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Sleeping pills . . . the dark side.

Posted: June 15, 2009

"The idea that you take a sleeping pill, you sleep better and do better the next day is just not true according to data," says Daniel F. Kripke, M.D, research professor of psychiatry, UC, San Diego. "There's a lot of scare talk about automobile accidents," he says. "The best evidence is that sleeping pills cause the auto accidents."

Despite this, millions of people who suffer from insomnia find popping a pill the easiest solution. Yet, according to a New York Times article, a recent study published in the Archives of Internal Medicine suggests that cognitive behavioral therapy may be more effective than sleeping pills in the long term for the treatment of insomnia and other sleep problems.

"The notion that it's fine to use a pill to schedule sleep when it's convenient is a relatively new concept," says Dr. Meir Kryger, professor of medicine at the University of Manitoba and the author of A Woman's Guide to Sleep Disorders. "We don't know if it's a good or a bad thing. The most important thing with insomnia is to make a diagnosis." He also stresses the importance of treating the underlying disorder, not simply the insomnia.

In the following article "Why Haven't You Heard This Opinion of Sleeping Pills From Every Expert?" , Dr. Kripke* reminds us that the idea that sleeping pills have a dark side is nothing new. Dr, Kripke also runs his own website, http://www.darksideofsleepingpills.com

Generations of physicians have shared my opinion, based on their own clinical experiences. Probably, the majority today agree. They are a silent majority, with little to be gained by making their opinions public. The sleeping pills industry has a billion dollars of yearly sales, and it has thought of many subtle ways of keeping its products popular. To be frank, the manufacturers of sleeping pills have often given the leaders of sleep research large monetary grants to test their products. These colleagues are very nice people who are not the sort to bite the hand which feeds them. Some of the most prominent leaders of sleep research have been supported mainly by drug company grants. The drug companies have used many subtle free offers and not-so-subtle methods of influencing the wider group of sleep clinicians to mute their critical attitude towards sleeping pills.

For several years, the National Sleep Foundation has launched a yearly publicity campaign about the dangers of insomnia, encouraging everybody to sleep 8 hours. Scientific evidence to support 8 hours sleep is almost nonexistent: for example, people live longer who sleep less (see above). Could this campaign be influenced by the fact that much of its money comes from sleeping pill manufacturers? Unfortunately, nobody advertises for behavioral treatments, or for hypnotic abstinence. The advertising for light treatment is minuscule compared to pharmaceutical advertising. The alternative to sleeping pills is to develop good sleep habits and good sleep attitudes. Good sleep habits and attitude are the best approach for a long-term sleep problem, and they produce surprising improvement.

*Daniel F. Kripke, M.D. is a licensed practicing physician certified by the American Board of Psychiatry and Neurology and a Professor of Psychiatry at the University of California, San Diego. Dr. Kripke was elected a Fellow of the American Psychiatric Association. Dr. Kripke has written hundreds of medical articles and has given invited lectures in 18 countries. In 1973, Dr. Kripke established one of the first sleep clinics in the United States. He has been treating patients with sleep disorders and doing research on sleep ever since.

Acknowledgment: I have been fortunate that my research has been supported for over 28 years mainly by the U.S. National Institutes of Health (NIH) and the Department of Veterans Affairs. The Department of Psychiatry and the Sam and Rose Stein Institute for Research on Aging of the University of California, San Diego have also supported my research, as has the Weingart Foundation and the American Cancer Society. Ambulatory Monitoring, Inc. (the manufacturer of the Actillume and other actigraphs) and Apollo Light Systems (who make bright light boxes) have supported our research, mainly through joint research projects funded by the National Institutes of Health. In the 1970's and 1980's, I did sleeping pill studies with Hoffmann-La Roche and Upjohn and once consulted with Schering, but for years I have avoided accepting any fee from pharmaceutical manufacturers, so that I would be free to report this information. It is important that readers understand for whom an author works. Being supported largely by public funds, I am able to speak out for public interests. I appreciate this opportunity.

Free PDF download of Dr. Kripke's booklet about the dangers of sleeping pills, The Dark Side of Sleeping Pills
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