Monday, October 29, 2007


Sweet dreams are made of these

After my recent foray into criticism of over-the-counter medicines, maybe I shouldn’t go here, but I can’t resist. It’s probably no surprise, but the New York Times tells us that sleep remedies don’t really work, but are fabulously popular anyway:

An analysis of sleeping pill studies found that when people were monitored in the lab, newer drugs like Ambien, Lunesta and Sonata worked better than fake pills. But the results were not overwhelming, said the analysis, which was published this year and financed by the National Institutes of Health.

The analysis said that viewed as a group, the pills reduced the average time to go to sleep 12.8 minutes compared with fake pills, and increased total sleep time 11.4 minutes. The drug makers point to individual studies with better results.

So, basically, taking these drugs gives you an extra 10 or 15 minutes of sleep. Is that worth the cost and the side effects? How much does 15 more minutes of sleep do for you?

And these are not over-the-counter medicines; they’re prescription drugs, and they’re expensive, on the order of $3 or $4 per pill.

Why are they popular? Well, not surprisingly, because people think they work better than the studies show that they do. And for sleep, that perception might be as important as measurable efficacy. If you think you slept better... maybe you did sleep better. Or, put another way, if you feel more rested the next day, you’re happy with the results.

Dr. Karl Doghramji, a sleep expert at Thomas Jefferson University in Philadelphia, agreed. “Sleeping pills do not increase sleep time dramatically, nor do they decrease wake time dramatically,” he said. “Despite those facts, we do find patients who, when they take them, have a high level of satisfaction.” Dr. Doghramji has disclosed in the past that he is a consultant to pharmaceutical companies.

Most sleeping pills work on the same brain receptors as drugs to treat anxiety. By reducing anxiety, the pills may make people worry less about not going to sleep. So they feel better.

Another theory about the discrepancy between measured sleep and perceived sleep involves a condition called anterograde amnesia. While under the influence of most sleep medications, people have trouble forming memories. When they wake up, they may simply forget they had trouble sleeping.

“If you forget how long you lay in bed tossing and turning, in some ways that’s just as good as sleeping,” said Dr. Gary S. Richardson, a sleep disorders specialist at Henry Ford Hospital in Detroit who is a consultant and speaker for pharmaceutical companies and has conducted industry-sponsored research.

I wonder, though, how that compares with valerian, mint tea, a glass of warm milk... or a new, more comfortable pillow.

We’ll give the last word to Paul McCartney:

Golden slumbers fill your eyes,
Smiles await you when you rise,
Sleep, pretty darling, do not cry,
And I will sing a lullabye.


Dr. Momentum said...

A few beers does a pretty good job. But look out for that expanding waistline.

Barry Leiba said...


Seriously, I find that alcohol might put one to sleep, but that it's generally an interrupted sleep, and not very restful.

Michelle said...

I second the few.. or more than a few beers thing. The problem with that sort of sleep is you don't feel particularly well or rested or able to do a damn thing the next day. Can kind of defeat the purpose really..

Shelley said...

I take an opposing view to sleeping pills for myself personally. I spent the majority of my life getting 2-3 hours (or less) of sleep a night as I suffer from a delayed sleep disorder. With the sleeping pill I can actually fall asleep. I do think I'm in a rather extreme sleep disorder group though, and I take OTC Unisom, not the more expensive prescription sleep aids. I would certainly prefer to not take the sleeping pills though.