Sleep Drugs are Over-Prescribed, May Harm Public Health

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If you fall asleep on the wings of Lunesta or swear that Ambien works like a dream, then you’re one of millions of Americans popping sleeping pills to have a good morning.

New research suggests that sleeping pills are heavily over-prescribed, raising potential public health concerns. The study, published online in the American Journal of Public Health on June 16, found that sleep drug use far outpaces need.

Researchers examined data from the National Ambulatory Medical Care Survey, an annual, nation-wide survey of physician office visits in the U.S. The survey included approximately 28,000 office visits per year, for adult patients ages 18 and older. They looked at a 15-year period, from 1993-2007, and compared rates of sleeplessness complaints and insomnia diagnoses to actual sleep drug prescriptions.

The results were striking.

In 1993, the number of sleep drug prescriptions was lower than the number of sleeplessness complaints. But by 2007, the number of sleep drug prescriptions was more than three times higher than the number of sleeplessness complaints, outpacing actual insomnia diagnoses by 13.8 million prescriptions.

A Jagged Little Pill

Insomnia is often treated with two kinds of sedatives: benzodiazepines (BDZs), which have a high risk of dependence with long-term use, and nonbenzodiazepine sedative hypnotics (NBSHs), which have a lower risk of dependence. NBSHs include popular sleep drugs like Ambien, Sonata and Lunesta.

NBSHs are advertised directly to consumers and after they hit the market in 1994, prescriptions for NBSHs grew 21 times faster than sleeplessness complaints and five times faster than insomnia diagnoses.

“Many people take them like a multivitamin—daily and indefinitely,” says Mairead Eastin Moloney, Ph.D., lead author and postdoctoral research fellow at the University of North Carolina.

That habit can have serious side effects.

Long-term use of any sleep drug can lead to tolerance and addiction. On average, NBSHs offer only 12 extra minutes of sleep and side effects include driving, eating and walking during sleep, as well as short-term memory loss.

QUIZ: What's Your Sleep Quality?

Adults over the age of 65 are more likely to have trouble sleeping due to changes in the brain and a higher rate of other medical problems, but surprisingly, they’re not getting the bulk of the sleep meds.

Instead, the study found that adults under 65 outpaced older adults on all measures of sleeplessness—complaints, diagnoses and prescriptions. The authors guess that non-biological issues were most likely at play, such as stress, ever-present technology and targeted marketing of sleep drugs.

The rise of sleeplessness and sleep drug use among younger adults may be a sign that medical solutions are being used to treat normal sleeplessness.