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Johns Hopkins Health Alert

How Safe Are Sleeping Pills?

Sleeping pills help millions of people with insomnia -- but for some, a good night’s sleep can turn into a nightmare. In this excerpt from a Health After 50 newsletter article, David Neubauer, M.D., Associate Director of the Johns Hopkins Sleep Disorders Center reviews the risks of sleeping pills.

You may have heard that the sleeping pill Ambien (zolpidem) has been linked to odd and potentially dangerous behavior -- users don’t just sleepwalk, they drive, make phone calls, eat large amounts of food, and strip off their clothes, all while “asleep.”

In response to these reports, the FDA has ordered the manufacturers of Ambien -- along with manufacturers of over 10 other popular sleeping pills -- to add a warning to product labels about these risks.

If you’re using sleeping pills to combat insomnia, the recent reports and subsequent warning required by the FDA may seem threatening. Yet David Neubauer, M.D., Associate Director of the Johns Hopkins Sleep Disorders Center and the author of Understanding Sleeplessness (Johns Hopkins University Press), says, “These dramatic sleeping pills side effects are really quite rare.”

In addition, not all the sleeping pills on the FDA’s list are equally as likely to cause side effects. “The FDA attached this warning to a very wide range of medications that work in different ways. For example, Rozerem (ramelteon) affects melatonin receptors in the brain and doesn’t cause memory difficulty, nor are there reports of its causing these kinds of strange behaviors,” Dr. Neubauer says. However, it has not been available as long as the other sleeping pills, so rarer side effects may not have yet come to doctors’ attention.

Bottom line advice on sleeping pills: To lower your already low risk of experiencing side effects from sleeping pills, Dr. Neubauer advises that you take no more than your prescribed dose of medication, avoid alcohol when using sleeping pills, and, most important, take your medication when you’re already in bed.

People taking sleeping pills should keep in touch with their doctor for regular reevaluation of progress and should also tell their doctor about any side effects that occur. And keep in mind that sleeping pills may not always be the solution to sleeplessness. Insomnia may be related to an underlying and/or undiagnosed medical condition such as depression, chronic pain, Alzheimer’s disease, or digestive problems. In some instances, treating an underlying disorder may put an end to sleepless nights.

The Sleeping Pills That Made the FDA Warning List:

  • Ambien (zolpidem)
  • Butisol (butabarbitol)
  • Carbrital (pentobarbital and carbromal)
  • Dalmane (flurazepam)
  • Doral (quazepam)
  • Halcion (triazolam)
  • Lunesta (eszopiclone)
  • Placidyl (ethchlorvynol)
  • Prosom (estazolam)
  • Restoril (temazepam)
  • Rozerem (ramelteon)
  • Seconal (secobarbital)
  • Sonata (zaleplon)

Posted in Healthy Living on September 3, 2008
Reviewed July 2009

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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or MediZine LLC, which has no responsibility for any comments posted on this site.




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