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Sleeping Pill Use Increases Risk of Death and Cancer


If you use sleeping pills such as zolpidem (Ambien) or temazepam (Restoril), even less than twice a month, you are at an increased risk of death, according to a new study in the online journal BMJ Open. The same study noted that high doses of sleeping pills may also increase your risk of cancer.

Use of sleeping pills is on the rise

The findings of this new study are disturbing, especially since use of sleeping pills (hypnotics) is on the rise. According to the authors, between 5% and 10% of adults used sleeping pills in the United States in 2010.

Data from the NHS Information Centre showed a 3% increase in prescriptions for sleeping pills between 2007/08 and 2010/11 in England, as well as a 28% rise in antidepressant use. Experts believe the stress of economic problems are causing more people to experience stress and difficulty sleeping.

In the new study, which was conducted by researchers at the Scripps Clinic Viterbi Family Sleep Center in La Jolla, California, and the Jackson Hole Center for Preventive Medicine in Jackson, Wyoming, the authors followed 10,529 adults (mean age, 54 years) who had been prescribed sleeping pills for an average of 2.5 years between 2002 and 2007. They were matched with 23,676 controls who had not used hypnotic prescriptions.

The two most commonly used sleeping pills were temezepam and zolpidem, which accounted for more than 50% of the drugs used. Others included eszopiclone, zaleplon, and various barbiturates and sedative antihistamines.

After allowing for factors such as age, underlying health conditions, sex, and lifestyle habits, the investigators found evidence of a link between use of the sleeping pills and an increased risk of death. More specifically:

  • People who were prescribed up to 18 doses a years were more than 3.5 times as likely to die as were individuals who were not prescribed sleeping pills
  • Individuals taking from 18 to 132 doses of sleeping pills were more than four times as likely to die
  • Anyone who took more than 132 doses of the pills were more than five times as likely to die as were non-using controls
  • Although these risks were seen in all age groups, the risks were greatest among people aged 18 to 55
  • Adults who took the highest number of doses were 35% more likely to be diagnosed with cancer, and this risk was not related to any pre-existing condition

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Dr. Trish Groves, editor-in-chief of BMJ Open, pointed out that “Although the authors have not been able to prove that sleeping pills cause premature death, their analyses have ruled out a wide range of other possible causative factors.”

So what now? The authors noted that “the meager benefits of hypnotics, as critically reviewed by groups without financial interest, would not justify substantial risks.” They pointed out that “a consensus is developing that cognitive-behavioral therapy of chronic insomnia may be more successful than hypnotics.”

In fact, a recent study in Psychology Research and Behavior Management reported on “New developments in cognitive behavioral therapy as the first-line treatment of insomnia.”

The authors, from the Sleep Medicine Center at Stanford University School of Medicine, reported that cognitive behavioral therapy for insomnia (CBTI) is well grounded in science and that “there is strong empirical evidence that CBTI is effective.”

The new findings of an association between use of sleeping pills and a substantially increased risk of death and cancer are reason to reconsider the use of these medications, say the authors, including even short-term use.

Kripke DR, Langer RD, Kline LE. Hypnotics’ association with mortality or cancer: a matched cohort study. BMJ Open 2012; 2:e000850. Doi:10.1136/bmjopen-2012-000850
Siebern AT, Manber R. New developments in cognitive behavioral therapy as the first-line treatment of insomnia. Psychology Research and Behavior Management 2011; 4:21-28

Image: Courtesy Wikimedia Commons



I would love to see medical providers move away from prescriptions and really educate patients about lifestyle changes to help with sleep.
I agree. Perhaps the findings of this study will prompt more doctors to take that step...and more healthcare consumers to say no to sleeping pills and seek alternatives.