Consumer Reports / April 22, 2016
Sleeplessness is complicated — but that hasn’t stopped millions from craving a simple chemical solution. Potions to ease the misery of insufficient sleep can be traced to the ancient Egyptians, who employed an extract of the opium poppy.
In a Consumer Reports survey, 37 percent of people who complained of sleep problems at least once per week said they had used an over-the-counter or prescription sleep drug in the previous year.
“But those benefits aren’t as great as many people assume, and the drugs have important harms,” says Dr. Lisa Schwartz, a drug-safety expert at Dartmouth’s Geisel School of Medicine in Hanover, N.H., who has worked with Consumer Reports Best Buy Drugs on investigating sleeping pills.
What’s more, the survey found that about half of people who take sleep aids use the drugs in potentially harmful ways — by, for example, taking them more often or longer than recommended or combining them with other medications or supplements.
Even taken as directed, sleeping pills pose risks, including next-day drowsiness. A study published online in June 2015 by the American Journal of Public Health found that people prescribed sleeping pills were around twice as likely to be in car crashes as other people. The researchers estimated that people taking sleep drugs were as likely to have a car crash as those driving with a blood alcohol level above the legal limit.
Several sleeping-pill instructions caution users to take the medications only if they can stay in bed for at least seven or eight hours.
And to address the dangers of next-day drowsiness, the Food and Drug Administration has cut in half the recommended doses for Ambien and Lunesta.
The labels for Ambien CR and Belsomra 20 milligrams, in fact, caution against driving at all the day after taking the pill. Yet Consumer Reports’ survey found that about a quarter of sleep-aid users drove with less than seven hours of sleep at least once in the previous year.
Sleeping pills can pose other dangers, too, including dizziness, falls, and fractures.
“These drugs are known to have a hangover effect that impairs coordination and balance into the next day, especially in older adults,” says Dr. Ariel Green, a geriatrician at the Johns Hopkins University School of Medicine in Baltimore.
Even over-the-counter sleep aids — such as Advil PM, Sominex, and ZzzQuil — pose risks, including daytime drowsiness, confusion, constipation, dry mouth, and problems urinating.
Consumer Reports’ medical experts recommend following these precautions, which apply to both prescription and over-the-counter sleep drugs:
■ Tell your doctor about all of the medications you take, including supplements. Many common drugs, such as certain antibiotics and antidepressants, can interact dangerously with sleep drugs.
■ Take the drugs only if you have time for at least seven or eight hours of sleep. Even if you’ve had that much sleep, don’t drive if you feel drowsy.
■ Do not take an extra dose if you wake up in the middle of the night.
■ Never mix sleeping pills with alcohol, recreational drugs, or other sleep drugs or supplements, including over-the-counter nighttime pain relievers and antihistamines, such as Benadryl Allergy, that contain the sedative diphenhydramine.
■ Start with the lowest recommended dose, especially until you know how the drug affects you.
■ Be cautious about frequent use. Taking sleep drugs regularly can breed dependence and raise the risk of adverse effects.
Editor's Note: This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).
