Sleeping pills: ¿angels or demons?

Dr. Javier Brualla, expert in Medicine of the Sleep, tells us what we need to know about the sleeping pills, are beneficial for our health or on the contrary they harm us?

Insomnia. 31% of Spaniards have or have had this problem on occasion. However, few people go to a doctor for this reason, and when they do, and come with a long story to tell, a list of all the medicines that have been taken over the years and with some questions like :

“¿Is there anything else I can take to sleep?, ¿any new medications? …… because I know them all and thye´re not doing any effetc to me.”

What I just described is usually the end of the story; but up to that point there is a long road that began several years ago and almost always follows the same script:

when the patient does not sleeps well ,home remedies or natural therapies (a glass of milk before appearing bed, an infusion of valerian, … … etc) are the first options ; the next step is usually to go onto the nearest pharmacy for medication, those sleeping pills that usually advertise on the media, and can be purchased without a prescription.

After the limited success of previous measures and tired that nothing works, just opting for the fastest way: hypnotics (sleeping pills).

“Finally! OMG I can sleep now!”. Well I’m glad to know that ….. and you will enjoy it! because this period of “honeymoon” unfortunately usually ends soon ; and is that the continued use of these drugs, due to a phenomenon of tolerance, we do need to gradually increase the dose if we want to achieve the same effects as in the begining of treatment.

Usually, a hypnotics are going to lose much of its effectiveness in 2 or 3 months of continuos use and when it reaches this point, doubts arise again: “I do not know what happens, I am slleping poorly again, even worse than before, and I think the pills do not work anymore ….. Maybe switching to another drug. ” Error !!

“Okay, but …. so much history for some pills !. Today people take many types of drugs and nothing happens ……..”. True !, but these are not a simple medicines ; think that 5% of Spaniards used routinely hypnotics for sleep-related problems, which means that in this country more than 2 million people consume these pills on a regular basis; and it is so disturbing that, according to the latest survey on alcohol and drugs in the general population in Spain, the consumption of sleeping pills and tranquilizers would have become, along with alcohol and snuff, the most widely used drug, even ahead of cannabis.

On the other hand, we must not forget that we are talking about drugs that are not entirely safe as they can cause daytime sleepiness and confusion, especially in the elderly, not to mention a recent study that has even relate the chronic use of these drugs with increased risk of developing Alzheimer’s disease.

“Yeah, but then …. do I need to take the damm pills or not? Is there any other way to sleep well at once without much risk or so much problem?  Because after reading all this yet I have more doubts and now I do not know what to do anymore…

Alternatives to the sleeping pills

What you need to know is that chronic insomnia hardly is to be cured only with pills. The solution is not simple and Sleep Units at Hospitals do not  have a “magic wand” to get you back to sleep quickly overnight (as we would like). No we don´t, but we do have alternative or complementary pharmacological  treatments which have proven very effective to get you back to sleep; and we also have some good tips here for you:

– We should never use hypnotics or sleeping pills uncontrollably. If you have trouble falling or staying asleep it is best not to self-medicate yourself and go to a specialist from the begining for instructions and the most suitable treatment.

– Always try to avoid chronic and systematic taking sleeping pills.

For some special cases, sleeping pills can become absolutely necessary. When hypnotics are administered for a limited time and are well indicated, are generally very helpful (we should not demonize them).

– We should not think of sleeping pills as the only treatment of insomnia. A good sleep practice and application of non-pharmacological measures, cognitive behavioral type, will be in the long run, much more powerful and effective than any pill.

– We must learn to gradually reduce the level of activity and “disconnect” (work, problems, … etc.) Two hours before the scheduled time for going to bed. If at sleeping time we are stressed or too “activated” no matter how many pills we take we will not avoid those “wide eyes”.

Dr. Javier Brualla

Clinical and Somnologist neurophysiologist (expert in sleep medicine)

Sleep Unit – Hospital International Vithas Medimar – Alicante

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