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Those Sleeping Pills May Be Killing You

timothy posted more than 2 years ago | from the ok-john-stick-to-the-vodka dept.

Medicine 237

dstates writes "A recent article in in BMJ Open reports a strong association between the use of prescription sleeping pills and mortality. The study used electronic health records for 2.5 million people covered by the Geisinger Health System to find 12 thousand who had been prescribed sleeping pills and a matched set of controls. Death rates were much higher in the patients taking sleeping pills and the risk increases with age. Kudos to the authors for publishing this in an open access journal."

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237 comments

Did they adjust for crazy? (1, Insightful)

elrous0 (869638) | more than 2 years ago | (#39186669)

Most of the people I know who take sleeping pills are not necessarily the most stable people in the world to begin with. Sorry to all you Ambien fans.

Re:Did they adjust for crazy? (2)

vlm (69642) | more than 2 years ago | (#39186731)

Most of the people I know who take sleeping pills are not necessarily the most stable people in the world to begin with. Sorry to all you Ambien fans.

Theoretically, yes. In practice I don't think so.

find 12 thousand who had been prescribed sleeping pills and a matched set of controls

Re:Did they adjust for crazy? (5, Insightful)

Aladrin (926209) | more than 2 years ago | (#39186807)

I couldn't find anything in it to suggest they had actually done a double-blind trial, or even a half-assed blind trial, so their results are purely correlation, and not causation, despite the time they spent talking about causation. They do suggest that 'hangovers' from the drugs are a cause of traffic accidents and such, though, so they at least thought of that.

No mention about mental stability that I saw.

Re:Did they adjust for crazy? (2)

Forty Two Tenfold (1134125) | more than 2 years ago | (#39187159)

a double-blind trial

In this case? Buzzword.

Should have been triple-blind... (5, Informative)

fedt (1096053) | more than 2 years ago | (#39187433)

The patients did not know they were being monitored (blind.) The doctors/nurses who entered the charts didn't know their patients' data would be used for this research (double-blind.) The people who analyzed the data, however, had everything upfront to poll and draw whatever conclusions they were looking for. "Using a query into the EHR..." "A further query of this subset..." "For each hypnotic user, we attempted to identify two controls with no record of a hypnotic prescription..." Sounds like they need a triple-blind experimental design.

Re:Did they adjust for crazy? (0)

Anonymous Coward | more than 2 years ago | (#39187739)

you really have no idea how medical research works, do you?

Re:Did they adjust for crazy? (0)

Anonymous Coward | more than 2 years ago | (#39186827)

I was wondering that myself - though I probably would have used "unhealthy lifestyle" instead of "crazy." Kind of like when they said there was a relation between people with good teeth and surviving cancer. Someone who cares about one aspect of their health is likely to keep on top of the others (eg: they get mammograms, prostate exams, etc).

I do wish people would be careful about following medical journals. Knowledge may be power but bad medicine can kill as surely as any disease.

Re:Did they adjust for crazy? (5, Insightful)

MozeeToby (1163751) | more than 2 years ago | (#39187153)

Most people taking prescription sleeping pills have been fighting sleep disorders for a long time, probably their entire adult lives. Getting terrible sleep for 30 or 40 years will probably increase your mortality regardless of what pills you're taking. Do the same study again only this time instead of looking at what drugs they're on, give them a sleep disorder questionnaire, drowsiness survey, and a sleep study. Then you'll have enough data that I actually care to look at your results.

Re:Did they adjust for crazy? (1)

reub2000 (705806) | more than 2 years ago | (#39187273)

Entire adult life? Try since childhood.

Re:Did they adjust for crazy? (2, Interesting)

Anonymous Coward | more than 2 years ago | (#39187731)

Yeah I had been having troubles sleeping since I was a kid and finally in the fall went to a sleep doctor. She set me up with a sleep study and found that as well as not sleeping long enough(had problems with my ceridian sleep schedule) I also had sleep apnea. I got CPAP and took some meletonin for a few months and man that was a crazy difference. It's like I had never had a good nights sleep in 20 years and all of the sudden you feel more energetic, awake and coherent.

Re:Did they adjust for crazy? (4, Funny)

MartinSchou (1360093) | more than 2 years ago | (#39187459)

Do the same study again only this time instead of looking at what drugs they're on, give them a sleep disorder questionnaire, drowsiness survey, and a sleep study.

Since they were looking at people who died, I think the ability to get them to answer questions would be much more interesting than what the answers would be.

Re:Did they adjust for crazy? (1)

Mashiki (184564) | more than 2 years ago | (#39187705)

There's no shortage of people(myself included) who don't sleep very much. A good night over the last two years for me would be 3 hours of straight sleep. Though the last week I've been sleeping 8-9 hours without a problem, mostly because I've started a new mix of pain killers and muscle relaxants.. It can be from a variety of problems though, but if they put up a request for volunteers to fill out info, they'd find them.

For myself it's chronic pain. Protip: Don't fracture your C2 and C3 while exercising(particularly situps), though if you do call yourself damn lucky and take out lottery tickets. Sleeping becomes the least of your problems then, you usually just keep going until exhaustion hits.

Re:Did they adjust for crazy? (3, Interesting)

jerryjnormandin (1942378) | more than 2 years ago | (#39187491)

As far as sleep goes, you are much better off doing what your grandparents did! Take a shot of brandy before bed. You will sleep... it's like nyquil.

Re:Did they adjust for crazy? (4, Interesting)

dsgrntlxmply (610492) | more than 2 years ago | (#39187713)

"The population is mostly of low socio-economic status, having less than high school education and less than one-third are insured under the Geisinger Health Plan."

"We were unable to control for depression, anxiety and other emotional factors because of Pennsylvania laws protecting the confidentiality of these diagnoses."

The results of this study ought to be interpreted in light both of the socio-economics, demographics, and regional characteristics of the population studied, and of the potentially crucial categories of comorbidity that were excluded.

My own use of zolpidem (Ambien) was during a time of an extraordinary convergence of situational stress factors. Once the stress conditions resolved, I was able to discontinue the drug.

Correllation != Causation (4, Insightful)

recoiledsnake (879048) | more than 2 years ago | (#39186681)

The people taking the medications might be dying sooner because they have insomnia which is not fixed by sleeping pills easily. The study should not compare with the general populace since they are, by definition, better sleepers than the group that isn't able to get good sleep.

Re:Correllation != Causation (1)

pclminion (145572) | more than 2 years ago | (#39186703)

They said "matched set of controls," not "general populace." How do you know they did it wrong?

Re:Correllation != Causation (4, Insightful)

vlm (69642) | more than 2 years ago | (#39186791)

Two "identical" guys one gets pill one doesn't is an anecdote.
12 thousand is not just a misdiagnosis. There must be something "different" about the 12K that did vs the 12K who did not, other than random chance. I don't think in the UK treatment plans are determined using dice or tarot cards, so there must be something special about the 12K who got the pills... or the 12K who didn't...

Re:Correllation != Causation (1)

Anonymous Coward | more than 2 years ago | (#39186867)

Irrelevant. The study doesn't prove anything. To reiterate, correlation != causation

Let's think about this. The type of person who is perscribed sleeping pills has inherent differences with their peers, general populace or filtered. So reasons for mortality could be any of a number of things, including:
-Sleeping pills themselves
-Mentally destructive paradigms that cause unhealthy stress
-Stressful lives
-Genetic, linked traits that yield insomnia and higher mortality
-etc

Re:Correllation != Causation (0)

Anonymous Coward | more than 2 years ago | (#39187757)

Correlation may not be sufficient to show causation, but it is necessary. To say the study doesn't prove anything is a bit disingenuous. It may not be proof of causation, but it certain does disproves the contrapositive.

Re:Correllation != Causation (4, Informative)

recoiledsnake (879048) | more than 2 years ago | (#39186869)

They said "matched set of controls," not "general populace." How do you know they did it wrong?

By RTFA, which I strongly advise you to do before jumping in to comment. They matched them on other factors like gender, sex, occupation etc, but not sleep trouble. Since lack of good sleep is a proven strong factor in heart disease and cancer, I feel that they did it wrong.

Re:Correllation != Causation (0)

Anonymous Coward | more than 2 years ago | (#39186997)

And even if they matched by sleep trouble, there's still something inherently different (be it characteristics/lifestyle or genetics) between someone who is prescribed and takes sleeping pills vs one who leaves it untreated or uses alternative treatment methods

Re:Correllation != Causation (4, Insightful)

Rakishi (759894) | more than 2 years ago | (#39187657)

Listen to your own advice and read the paper yourself before commenting.

They specifically compensated later on for difference in heart disease, asthma so on. The impact on the final result was minimal.

Re:Correllation != Causation (2)

Dunbal (464142) | more than 2 years ago | (#39186881)

Because their results make absolutely no sense. According to the study you are more likely to die from any cause because you were prescribed sleeping pills. Therefore the act of receiving a prescription somehow increases your risk of heart disease, cancer, etc. They also state that statistically these patients did not already have disease when the experiment was begun.

Well good thing science isn't just about explaining statistics. I'm waiting for an adequate plausible explanation for the above. The fact that their confidence interval bands overlap does not help their cause at all.

Re:Correllation != Causation (1)

Man On Pink Corner (1089867) | more than 2 years ago | (#39187361)

According to the study you are more likely to die from any cause because you were prescribed sleeping pills. Therefore the act of receiving a prescription somehow increases your risk of heart disease, cancer, etc. They also state that statistically these patients did not already have disease when the experiment was begun.

I don't see anything that can't be explained by the simple fact that older people often have trouble sleeping, and are more likely to take sleeping pills. Ever see anyone under 50 in a Sominex commercial?

Re:Correllation != Causation (0)

Anonymous Coward | more than 2 years ago | (#39187487)

I've never seen a Sominex commercial, but in the Lunesta ones it's not a 50 year old rockin that nighty.

Re:Correllation != Causation (5, Insightful)

mystikkman (1487801) | more than 2 years ago | (#39186745)

Bingo, this is like comparing the death rates of people taking heart medications versus people who don't and then claiming the medications are killing the folks when it could be that heart disease is what is killing them and the pills are not 100% effective at all times to deal with the problem.

Also, it has been proved that bad sleep is a killer by itself, so comparing the death rates of people with sleep issues who did and who did not take medications may actually show that not taking sleeping pills might kill you if you have insomnia, which is the exact opposite of what the headline is claiming.

Re:Correllation != Causation (5, Informative)

sjames (1099) | more than 2 years ago | (#39186851)

A matched set of controls in your example would be people with comparable heart disease who were not given the medixation. It appears that they have done that in this study:

Models addressing potential confounding of mortality association by health status To further address the possibility that hypnotic-associated hazards were due to use of hypnotic drugs by patients with a greater burden of disease, so that elevated risks of death might be attributable to comorbidities rather than to hypnotic medications, we conducted analyses within subgroups of hypnotic non-users and users defined by diagnoses in specific disease classes (supplemental table 7). Allowing for differences in sample size, hazards in subgroups restricted to patients with specific diseases were generally consistent with the overall findings. We also observed no statistically reliable differences in death HR in subgroups constructed to assess the overall burden of disease by stratifying on the total number of comorbidities diagnosed for each patient, and no reliable differences in death HR comparing groups diagnosed with different numbers of comorbidity classes. Whereas the raw death rate of the user cohort was 4.86 times that of non-user controls (table 1), adjustment for all covariates (eg, age, gender, BMI, smoking) with stratification by comorbidities only reduced the overall HR to 4.56 (95% CI 3.95 to 5.26).

Re:Correllation != Causation (3, Insightful)

mystikkman (1487801) | more than 2 years ago | (#39187035)

This was a not a controlled study but is a general experiment so that does raise the question of why a doctor would not prescribe sleeping pills to someone who is having a lot of trouble sleeping?

The only way to conclusively prove this would be to take patients who are going to be prescribed sleeping pills, split them into two while adjusting for other controls and have one group take the pills and other placebos and then monitor them.

Re:Correllation != Causation (1)

nedlohs (1335013) | more than 2 years ago | (#39187303)

So are you suggesting they deny a random group what is the current medication for a condition before this type of data analysis study?

I suspect you'll have trouble getting ethics approval if you don't do the data study and have it show what this one does first.

Re:Correllation != Causation (0)

Anonymous Coward | more than 2 years ago | (#39187455)

Benzodiazepines (see article) are also prescribed for anxiety and taken over the day, not specifically as "sleeping pills". At least in the Netherlands seresta (oxazepam) is handed out like candy. Or at least that was the case in 2003. I suffered for months withdrawal effects, see also Quitting Oxazepam (Serax) - personal experience with withdrawal [johnbokma.com] .

Re:Correllation != Causation (2)

MozeeToby (1163751) | more than 2 years ago | (#39187291)

Whereas the raw death rate of the user cohort was 4.86 times that of non-user controls (table 1), adjustment for all covariates (eg, age, gender, BMI, smoking) with stratification by comorbidities only reduced the overall HR to 4.56 (95% CI 3.95 to 5.26).

You know what I don't see in the list of variables they controlled for? Sleep issues. It's not a matched set of controls if your experimental group is diagnosed with a serious medical condition (in this case sleep disorders) and your control group is not.

Re:Correllation != Causation (3, Insightful)

Rakishi (759894) | more than 2 years ago | (#39187787)

They tried to do that under the assumption that in general a lack of sleep probably doesn't kill you. The hypertension, or diabetes, or heart disease, or liver failure or obesity is that kills you. They did control for differences in those factors and found no change in their results.

Of course, the increased rate of crashing your car into to a wall at 90mph due to insomnia wouldn't be taken into account.

Re:Correllation != Causation (1)

nedlohs (1335013) | more than 2 years ago | (#39186951)

Because of course you know this but the researchers doing the work didn't hink of that because they are idiots?

So which part of their methodology specifically do you have a problem with, given you must have checked it before spouting off, right?

Here you go, here's some of the methodology paragraphs from the linked article, though of course you also read the supplementary material to I hope (slashdot doesn't like some of the fancy characters like +/-):

Using a query into the EHR, we selected all 224â757 primary care patients â¥18 years of age with outpatient visits between 1 January 2002 and 30 September 2006. A further query of this subset identified 12â465 unique patients who had at least one order for a hypnotic medication and were followed-up and survived â¥3 months subsequent to that order. For each hypnotic user, we attempted to identify two controls with no record of a hypnotic prescription in the EHR at any time from among the 212â292 remaining non-users. Non-user controls were matched to the user cohort by: sex, age ±5 years, smoking status and start of period of observation either by calendar date ±1 year (preferred) or by length of observation. A control likewise could not have <3 months of observation in the EHR. We identified 24â793 controls, there being fewer than 200 hypnotic users for whom only one control could be matched. We extracted demographic data, height and weight measurements, diagnoses recorded in outpatient visit records, problem lists and the cancer registry, and orders for all medications, including the indication associated with that order. Only hypnotics frequently prescribed in the EHR and FDA-indicated by the US Food and Drug Administration for insomnia were included in these analyses and then only if it appeared that bedtime dosage was intended (see supplemental files). Roughly three of four (76.3%) of prescribed hypnotics had an explicitly sleep-related indication since physicians often use another diagnosis when they believe that insomnia is secondary to other conditions.9 Medication orders were further reviewed by a physician (DFK) to exclude initially identified patients who did not fully meet criteria for users and matched non-users of hypnotics. Two per cent of patients were excluded for these reasons. Patients diagnosed with major cancer (apart from non-melanoma skin cancers) before the period of observation or within the first 0.05 years of follow-up were also excluded, reducing the numbers to 10â531 users and 23â674 matched non-user controls.

As prospectively planned, we examined the associations of hypnotic prescriptions with deaths, using Cox proportional hazards models in SPSS V.12.0.0 (SPSS, Inc.). Backwards stepwise models were calculated, with likelihood ratio criteria of p<0.10 to retain a variable and p<0.05 to re-enter. To control for potential confounders, model covariates included age, sex, ethnicity, marital status, body mass index (BMI) and self-reported alcohol use and smoking status. To minimise confounding by indication (eg, a physician might have prescribed a hypnotic to treat a non-sleep condition associated with disturbed sleep), comorbid diagnoses were entered as strata in the primary models as described in the following paragraph, and other models were constructed limited to users and controls with specific categories of comorbidity. To address the possibility that hypnotics were prescribed for an emerging condition that was not yet recorded as a diagnosis, comorbid conditions were controlled whether first diagnosed before or during the period of observation.

To control for different classes of comorbidity and each patient's overall burden of comorbidities, the primary proportional hazards models were constructed incorporating stratification on up to 116 comorbidity combinations. The 116 strata compared almost all hypnotic users with non-users having exactly the same combinations of 12 classes of comorbidity. Two sets of additional models were constructed for confirmation of effects. One used strata constructed using the numbers of comorbidities comparing hazards in hypnotic users and non-users with equivalent numbers of major comorbid conditions. Another set of models restricted the population in each model to users and controls having a specific class of major chronic disease. Additional methods are described in the online supplemental files.

Re:Correllation != Causation (0)

Anonymous Coward | more than 2 years ago | (#39187079)

To elaborate, notice the qualifier prescription sleeping pills. Which means they are studying people with serious sleeping problems, which was not one of the factors controlled for.

Re:Correllation != Causation (0)

Anonymous Coward | more than 2 years ago | (#39186799)

True, The high correlation between taking sleeping pills and mortality is concerning but it may turn out that the poeple involved were mortal even before they took the pills. More studies needed.

Re:Correllation != Causation (2)

wisnoskij (1206448) | more than 2 years ago | (#39186919)

That is the point of the controls.
"Correlation != Causation" is used when you find a statistical trend in a group.
But if you take a group and have some of that group be the controls (identical except for one variable) then you cannot say that.
You could find a flaw in their control method, but simply saying "Correlation != Causation" is idiotic in all situations like this.

Re:Correllation != Causation (2, Insightful)

Anonymous Coward | more than 2 years ago | (#39187113)

Those were not controls. They were simply a group matched on a very few parameters. Not everything. Not nearly everything relevant.

A control would have been to take people diagnosed exactly the same and giving some sleeping pills and the others placebos. That didn't happen. The sleeping pill group might have all had a family history of sleep apnea which was not diagnosed before giving the pills. We don't know because there was no randomization.

"Correlation != Causation" is EXACTLY the case we have here.

Re:Correllation != Causation (2)

NatasRevol (731260) | more than 2 years ago | (#39187127)

Most people are arguing that their controls - sex, gender, occupation - didn't control enough for sleep variations.

Re:Correllation != Causation (0)

Anonymous Coward | more than 2 years ago | (#39186923)

I just had a similar discussion with my doctor. The medical need for sleeping pills generally means they are fixing a symptom of another condition...overweight, severe depression or anxiety, sleep apnea, etc...

I'd go with the "correlation does not equal causality" ... But this is an insurance company writing the report.

Re:Correllation != Causation (0)

Anonymous Coward | more than 2 years ago | (#39187217)

"But this is an insurance company writing the report."

This is key here. Correlation is fine for the purposes of an insurance company. It expresses the likelihood of costs to the company. Actuarial folks just need a correlation. It doesn't need to be causation to be 'good enough' for what they are trying to do. It's a different job/aim than what is important to the scientist/doctor/patient, where knowing the causation is important.

Re:Correllation != Causation (1)

Rogerborg (306625) | more than 2 years ago | (#39186953)

But absence of evidence is not evidence of absence.

Also, a bird in the hand is worth two in the bush, fools rush in where angels fear to tread, and do you believe in life after love?

I'd go on, but XKCD has as usual provided appropriate mouseover text [xkcd.com] .

Re:Correllation != Causation (1)

dmomo (256005) | more than 2 years ago | (#39186959)

Correllation == Association though.

That's what they're claiming. Just because it's not the cause, doesn't mean it's not useful to know. Your theory about insomnia certainly isn't one that the researchers are unaware of. They're collecting data as they should be.

Re:Correllation != Causation (1)

metlin (258108) | more than 2 years ago | (#39187073)

I'm tired of seeing these stupid comments every time an article on statistics is brought up. Clearly, a bunch of scientists doing studies along these lines know less about statistics and research design than some random Slashdot poster. Gee. Get over yourself.

Re:Correllation != Causation (4, Insightful)

recoiledsnake (879048) | more than 2 years ago | (#39187181)

I'm tired of seeing these stupid comments every time an article on statistics is brought up. Clearly, a bunch of scientists doing studies along these lines know less about statistics and research design than some random Slashdot poster. Gee. Get over yourself.

Are you sure?

http://www.guardian.co.uk/commentisfree/2011/sep/09/bad-science-research-error [guardian.co.uk]

But in just this situation, academics in neuroscience papers routinely claim to have found a difference in response, in every field imaginable, with all kinds of stimuli and interventions: comparing younger versus older participants; in patients against normal volunteers; between different brain areas; and so on.

How often? Nieuwenhuis looked at 513 papers published in five prestigious neuroscience journals over two years. In half the 157 studies where this error could have been made, it was. They broadened their search to 120 cellular and molecular articles in Nature Neuroscience, during 2009 and 2010: they found 25 studies committing this fallacy, and not one single paper analysed differences in effect sizes correctly.

These errors are appearing throughout the most prestigious journals for the field of neuroscience. How can we explain that? Analysing data correctly, to identify a "difference in differences", is a little tricksy, so thinking generously, we might suggest that researchers worry it's too longwinded for a paper, or too difficult for readers. Alternatively, less generously, we might decide it's too tricky for the researchers themselves.

Why is it wrong for a Slashdot poster to have a conversation over the statistics involved when the headline is so sensationalist? What if someone reading stops taking sleeping pills that are helping them sleep and then get needlessly killed by insomnia because of bad statistics? Can't there atleast be a discussion on the statistics used?

I am tired of seeing stupid comments like yours that actually don't refute anything and instead attack the poster and call scientists infallible and above question.

Re:Correllation != Causation (1)

CSMoran (1577071) | more than 2 years ago | (#39187183)

I'm tired of seeing these stupid comments every time an article on statistics is brought up.

Me too.

Clearly, a bunch of scientists doing studies along these lines know less about statistics and research design than some random Slashdot poster.

Than a random slashdot poster, yes. That this implies that all slashdot posters don't know shit about statistics is fallacious.

Re:Correllation != Causation (0)

Anonymous Coward | more than 2 years ago | (#39187109)

Not to mention that the sicker you are, the more likely you are to have sleep problems, which in turn means you are more likely to take sleeping pills. Furthermore there are diseases other then insomnia which cause insomnia as a symptom which have a high mortality rate--for example speep apeaniacs

How often is this done? (1)

pclminion (145572) | more than 2 years ago | (#39186689)

How often is healthcare data used for these sorts of studies? Not that I have a problem with it, quite the opposite, so long as the data is sanitized. To me it makes more sense to data mine existing records than set up and conduct expensive studies, am I missing something or is this actually commonly done?

Re:How often is this done? (0)

Anonymous Coward | more than 2 years ago | (#39186773)

Don't worry, Tommy"); drop table subjects; will make sure the data is very sanitary.

Re:How often is this done? (-1)

Anonymous Coward | more than 2 years ago | (#39187017)

Bravo to you, sir, for coming up with something clever, funny, and original.

If any fag links to that site in response to your comment, then he will be an unoriginal hipster doofas.

Re:How often is this done? (0)

Anonymous Coward | more than 2 years ago | (#39186889)

I don't know the answer to your questions, but; I read a lot of medical journals that are not open to the public and I don't often see studies like this even in those journals. It seems like a good idea and I wonder why it isn't done more often.

Re:How often is this done? (3, Insightful)

canajin56 (660655) | more than 2 years ago | (#39187013)

They're called "statistical studies" and they are used as evidence that a real study should be done, not that there's an actual effect in play. The problem with such studies is that they try their best to select an identical control group, but it's hard to do so. In this case it means matching the 15,000 people on the drug with 15,000 people who also have been diagnosed with insomnia (and for similar reasons), but all elected not to be medicated for it. Then you hope that that decision isn't in any way correlated with other behaviors that might increase or decrease the death rate.

Melatonin? (0)

Anonymous Coward | more than 2 years ago | (#39186715)

What about melatonin? Sleeping pills don't work for me but 1mg of melatonin knocks me out easily. I figure it's safe because melatonin is naturally produced by the body anyway to signal you that it's time for sleep.

Re:Melatonin? (4, Informative)

RobCull (1658279) | more than 2 years ago | (#39187403)

Melatonin is fine and I highly recommend its use, opposed to traditional sleep aids (I use it). Melatonin is a sleep aid, in that it aids you in falling asleep... but it is different from traditional (prescription) sleep aids such as Ambien, in that it is a hormone supplement.

Melatonin is a non-benzodiazepine, while traditional sleep aids are benzodiazepines. Melatonin (N-acetyl-5 methoxytryptamine) is a compound naturally created in the pineal gland of the brain which triggers sleep. This should not be confused with the feeling of being tired, depleted of energy, or "heavy eyes." Traditional sleep aids act more like an anesthetic, actually making you feel tired and/or knocking you out.

Melatonin is non-habit forming, nor does the body develop tolerances for it, as in drugs like Ambien. It's kind of like a "passive" sleep aid, while Ambien/Benadryl/Lunesta/etc would be "active" sleep aids. There's a reason why it is available over-the-counter.

Note- while you can get Melatonin over-the-counter, you'll likely find nothing higher than 1mg doses (sometimes up to 3mg). You CAN, however, get a prescription for it. Then you can get a higher dose (up to 5mg?), in larger quantities (bottle of 40 as opposed to over-the-counter pack of 14ish), and your insurance will likely cover it.
Warning- with higher doses, especially if your body is already producing it's own, it may take a while for your body to expel the excess in the morning. This could make you feel groggy, make it hard to wake up, and make it too easy for you to fall back asleep (i.e. while driving). Take it 20-60min before sleep, sleep for at least 8 hours, give yourself 20-60min to wake up before driving.

Hope this helps! :o]

Neat but not surprising (1)

Anrego (830717) | more than 2 years ago | (#39186811)

Neat, but not surprising.

Taking pills to help/force you to fall asleep on a consistent basis can't be good for you. That said, neither can not sleeping on a consistent basis. Even with the risks in mind, I imagine in many cases it still makes sense to keep taking the pills?

Luckily I sleep like a log.

Re:Neat but not surprising (0)

Anonymous Coward | more than 2 years ago | (#39187003)

As someone who takes Xanax, I can pretty much guarantee that my life will be longer with the drug than with untreated insomnia.

Re:Neat but not surprising (4, Interesting)

19thNervousBreakdown (768619) | more than 2 years ago | (#39187225)

I quit smoking because I don't want to get cancer, and I don't want to smell bad all the time, and I don't want to be out of breath walking up the stairs. That said, I loved smoking. I still miss it every day, but the risks are greater than the rewards.

Stop taking my sleeping pills? Hah. Have you ever been so tired that you get a sore throat? Or that you argue with yourself at a stop light, "no, don't close your eyes, I know it would feel really really good but if you do that you'll miss the green and might not wake up until somebody knocks on your window"? Your legs shake, you feel sick to your stomach, your palms sweat constantly, your eyes try to close with all their might until you can hear the muscles straining in your ears.

Now try feeling like that for months on end. Stop taking my sleeping pills? Fuck that shit, I'd rather die early.

NEWS FLASH (0)

Anonymous Coward | more than 2 years ago | (#39186813)

unhealthy people, have a higher mortality rate?

Chronic Pain Problems (1)

jamiedolan (1743242) | more than 2 years ago | (#39186829)

I strongly suspect a lot of people with chronic pain issues are on some kind of sleeping pills. These people may have skewed the study because they already have health conditions that are leading to increased mortality.

Re:Chronic Pain Problems (1)

fahrbot-bot (874524) | more than 2 years ago | (#39187371)

I strongly suspect a lot of people with chronic pain issues are on some kind of sleeping pills.

The types of pills in the study - hypnotics - don't really help when you're in pain. Of course, they would if you mixed them with strong pain-killers, but then you'd have the possibly of actually dying (dieing?) in your sleep...

If you have a hard time sleepin (0)

Anonymous Coward | more than 2 years ago | (#39186839)

1) Exercise
2) If you can't, then try Bija Sleep Well tea. Really works.

Re:If you have a hard time sleepin (0)

Anonymous Coward | more than 2 years ago | (#39186905)

There's no need to shill for a specific brand. I don't know what's in your selection. Anything with chamomile in it will tend to make you sleepy unless it's counterbalanced by some other herb. YMMV. Chamomile works for me. I'm sure there are plenty of people who have a cup and it does nothing. Perhaps there are even people kept up by it. I know that some people can be kept up by sleeping pills because they're nervous about what the pill might do. I'm sure herbs are no different.

Re:If you have a hard time sleepin (1)

hawguy (1600213) | more than 2 years ago | (#39187533)

There's no need to shill for a specific brand. I don't know what's in your selection Anything with chamomile in it will tend to make you sleepy unless it's counterbalanced by some other herb. YMMV. Chamomile works for me. I'm sure there are plenty of people who have a cup and it does nothing. Perhaps there are even people kept up by it. I know that some people can be kept up by sleeping pills because they're nervous about what the pill might do. I'm sure herbs are no different.

Isn't that the entire reason to "shill" for a specific brand? He has a specific brand that works for him so that's what he's recommending. He doesn't know what's in every "sleepy time" tea on the market, and probably doesn't even know what's in his specific brand of tea that makes him sleepy, all he knows is that it works. For him.

Re:If you have a hard time sleepin (1)

Xacid (560407) | more than 2 years ago | (#39186931)

#1 has been my experience as well. I have a few friends who mention having constant problems sleeping. They're also the most inactive and eat like hell. Inactive to the point of refusing anything that might cause activity. :/

Sure, cardio isn't necessarily as fun as playing Xbox but sleeping awesome is totally worth it. I "trick" myself into exercising by just picking up a sport and sticking with it. Treadmills are boring, but sport can be fun with the right crowd.

Do The Stats Include Suicide By Sleeping Pills? (0)

Anonymous Coward | more than 2 years ago | (#39186841)

Like including Suicide by Gun in Gun Deaths...

Re:Do The Stats Include Suicide By Sleeping Pills? (1)

reub2000 (705806) | more than 2 years ago | (#39187517)

The stats are for Zolpidem and Temazepam, drugs which have a high therapeutic index ration, in other words, several time a one month supply, which is all that a pharmacy is allowed to dispense at the same time. I highly doubt anyone is using these drugs to kill themselves.

You can't deduce causality from longitudinal study (1)

gust0208 (968926) | more than 2 years ago | (#39186875)

After reading the full study report, the headline for this post is more than a bit sensational (disappointing for /.). This was a longitudinal study comparing a set of data from a certain time period and can't be used to determine causality. Also, the control were only matched on a few data points, making this difficult to apply to a general population or even interpret if there was an actually difference in mortality given that table 3 showing differences in co-morbid diagnoses shows large disparity in key areas like cardiovascular risks, hypertension, heart failure. This point underlies why this study is not helpful. Many serious medical illnesses have insomnia has a symptom, and often treated with a sedative hypnotic. This DOES NOT mean that the sedative hypnotics are "killing" people. I hate studies like this.

this depth of sleep was (0)

Anonymous Coward | more than 2 years ago | (#39186877)

not intended...

Most drugs are bunk (4, Insightful)

Hatta (162192) | more than 2 years ago | (#39186879)

Drug companies spend more on marketing than they spend on research. Is it any surprise that these stories keep coming up? SSRIs were going to cure everyone's depression. Now we find out that they're addictive, and only effective in the very worst cases of depression. Vioxx was going to usher in a new age of pain relief for arthritis, turns out it killed tens of thousands of people. Hormone replacement therapy was considered essential to prevent osteoporosis in women. Turns out it also causes bone remodeling that makes certain types of fractures even more common. Don't be surprised if we find out in the future that wonder drugs like statins carry risks we haven't been made aware of.

Pharmaceutical companies should not be allowed to market. Not to the general public, and not to doctors either.

Re:Most drugs are bunk (1)

Anonymous Coward | more than 2 years ago | (#39187125)

Look up Red Yeast Rice (http://www.naturalnews.com/022046.html) and compare it to statins. Because the active ingredient is essentially the same (RYR contains natural statins), the supplement was pulled from the market due to it being too similar to a drug. Guess which was on the market first? Hint: one has been used for over 1000 years. Also, see: http://www.peoplespharmacy.com/2010/07/11/how-safe-are-statins/ [peoplespharmacy.com] for an interesting take on long term statin safety.

Re:Most drugs are bunk (1)

Anonymous Coward | more than 2 years ago | (#39187215)

Hormone replacement therapy was considered essential to prevent osteoporosis in women. Turns out it also causes bone remodeling that makes certain types of fractures even more common.

Actually, estrogen is quite effective at preventing fractures. It does raise the risk of certain types of cancer though. You were probably thinking of bisphosphonates, which can make certain types of fractures more common.

Re:Most drugs are bunk (1)

snowgirl (978879) | more than 2 years ago | (#39187357)

Actually, estrogen is quite effective at preventing fractures.

Which would be good news if it didn't cause a higher incident of clotting crises... (infarctions, strokes, DVTs, etc)

I've seen some recommendations on estrogen users to stop taking their estrogen at least a whole month before going on a long-distance flight, due to DVT risk...

Re:Most drugs are bunk (1)

dgatwood (11270) | more than 2 years ago | (#39187305)

Don't be surprised if we find out in the future that wonder drugs like statins carry risks we haven't been made aware of.

As opposed to all the serious risks we have been made aware of? Muscle damage, cognitive dysfunction, etc.

Not moving legs while drugged (0)

Anonymous Coward | more than 2 years ago | (#39186911)

Just a thought: much recent research shows that not moving one's legs for long periods of time can cause clotting problems, even while awake. What if these people are sleeping without the "normal" tossing and turning, and getting decreased limb circulation while they sleep extra-deeply?

Read their conclusion: (1)

Anonymous Coward | more than 2 years ago | (#39186991)

Before you kneejerks get going ("it don' apply causality naw, ya'here?"), please read a couple excerpts:
"Receiving hypnotic prescriptions was associated with greater than threefold increased hazards of death even when prescribed 18 pills/year. This association held in separate analyses for several commonly used hypnotics and for newer shorter-acting drugs. Control of selective prescription of hypnotics for patients in poor health did not explain the observed excess mortality."

And regarding the limitations of the study:
"Cohort studies demonstrating association do not necessarily imply causality, but the preferable randomised controlled trial method for assessing hypnotic risks may be impractical due to ethical and funding limitations."

There is obviously cause for concern here, but not panic. People on sleeping medication should talk to their doctors about this.

You don't say? (0)

Anonymous Coward | more than 2 years ago | (#39186995)

So, sick people are dying sooner than those who are healthy?

When I die ... (5, Funny)

PPH (736903) | more than 2 years ago | (#39187007)

... I want to go quietly, in my sleep. Like my grandfather.
Not screaming in terror, like his passengers.

Sleep disorders may be normal, pills are not good! (1)

scharkalvin (72228) | more than 2 years ago | (#39187025)

A recent post to /. pointed to several articles that brought up the fact that a solid 8 hours of sleep may not be normal.
http://www.bbc.co.uk/news/magazine-16964783
http://en.wikipedia.org/wiki/Segmented_sleep
http://www.history.vt.edu/Ekirch/sleepcommentary.html
http://www.nytimes.com/2006/02/19/opinion/19ekirch.html
Our brains may very well be wired to a distrupted sleep and taking pills to 'correct' this is not a good idea!

Yep, right (0)

Anonymous Coward | more than 2 years ago | (#39187029)

Yep, and another study shows that everyone that drank milk in 1776 is NOW DEAD.

They did not have "matched controls". Matched controls would be people with sleeping disorders that were not prescribed sleeping pills. See how long you'll live if you can't sleep.

Re:Yep, right (1)

HBI (604924) | more than 2 years ago | (#39187093)

Did you consider: Even if this study is flawed, it might do something about the approach of providing benzos to people who have trouble sleeping. Maybe the actual reason why they aren't sleeping will be investigated. It's probably something completely treatable: overstress, uncontrolled diabetes, nutritional deficiencies, abuse of some other substance like caffeine, etc.

Maybe they needed more sleeping pills. (1)

dittbub (2425592) | more than 2 years ago | (#39187157)

What if the higher death rates are because they aren't getting enough sleep!?!

Working as advertised (1, Funny)

ark1 (873448) | more than 2 years ago | (#39187213)

These pills are supposed to put you to sleep, waking up again was never promised.

I stopped taking sleeping pills... (1)

Oswald McWeany (2428506) | more than 2 years ago | (#39187239)

I stopped taking sleeping pills because they had an unintended side affect for me. They kept me awake.

Caffeine has no affect on me- but taking a sleeping pill keeps me awake all night. I have some odd body chemistry no doubt.

Those Hospitals May Be Killing You (4, Funny)

satuon (1822492) | more than 2 years ago | (#39187279)

Urgent bulletin. A new study has found that people having extended stays inside hospitals have a much higher mortality rate than people who don't. Avoid hospitals at all costs.

I don't know about you... (0)

Anonymous Coward | more than 2 years ago | (#39187389)

...but reading this article just cured my insomnia.

NERRRRRRRRRRRRRRRRRRRRRRRRRRRRDSSSSssssssssssssssssssssssssssssssssss

Sleeping pills not necessarily the cause... (2)

rs1n (1867908) | more than 2 years ago | (#39187399)

...it could be the fact that those who have trouble sleeping are pre-dispositioned to having lower mortality. The fact that they also taking sleeping pills is a side issue. I'm just sayin...

Great Work (3, Insightful)

trongey (21550) | more than 2 years ago | (#39187409)

I'm glad they discovered that death risk increases with age.
Did you ever wonder how they come up with death rates that are less than 100%?

more caffiene (0)

Anonymous Coward | more than 2 years ago | (#39187477)

more coffee! more bawlz! more energy drinks! drink all the caffeine!

then take sleeping pills.

Irrelevant Statistic (0)

Anonymous Coward | more than 2 years ago | (#39187549)

Death rates were much higher in the patients taking sleeping pills

Completely invalid. In fact, I'm willing to bet that every person who is now dead was alive at one time, whether or not the individual has been taking sleeping pills. In fact, I have completely anecdotal evidence supporting my hypothesis; each person I know who has died was living at one time.

Unless the way to immortality is to never take a sleeping pill...

increased mortality? (0)

Anonymous Coward | more than 2 years ago | (#39187559)

Did fewer people in the control group die than in the test group? How does one sign up?

Correlation!=causality (3, Informative)

ridgecritter (934252) | more than 2 years ago | (#39187563)

And the authors recognize this - from TFA:

"Cohort studies demonstrating association do not necessarily imply causality, but the preferable randomised controlled trial method for assessing hypnotic risks may be impractical due to ethical and funding limitations."

It's well-known that sleep disturbances are correlated with higher mortality. This study could simply be uncovering that people who have sleep disturbances (and who are therefore in a higher mortality group) are more likely to ask for meds to help them sleep. Can't see that there's any big news here.

Find the root cause not symptom treating. (2)

unlocked (305145) | more than 2 years ago | (#39187587)

I just lived through six years of chronic insomnia and went down the whole path of doctors and pills. What it turned out to be was a undiagnosed heart arrhythmia caused by a untreated infection which was exasperated by fluroquinalone which almost killed me. It just shows that Doctors just collect a paycheck and push what ever pills big pharma claims works.( it took 6 years and about $300,000 in medical bills and completely wiped out my financials and credit) After getting on propafenone for the arrhythmia for 1 year my insomnia went away and my arrhythmia has went away. I had to revamp my diet and get rid of all stress from work and sleep 8-10 hours a night and I have about made a complete recovery. A recent medical paper has shown that a messed up circadian rhythm can cause all kinds of heart problems. This study just shows how little doctoring and how much pill pushing is done. They should be trying to find the root cause of the problem instead of trying treat the symptoms so you can get back to your slave to the grind job that is killing you.

Btetta almost killed me (1)

Anonymous Coward | more than 2 years ago | (#39187627)

I'm pretty healthy. The Doc put me on byetta to get my borderline glucose down. Everything else was fine until 8 months on byetta! I had a scare, microalbumin was at 1586! Microalbumin/Creatine ratio was at 800! I thought I was gonna loose the kidneys. I didn't wait for my Dr. to say stop taking it. When I got the results I didn't know it was the byetta. I did a search on the fda.gov website and found a warning about byetta. So I stopped taking it, stopped working out hard for a little. Bought some urine test strips and in a a few days it appeares that it healed since now I can't measure it. I told my wife that if the strip was blue or purple then we should look at selling the house. well.. at least the strip was only beige/pink ... normal. I get an official test this weekend. I hope the sticks are accurate and that the problem I was experiencing is gone. I'm going to workout hard this weekend to see if the reading goes up a little. I'm still scared actually. I'd rather be borderline diabetic. The risk of taking byetta isn't worth it.
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