sleeping-pill

Could Ambien increase your risk of death?

Feb. 28, 2012 at 12:00 PM ET

By Dr. Nancy Snyderman

Chief Medical Editor, NBC

For the millions of Americans who use sleeping pills, a new study suggests the prescription medications may be doing more harm than good.

About 10 percent of Americans take some kind of sleep aid at night. Scripps Health researchers found that people who take any of a range of sleeping pills, or hypnotics, have a four-fold increase in death.  Even people who took very low doses – as few as 18 pills a year – had a greater mortality risk.

Ambien was the most widely prescribed sleep aid, although other drugs such as Lunesta, Sonata, Restoril, barbituates and sedative antihistamines were also included in the research.  

The researchers tracked over 10,000 patients from the Geisinger Health System in Pennsylvania who were prescribed sleeping pills for an average of 2.5 years and compared them to people who were matched for age, lifestyle and underlying health problems. Other research has indicated that women are more likely to take sleep aids than men, particularly women between the ages of 40 and 59. The average age for all the participants in the study was 54.

The headline is frightening, but it’s not a cause-and-effect study. It's an association. Scientifically, that means just because you take an Ambien doesn’t mean you’re going to die. But people who take the pills have an increased risk because of a number of associated factors: possible mixed drug overdoses; depression; anxiety; impaired motor and cognitive skills (if someone takes a pill by accident and drives); and sleep apnea. 

A big limitation in the study is that all the data was based on prescriptions, which doesn’t mean the pills were actually taken or whether the prescriptions were even filled. Also, the researchers couldn’t be certain whether the participants who didn’t receive sleeping pill prescriptions were taking over-the-counter antihistamine sleep drugs or non-prescribed hypnotics. While the Scripps study is provocative and flawed, there have been numerous other studies showing an increased risk of mortality from sleep medications.

On TODAY Tuesday, the Pharmaceutical Manufacturers Association responded, saying, “Prescription medicines undergo thorough clinical trials regulated by the FDA and are FDA-approved on the basis of their safety and effectiveness. Biopharmaceutical research companies also work closely with the FDA throughout the life of approved medicines, continuing to monitor the medicines for safety issues.”

However, it goes to the bigger picture that we are overmedicated as a society. More people are on anti-anxiety medications and sleeping aids than any time in history. A lot of people take sleep aids because we have a conventional wisdom that everyone needs eight hours of sleep at night. When we have insomnia, we panic. Working women, in particular, have no downtime, so it's not surprising that we're self-medicating. 

My advice to people who take sleep aids is to remember: These things and alcohol or other anti-anxiety medicines don’t mix. That's where a lot of people get into trouble.

Everything you put in your mouth can have a downside. Use the sleeping aids sparingly. If you’re using them all the time, think about what you can change in your life so you don’t have to rely on medication.

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