Sleep Drugs are Over-Prescribed, May Harm Public Health

Is Sleeplessness Really a Medical Problem?  

Studies estimate that approximately 30 percent of Americans experience at least one symptom of insomnia in a given year, but only an estimated 10 percent meet the Diagnostic and Statistical Manual-IV-TR criteria for insomnia, which requires that the symptoms have persisted for at least one month and impair daytime function.

Over the study’s 15-year span, annual insomnia diagnoses increased from less than one million to 6.1 million. Prescriptions for NBSHs rose even faster, from roughly half a million in 1994 to 16.2 million in 2007, suggesting that people are taking sleep drugs for ordinary sleeplessness.

Courtesy of Mairead Eastin Moloney, Ph.D.MOLONEY, Figure 1 - Sleeplessness-related trends of complaint, insomnia diagnosis, benzodiazepine (BDZ) and nonbenzodiazepine sedative hypnotic (NBSH) prescription as a result of physician office visits: United States, 1993-2007.

Sleeplessness, unlike chronic insomnia, is a relatively normal part of human life. Whether parenting, poor sleep habits, stress or other common issues interfere with a good night’s rest, most people experience some difficulty sleeping.  

The authors warn that treating ordinary sleeplessness as a medical problem “may reframe and transform ideas of physical and emotional normalcy, prompting the overuse of potentially harmful drugs.” In other words, people may be treated for problems they don’t have.

Still, sleeplessness is concerning.

Sleep is incredibly important and often undervalued. (We’ll sleep when we’re dead, right?) Six to eight hours of sleep per night is essential for heart health, energy, healthy skin, good posture and weight management. It even refreshes neurotransmitters that help suppress pain. You need to catch your Z’s.

But when sleeplessness strikes, sleep aids are not the only answer. “There are natural ways to cure insomnia,” says James Maas, Ph.D., YouBeauty Sleep Expert. “For many people, insomnia is a behavioral issue.” Sleep drugs may simply be a Band-Aid for underlying stress or poor sleep habits, which when ignored, will eventually do more damage than a sleep drug can repair.

More importantly, difficulty sleeping can betray a deeper psychological issue, especially depression or anxiety. In fact, a 2007 study published in the Journal of Clinical Sleep Medicine estimated that 40 percent of insomnia patients also have a psychiatric condition, most commonly depression.

In those cases, the underlying problem needs to be treated—sleeplessness is merely a symptom.

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Treating Sleeplessness Properly

For the millions of people suffering from sleeplessness, a pill may be the only solution they’re offered.

“Most physicians aren’t educated on behavioral therapies for sleep,” says Moloney. “Many patients want the easy fix and physicians may not have many other options in their tool-kits.

However, behavioral therapies for sleeplessness are shown to be highly effective.

Behavioral treatments include learning to relax, keeping a sleep diary, limiting the time you spend in bed and changing basic lifestyle habits like drinking caffeine after 4pm, exercising in the late evening, or watching TV in bed.

MORE: Meditate for Sleep

The American Academy of Sleep Medicine recommends behavioral treatments as a first-line approach and suggests that anyone taking sleep drugs should be educated about and encouraged to try behavioral treatments as well.

“Unlike sleep medications,” Moloney says, “the effects of behavioral therapies are enduring and lack side effects.”

If you’re sleepless in Seattle, the city that never sleeps or any other city, think twice before you pop a pill. Ask yourself whether your sleeplessness is a medical problem or a life problem. By addressing the root of the problem up front, you’ll sleep better and easier than any pill could promise.