Michael Jackson’s tragic death from an overdose of propofol (marketed as Diprivan) highlights the dangers of taking sedatives to sleep…
Between a third and half of adults have insomnia and complain of poor sleep.
Most of us won’t be taking propofol, which is administered intravenously and most commonly used for surgical procedures and veterinary medicine, not for insomnia.
But two of the other drugs in Michael Jackson’s pharmaceutical nightcap – Ativan and Versed – are commonly prescribed for insomnia, even though as benzodiazepines they have been shown in ECG studies to produce a poor quality of sleep, and in the case of Ativan to produce withdrawal symptoms like rebound insomnia (the return of the symptom in a more severe form) after as few as seven days of use.
It’s a stark reminder sleeping pills are not harmless jubes, although they may be effective in ending your sleep problems in the short term.
So how can you take them safely, while avoiding the side effects?
What type of sleeping pill should you take?
Most sleeping pills are “sedative hypnotics” and fall into three broad categories: benzodiazepines, barbiturates, and various hypnotics.
Benzodiazepines such as Xanax, Valium, Ativan, and Librium are anti- anxiety medications, which are also used to treat insomnia. All benzodiazepines are potentially addictive.
Barbiturates are short or long term acting sedatives which got a bad name for themselves in the 50s and 60s because of their psychological and physical addictiveness, and have generally been replaced by newer drugs. Luminal and Mebaral are two still prescribed for insomnia.
Non habit forming hypnotics help reduce the time it takes to fall asleep. Lunesta, Sonata, and Ambien work quickly to increase drowsiness and sleep.
Rozerem, the newest approved by the FDA, acts differently from other sleep medicines. Rather than depressing the central nervous system, it mimics melatonin, a chemical that helps regulate the body’s natural sleep-wake cycle. Sleep experts however query whether it is effective for sleep disturbances not caused by jet lag or sleep rhythm disturbance.
Common Side Effects of Sleeping Pills
Sleeping pills make you breathe more slowly and less deeply. That can be dangerous for people with uncontrolled lung problems such as asthma. They may also provoke an allergic reaction.
Common side effects of prescription sleeping pills such as Lunesta, Sonata, Ambien, Rozerem, and Halcion may include:
Can I become dependent on sleeping pills?
Short-term use – over several weeks – may be fine. Use for longer periods and you may build up a tolerance and it becomes less effective. You may also become psychologically dependent on the medicine. Then the idea of going to sleep without it will make you anxious. Some studies show that long-term use of sleeping pills actually interferes with sleep.
Natural alternatives to sleeping pills
There are a range of options you can consider to avoid using sleeping pills which may have much better long term results. These include making lifestyle changes like avoiding coffee or alcohol in the evening, developing a deliberately peaceful bedtime routine, keeping a worry journal, and taking natural sleep aids like valerian or melatonin.