Do Sleeping Pills Really Make People Sleep Well?

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Chronobiol Med. 2022;4(4):135-136
Publication date (electronic) : 2022 December 29
doi : https://doi.org/10.33069/cim.2022.0034
1Department of Psychiatry, Korea University College of Medicine, Seoul, Korea
2Chronobiology Institute, Korea University, Seoul, Korea
Corresponding author: Heon-Jeong Lee, MD, PhD, Department of Psychiatry, Anam Hospital, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk- gu, Seoul 02841, Korea. Tel: 82-2-920-6721, E-mail: leehjeong@korea.ac.kr
Received 2022 December 11; Accepted 2022 December 14.

Some expect that sleeping pills are merely sleep-inducing drugs and will have no significant side effects, which is a misleading idea. Since practically all sleeping pills developed to date are tolerant, prolonged usage will reduce their effectiveness. Additionally, the use of sleeping pills can lead to dependence, which makes insomnia worse and more persistent. As a sleep specialist, one of the difficulties is helping patients who have been taking sleeping pills for years to stop taking them. It takes a lot of effort to persuade patients to stop using sleeping pills, and successfully quitting them is not easy. Sometimes sleep specialists have no choice but to confront patients about giving up sleeping pills. However, patients who are already reliant on sleeping pills should not hesitate to go through this challenging procedure to treat insomnia because the problem cannot be resolved unless they quit taking the pills.

Fortunately, in most cases, persistent persuasion eventually reduces and finally eliminates the use of sleeping pills. Although the process is never easy, stopping the use of sleeping pills is not that difficult if the patient’s sleep disorder is treated (e.g., sleep apnea, restless legs syndrome, etc.) and the innate circadian rhythm is restored. What is challenging is the process of kicking the habit of using sleeping pills, starting activities early in the morning for exposure to sufficient light, and putting them into practice.

This issue of Chronobiology in Medicine published a paper on the link between the use of benzodiazepines and dementia [1]. Considering that mental illness is common and many are prescribed benzodiazepines, it is important for clinicians to study and be alert to the advantages or pitfalls of benzodiazepines. Dementia is also one of the global health problems, and it requires significant financial resources and manpower to treat and manage its patients. Moreover, there have been numerous questions and debates concerning whether benzodiazepines are harmful because they can interfere with memory functions.

Many studies examining the link between sleeping pills and diagnosis of dementia have reported that long-term use of such drugs can harm future brain health [2,3]. Sun et al. [1] reported that benzodiazepines, especially long-acting benzodiazepines, are related to dementia. This paper will aid clinicians in comprehending and paying closer attention to the use of benzodiazepines, which are frequently used off-label to treat insomnia in addition to relieving anxiety.

Despite the study’s many limitations, it may be claimed that the results suggest that benzodiazepine exposure is related to dementia. Therefore, people who prescribe benzodiazepines should be cautious about the possibility of memory impairment and dementia. It is certain that sleeping well is crucial for the prevention and treatment of various neuropsychiatric disorders, including dementia. However, this is not possible by taking sleeping pills. It is important to maintain a good circadian rhythm in daily life and eliminate various physical, psychological, and environmental factors that interfere with sleep.

Notes

Funding Statement

This study was supported by the Korea Health 21 R&D Project funded by the National Research Foundation of Korea (2019R1A2C2084158).

References

1. Sun TH, Yeom JW, Cho CH, Lee HJ. The association between benzodiazepines and dementia in South Korea: a nation-wide study. Chronobiol Med 2022;4:152–156.
2. Billioti de Gage S, Begaud B, Bazin F, Verdoux H, Dartigues JF, Peres K, et al. Benzodiazepine use and risk of dementia: prospective population based study. BMJ 2012;345e6231.
3. Robbins R, DiClemente RJ, Troxel AB, Jean-Louis G, Butler M, Rapoport DM, et al. Sleep medication use and incident dementia in a nationally representative sample of older adults in the US. Sleep Med 2021;79:183–189.

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