The risks of taking sleeping pills increase as we get older 💊😴
A sleeping pill can help your sleep problems for the short term. But it’s important to understand everything you need to know about sleeping pills.
For millions of people, one of the biggest obstacles of the day (or in this case, the night) is getting a good sleep. However, research suggests the potential risks of using sleeping pills may increase as we get older, which is a concern as data suggests that more than a third of adults aged 65 and older take them.
Compared to younger people, older adults have a greater chance of health problems on sleep meds. When you’re older, sleeping pills tend to stay in your system longer. Drowsiness can last into the day after you’ve taken them. We are also at greater risk of becoming confused, experiencing memory loss, or having a fall and/or a fracture when taking a sleeping pill of this type. You are also more likely to need to be hospitalised unexpectedly. These risks are even greater if you are taking other regular medicines as well as sleeping pills.
The biggest risk, according to Dr. Morehouse, is falls. “Getting up to go to the bathroom becomes more common as you get older,” Dr. Morehouse said. “And if you’ve got a sleeping medication on board, and maybe you have trouble with vision and walking generally, that causes you to fall. Then, because you have osteoporosis, you break something and end up in the hospital. Then a whole host of bad things can happen.”
According to Consumer Reports’ Choosing Wisely campaign, taking sleep meds may also cause dependency and increase your risk of car accidents, and more than double your risk of falls and fractures, common causes of hospitalisations and death in older adults.
The most common prescription sleeping pills are benzodiazepines, also known as the “pam” drugs, such as lorazepam and diazepam. In the 1980s new nonbenzodiazepine “z drugs,” such as zopiclone, were marketed as having fewer side effects, safer than sleeping pills and being less likely to cause dependence. However, the ‘hangover effects’, memory loss and potential for side effects and serious accidents are still possible with these medicines, as are issues with tolerance, dependence, withdrawal symptoms and rebound sleep problems. There is no convincing evidence that these newer sleeping pills are safer or more effective for sleep than a benzodiazepine medicine.
“If older adults believe that these changes are a normal, inevitable part of aging, they may not think of it as something to discuss with their doctor. And not discussing it can potentially lead to health issues (related to sleep) not being identified and managed,” says Preeti Malani, M.D., chief health officer and a professor of medicine in the division of infectious diseases at the University of Michigan.
No matter your age, Malani recommends adding any concerns about sleep to the list of topics you discuss with your doctor during regular checkups. That way, he or she can rule out any underlying conditions that may be causing your lack of sleep, for example, anxiety, depression, restless legs syndrome, and even heart disease.
Other common side effects from sleeping pills
Common side effects of prescription sleeping pills such as Ambien, Halcion, Lunesta, Rozerem, and Sonata include:
- Burning or tingling in the hands, arms, feet, or legs
- Changes in appetite
- Balance problems
- Daytime drowsiness
- Dry mouth or throat
- Impairment the next day
- Mental slowing or problems with attention or memory
- Stomach pain or tenderness
- Uncontrollable shaking of a part of the body
- Unusual dreams
It’s important to be aware of possible sleeping pill side effects so you can stop the drug and call your doctor immediately to avoid a more serious health problem.
Study suggests sleeping pills increase risk of death
The study was carried out in the US, where up to 10% of the adult population took sleeping pills in 2010. The authors estimate that sleeping pills may have been associated with 320,000 to 507,000 extra deaths in the US that year.
Over a two-and-a-half-year period, they compared the death rates among more than 10,500 people who received sleeping pill prescriptions with those of more than 23,600 others – matched for age, state of health and other factors – who had not received such medication. The average age of the study group was 54.
The scientists in the study found that even at a relatively low rate of prescription – fewer than 18 doses a year – those who were given the pills had a 3.5 times greater risk of death compared with those who were not prescribed them. Individuals who were given pills more frequently – between 18 and 132 doses in a year – were more than four times more likely to be dead at the end of the study. The risk of death for those on the most pills – 132 doses or more a year – was more than five times that of those on no pills.
Ways to sleep better without medicines
Behavioural therapies such as progressive muscle relaxation, breathing exercises, meditation, counselling support and advice (e.g. cognitive therapy) and good sleep habits are the best ways to manage sleep problems long term.
Other techniques in your own control include waking up at the same time every day, avoiding caffeine six hours before bedtime, exercising regularly, avoiding alcohol at night, avoiding smartphone and e-reader screens in bed, and setting the sleeping mood.
These non-medicine therapies can take a few weeks to start working, but be patient. Unlike sleeping pills, you will be able to:
- focus on correcting the factors that often contribute to sleep problems
- let your body sleep as deeply as it needs to so you feel rested the next day
- avoid any side effects, dependence and other possible harms of sleeping pills
How to develop good sleep habits, naturally
Regulate your sleep
- Try to go to sleep and wake up at the same times each day.
- Avoid naps during the day. If you do nap, keep it to 20 minutes.
- Avoid oversleeping.
- Avoid bright light in the evening.
- Seek out some bright light when you wake up each morning.
- Don’t stay in bed worrying. If you’re awake for more than 20 minutes — go to another room and do something that relaxes you, such as reading a book, listening to music or meditating.
Create a sleep-friendly environment
- Be as active as possible during the day, exercise and spend some time outdoors.
- Don’t eat, work, watch television, read or discuss problems in bed.
- Avoid working on a computer, tablet or smartphone late in the evening.
- Avoid caffeinated drinks after midday and reduce your overall daily caffeine intake.
- Avoid heavy meals and vigorous exercise within 3 hours of going to bed.
- Avoid smoking and drinking alcohol in the evening.
- Keep your pets, the TV, and brightly lit digital clocks out of the bedroom.
While you’re hear, read our article 14 tips to develop good sleeping habits
Talk with your health professional about which non-medicine therapies best suit your situation and where you can get further support to learn relaxation techniques or access counselling.
If you have tried these tips and are still having problems with sleep, ask your doctor about other treatment options. Your doctor will help you find what works for you and may also refer you to a sleep specialist, a sleep clinic, or suggest you fill out a sleep diary.
There are a large number of sleep clinics across Australia. To find out which clinics are in your area, contact your local branch of Sleep Disorders Australia.
Handy tip: How Blue Light Disrupts Sleep
Artificial light, especially the light emitted from the electronics we love including televisions,
iPads, computer monitors, and smartphones, are destroying our sleep. According to a poll released by the National Sleep Foundation, 95 percent of Americans use one of these devices within an hour before going to bed. This light is absorbed through the eyes, which sends a signal to the pineal gland that it’s daytime and time to halt production of melatonin, the body’s natural sleep cycle regulator.
Using a tablet such as an iPad seems to be the worst device to use before bedtime. Research shows that two hours of iPad use before bedtime reduces melatonin levels by 22 percent.
Tablet use is more detrimental than watching TV or looking at a computer monitor since tablets emit shorter wavelength radiation and are held closer to the eyes. They are also worse than smartphones since they have larger screens but are held at similar distance. And these are the devices most likely to wind up in bed with you as the last thing you do before retiring.
One study that compared reading a paper book with reading on an iPad before bed concluded that, “iPad use increases the time it takes to fall asleep, decreases rapid eye movement (REM, or dreaming) sleep and decreases feelings of sleepiness in the evening as well as alertness the next morning. The use of these devices before bedtime prolongs the time it takes to fall asleep, delays the circadian clock, suppresses levels of the sleep-promoting hormone melatonin, reduces the amount and delays the timing of REM sleep, and reduces alertness the following morning.”
– NPS Medicine Wise, Sleeping pills and older people: the risks. 31 March 2015. Read article
– The Globe and Mail, The dangers of sleeping pills for seniors. By Nancy Carr, August 2015. Read article
– How Artificial Light Is Ruining Your Sleep. By Deane Alban, November 2015. Read article
– The Guardian. Sleeping pills increase risk of death, study suggests. By Sarah Boseley, 28 April 2021. Read article
– WebMD, Understanding the Side Effects of Sleeping Pills. By By Debra Fulghum Bruce, PhD, 27 July 2021. Read article
Looking for more insights on a better night’s sleep?
Volume three provides a different perspective on the normal issues relating to your health, such as exercise, nutrition and relaxation. Everything we do in life has some form of influence to our subconscious, and these are great examples. Understand why maintaining a social lifestyle does wonders for your mental health and overall wellbeing, learn the positives stemmed from generosity and volunteering, as well as the importance of getting quality sleep. Read more on Volume 3 – The Why’s of Goodness.