The American College of Physicians has issued new guidelines for managing chronic insomnia, among them: DON’T pop pills to get to sleep!
According to the new recommendations, cognitive behavioral therapy should come first in attempting to manage insomnia, with drugs left as a last resort.
According to doctors at the organization, medications can include side effects and may even make sleep issues worse over time.
Drugs “Don’t Provide Natural Sleep”
One of the primary concerns professed by physicans at the organization is that drugs artifically induce sleep and therefore, may not necessarily give the normal, restful sleep one needs.
“Drugs don’t provide a natural sleep,” insisted American College of Physicians president Nitin Damale in an interview with the Wall Street Journal, “and the side effects are significant.”
He added that older patients have more to worry about than their younger counterparts, per findings. “[The danger of taking drugs to counteract insomnia is] true in all age groups, but even more problematic for older adults,” Damale said.
Unwanted Side Effects
One major concern noted during the course of the 15-year study was that many sleep-producing medications produce unwanted, and potentially harmful, side effects.
Sleep-inducing medications differ in strength and composition, but a few side effects noted by physicians include:
- fuzzy thinking
- memory gaps (particularly short-term memory)
- weakness and impaired balance
- an increased risk of accidents, particularly motor vehicle or machinery incidents
Over the long term, effects may be longer-lasting or even permanent, producing increases in medical costs. In addition, many sleep medications are only covered by health insurance for limited periods, depending upon the insurance carrier and terms of coverage. This means even higher costs for the patient.
The Worst Offenders
Just what medications are we talking about here? According to the study, the most common and potentially most harmful insomnia medications studied included:
- sedative hypnotics (particularly benzodiazapenes, such as Halcion)
- non-benzodiazapenes (Ambien, Lunesta, Sonata)
- orexin receptor antagonists (Belsomra)
- over-the-counter sleep aids
In addition to the side effects listed, some sleep aids, such as benzodiazapenes, can be addictive, according to researchers.
What’s the Solution?
According to the study, cognitive behavioral therapy and non-drug changes should be an insomnia sufferer’s first course of action. Recommendations include keeping a sleep journal/sleep diary to help pinpoint issues related to an inability to fall asleep, as well as avoiding caffeine in the afternoon and evening, maintaining a cool temperature in the bedroom, and avoiding alcohol.
Since, in a catch-22 fashion, fear of not being able to fall asleep may make insomnia worse, some patients may wish to hide the clock so they are unable to see the minutes and hours ticking by.
Eating well and exercising may help too, according to researchers.