Sleeping pills impair daytime thinking.
He side effects of the prescription sleeping pills are much like their benefits.
At night, we want our brain cells to stop working (unless we need to get up in
the middle of the night), so sleeping pills make the brain less active. If the
sleeping pill is in the blood during the day, it will make the daytime brain less active
and less functional. The problem is that no sleeping pill remains in the blood all
night, impairing consciousness, and then suddenly evaporates at the moment of
awakening. Besides, a large percentage of people who take sleeping pills do often
get up at night, at a time when the sleeping pill could cause falls or confusion. Most
of the marketed prescription hypnotics, when taken at bedtime, will remain in the blood with at least half strength when morning comes.
Only a few prescription hypnotics marketed in the U.S. leave the blood fast
enough to be largely gone from the blood by morning: these include zolpidem
(Ambien), zaleplon (Sonata), and triazolam (Halcion). Even these drugs may be
found in the morning blood if they are taken in the middle of the night. Ambien CR
may sometimes affect people the next morning, and eszopiclone (Lunesta) is likely
to produce a few hours of morning impairment, particularly among people over age
60. On January 10, 2013, the FDA issued a warning recommending that the usual
dose of zolpidem (Ambien) be no more than 6.25 mg for women. The FDA had
finally discovered that a percentage of patients have enough zolpidem in the blood
the next morning to impair performance such as driving. Oddly enough, despite the
brief half-life (time to be half-dissipated) of zolpidem, zaleplon, and triazolam, there
is fragmentary evidence that these short-acting hypnotics produce impairments
lasting after their disappearance from the blood.[16] Perhaps this is because a
percentage of people have genetic variations in their metabolism of sleeping pills
which may cause dangerous concentrations to linger. Ramelteon (Rozerem)
produces no next-day impairment according to the manufacturer studies, but one
well-controlled independent European study showed impairment in driving
performance.
The psychological effects
are to make us sleepy,
reduce alertness and
vigilance, slow reaction
times and judgment, and
impair aspects of
intelligence and memory
As explained above, sleeping pills suppress the action potentials of a wide variety of brain cells. The psychological effects are to make us sleepy, reduce alertness and vigilance, slow reaction times and judgment, and impair aspects of intelligence and memory. Literally
hundreds of studies have been done concerning the psychological effects of sleeping pills, both within a few hours after
ingestion and then during the day following taking a sleeping pill at bedtime.[17] To
summarize an extremely complex group of studies, almost all sleeping pills produce
immediate impairments of memory and performance. Further, there is extensive
evidence that sleeping pills on average impair performance and memory on the
following day.
Sleeping pills generally
make function WORSE the
next day.
To view sleeping pill advertising, you might imagine sleeping pills help you to
work better, think better, or function better the next day. This is deceptive. With very
few exceptions, controlled studies supported by the manufacturers show that
sleeping pills make test performance WORSE on the following day, or have no
effect on performance. Look through the FDA files for Ambien, Lunesta, Sonata,
and Rozerem, at the FDA website.[18] See if you can find any evidence that these
drugs improved next-day performance for people with insomnia.
The problem of daytime impairment is more severe with the longer-acting drugs
such as flurazepam (Dalmane) and quazepam (Doral), because the active by-
products of these drugs remain in the blood day after day following only a single dose. When one of the long-acting drugs is taken every night, the blood
concentrations accumulate day by day, increasing for up to 10-20 days, reaching
much higher concentrations than after the initial dose. Therefore, with flurazepam
(Dalmane) and quazepam (Doral), and also with diazepam (Valium) and
chlordiazepoxide (Librium) when they are taken nightly as sleeping pills, daytime
impairment accumulates after consecutive days of use.[19]
Remarkably there has been only a smattering of evidence in special conditions
that any sleeping pill ever improves daytime performance. Even when it is possible
to show that sleeping pills increase sleep (a little) and even though the short-acting
drugs are gone by morning, sleeping pills generally do not improve people’s ability
to function in their lives. The few experiments where sleeping pills seemed to
produce transient improvements in performance often involved models of jet lag
and shift work, not the common problem of the aging person with insomnia. In the
hundreds of studies where the pharmaceutical industry has studied hypnotic effects
on waking function, the emphasis has been on trying to reduce impairments caused
by these products, not on assisting people’s ability to carry on their lives. A person’s
hope and belief that a prescription sleeping pill will improve the person’s function on
the next day is consistently betrayed. It simply does not work
