Sleeping pills may be doing you harm

Elderly at risk of dizzy spells, says study

SLEEPING pills could do more harm than good, researchers have warned. The debilitating side effects of medicines commonly prescribed for insomnia in older patients outweigh the benefits in most cases, it is claimed.

With an estimated ten million Britons having problems sleeping, around 20 million prescriptions for pills are issued each year.

These include traditional benzodiazepines – such as diazepam and the no- longer available temazepam – and the newer sedative hypnotics. An analysis of 24 studies shows the adverse effects are so widespread that non- drug treatments are a better option for insomnia.

The Canadian study is published today in the online edition of the British Medical Journal.

Dr Irshaad Ebrahim, consultant neuropsychiatrist in sleep disorders and director of the London Sleep Centre in Harley Street, said the best approach to sleeping problems was to look beyond the failure to drop off.

‘We adopt a holistic approach looking at lifestyle habits, attitudes and behaviour,’ he explained yesterday.

‘ If medication is necessary, doctors have got to be very careful and take into account medical conditions and other medications being taken by the patient.

‘Sleeping pills are a means to an end, not an end in itself.’

Researchers from the Centre for Addiction and Mental Health in Toronto, Canada, looked at studies carried out between 1996 and 2003 involv-

RESEARCHERS

looked at studies on the following prescription drugs: zaleplon ( also known under brand name Sonata), zolpidem ( S t i l n o c t ) , ioprazolam, nitrazepam ( Mogadon), triazolam, chlormethiazole, quaze- ing 2,417 patients, considering the effects of sedatives and sleeping pills.

They found a wide range of side effects among older patients, including dizziness, loss of balance and disorientation.

Effects such as dizziness or loss of balance were reported in 13 of the studies examined.

In seven instances, these resulted in serious consequences, including six falls and one car crash.

The drugs involved in the research included benzodiazepines such as nitrazepam and temazepam.

These drugs, which are also prescribed for short-term anxiety, work by stimulating brain receptors which induce sleep.

The study also looked at sedative hypnotics including zaleplon, zolpidem and zopiclone, which are supposed to cause fewer dependency problems, along with sedating antihistamines.

The researchers said there were potential benefits for those taking sedatives, such as more uninterrupted sleep, ease of getting to sleep and the amount of time spent sleeping.

But overall, older patients were more than twice as likely to experience a negative effect taking drugs to help them sleep as they were to gain a better quality of sleep.

Dr Usoa Busto, who led the pam, zopiclone ( Zimovane), midazolam ( Hypnovel), brotizolam, f lurazepam, ormetazepam and temazepam.

Herbal- based sleeping aids, such as Nytol, which can be bought over the counter, did not form part of the study. research, said: ‘ Although the improvements in sleep variables obtained from prescription sedative hypnotics are statistically significant, the effect size is small, and the clinical benefits may be modest at best.

‘In people over 60, the benefits of these drugs may not justify the increased risk.’

Non- drug treatments, such as cognitive behaviour therapy, were useful in helping older patients deal with insomnia and have fewer risks, the researchers said.

These include keeping a sleep diary and taking practical steps to ensure the bedroom is associated with sleep.

Professor Jim Horne, a sleep research expert, said old- style benzodiazepines were no longer prescribed for sleeping problems.

He said: ‘It would have been helpful if the study had separated out the problems they caused, and the newer drugs which may have less adverse effects.’

Dr Lorna Layward, research manager at Help the Aged, said the study was vital as there had not been enough research into the problem.

She said as many as half of all older people suffer from irregular patterns of sleep, accounting for 40 per cent of sleeping pill prescriptions.

j.hope@dailymail.co.uk