used in situations such as jet lag, where it may be beneficial. It is not an FDA regulated substance, however, and so people don't always know what they're getting when they buy melatonin.
Over-the-counter sleeping pills may also contain antihistamines and while these can help a person sleep, they have other side effects, including dry eyes and mouth. They may also cause an altered mental state, and this can be especially concerning in older adults, Alapat said.
But before turning to any type of sleep aid, Alapat recommends a visit to a physician, and more specifically a sleep disorders specialist.
"A lot of patients who complain of insomnia may have some other medical condition that needs to be addressed," he said. "Without addressing those other issues, the use of medications is often futile."
Underlying health conditions that may affect sleep include, but are not limited to, sleep apnea, restless legs syndrome and depression.
"There are many other medical disorders that should be evaluated before the diagnosis of insomnia can be reached," Alapat said.
Medication is usually only a small part, if any, of a treatment plan for patients who suffer from insomnia and other sleep issues, Alapat said, and should not be considered a long-term solution.
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