Drawing on data from 685 women that suffer from sleep problems, from difficulty falling asleep to frequent waking or rising too early, scientists found that there was no improvement in sleep quality or duration after one or two years taking the tablet.
While 238 of the women were given sleeping pills, and 447 a placebo, researchers found no discernible difference between the two groups, neither in sleep quality nor duration.
All the women in the study, who had an average age of 49.5 years, reported initial difficulty falling asleep and waking early on one night in three and waking frequently on two nights out of three.
The study’s lead author has said the results show there is little evidence for the efficacy of the sleeping pills over long periods of time, despite their widespread use.
‘Sleep difficulties are common. Not surprisingly, the use of sleep medications has also grown over the last two decades,’ said Dr Daniel Solomon.
‘These agents have a range of safety concerns and recent reports describe substantial driving impairments.
‘Most data regarding their efficacy derive from short-term studies (ie, 2-12 weeks), but these agents appear to be used over the long-term by many patients.
‘In this analysis of the long-term impact of sleep medications…sleep medication use was not associated with reduced sleep disturbances.
‘When physicians or other clinicians prescribe these medicines, they often begin with short-term prescriptions, but many patients receiving these prescriptions become long-term users.
‘While there are good data from randomised control trials that these medications improve sleep disturbances in the short term, the results we present here represent some of the only data on these medications’ long-term impact on sleep.
‘The lack of benefit observed in the current study suggests that when physicians begin prescribing these medicines they should discuss with patients that many patients continue them long-term, and that there is scant evidence demonstrating benefit to using these medicines beyond several months.’
Sleep, despite being something that many choose to forgo in place of socialising and work, is closely associated with a raft of health indicators – lack of it can lead to diabetes, high blood pressure, pain and depression.
Having trouble with sleep is relatively common, with around 30% of people suffering from some sort of sleep problem at least once a week.
Doctors typically prescribe drugs for short-term benefit, like benzodiazepines, zolpidem, zaleplon and eszopiclone – but the Boston study has found that these don’t necessarily help over a long time period.
The NHS says GPs are advised to only prescribe these drugs as a last resort, though, because of the risk of side-effects and addiction.
But the researchers say that their findings should make doctors really ‘pause for thought’ before prescribing any sleeping pills.
However, the researchers also said that the drugs could work well in some ‘small percentage of patients’ with sleep problems over several years.
The cause of most insomnia can be relatively simple – stress, anxiety or depression are all large factors, as well as noise, a room too cold or hot, an uncomfortable bed, or stimulants like alcohol or caffeine.
Professor Martin Marshall, Chair of the Royal College of GPs, said: ‘Sleep problems can have a serious and negative impact on a patient’s physical and mental health and wellbeing.
‘Whilst sleep medication can be effective for some patients in the short term, it does not come without risk, so GPs will only prescribe it to patients when alternative treatment options have been explored.
‘Stress, anxiety and lifestyle factors, such as drinking alcohol or caffeine, can all contribute to sleep problems and can often be addressed without medication.
‘If medication is prescribed, it will be after a frank conversation with the patient about the potential risks and benefits – and GPs will generally prescribe the lowest possible amount for the shortest possible time.
‘This is an interesting study and it’s important that it is taken into account as clinical guidelines are developed and updated.’