A recent study published in the British Medical Journal has found that prescription sleeping pills, such as Ambien and Restoril, are associated with increased risks for cancer and death.1 In the study, individuals who were prescribed 1 to 18 doses of insomnia drugs per year were 3.6 times more likely to die during the study period of 2.5 years than individuals who did not use these drugs. The risk of death was 4.4 times higher for individuals who were prescribed 18-132 doses and 5.3 times higher for individuals prescribed >132 doses per year. Individuals who were prescribed more than 132 doses per year were also found to have 1.4 times more risk of developing cancer.
While the study does not prove these drugs cause death or cancer, it serves as a caution on their use and highlights the need for individuals to explore other remedies for insomnia before resorting to drug therapy. For example, any underlying conditions that can contribute to insomnia, such as depression, restless leg syndrome and hyperthyroidism, should be treated first. Other non-drug based treatments should also be explored before turning to prescription sleeping pills. These include: eliminating caffeine and nicotine 4-6 hours before bedtime; avoiding alcohol as a sleep aid; avoiding exercise within 3 hours of bedtime; creating a comfortable environment with noise, light and extreme temperatures controlled; maintaining a regular time to wake up each day; getting out of bed and going to another room if unable to fall asleep or fall back to sleep within 15-20 minutes; and avoiding daytime napping. For those who have tried all other available treatments and still suffer from significant insomnia, prescription medications may still be beneficial as untreated insomnia has significant mental and physical health consequences. However, given the results of this study, we should all think twice before taking these medications.
Nate Kelly, MPH, RD, LDN
1. Kripke DF et al. Hypnotics’ association with mortality or cancer: A matched cohort study. BMJ Open 2012 Feb 27; 2:e000850.