Thursday, December 20, 2012

How Do Sleeping Pills Really Work?

Study Says It's Partly Becasue You Think They Do BySalynn Boyles
WebMD Health News Reviewed byBrunilda Nazario, MD man sleeping

Dec. 20, 2012 -- The most widely prescribed sleeping pills do help people get to sleep, but maybe not only because of the medicine, a new study suggests.

When researchers combined studies of some of the newer prescription sleep drugs, they concluded that the drugs owe about half their benefits to a placebo effect.

But at least one sleep expert disagrees with that conclusion.

Jobs That Wreck Your Sleep

Benefits Small, Study Finds

The drugs included in the study were the sleep aids Ambien, Lunesta, and Sonata and their generic versions.

The researchers conclude that these drugs improved people's ability to fall asleep compared to a placebo; however, the size of the effect was small.

They add that the risk of side effects and the potential for addiction need to be weighed  when considering using these medications for treating insomnia.  

Side effects of sleeping pills can include memory loss, daytime sleepiness, and increased risk of falls, and researchers say the drugs may be especially risky for older patients.  

But a sleep specialist says the study does little to convince him that the drugs -- used by millions of people worldwide -- are less effective than studies suggest.

“The fact is that it is difficult to measure the effectiveness of sleep medications in studies. Patients take them and they either work or they don’t.”

“I don’t see how these researchers can come to the conclusion that 50% of the effect of these sleeping pills are due to the placebo effect,” says David Volpi, MD, of the sleep disorders division of Lenox Hill Hospital in New York.

Sleep Aid Helps Users Fall Asleep Faster

The new analysis, published in BMJ, was a collaborative effort by scientists from the University of Lincoln in the U.K., Harvard University, and the University of Connecticut.

It included data from 13 trials submitted by pharmaceutical companies to the FDA for approval of eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien).

The studies focused on the time it took to fall asleep after taking the drug.

The new analysis shows that sleeping pill users fell asleep about 22 minutes faster than non-users. Those on placebo fell asleep after 42 minutes.

According to researcher A. Niroshan Siriwardena, MD, PhD, one of the major limitations of studies submitted to the FDA is that they failed to measure some of the most troubling issues associated with sleep disturbances including total sleep time, waking after falling asleep, and daytime sleepiness.

“Because the studies didn’t measure these things, we cannot say whether these drugs are useful for improving these outcomes,” he says.

Nondrug Sleep Treatments Effective

Volpi says prescription sleeping pills are often used by patients for much longer than they were originally intended.

These drugs are overprescribed and patients stay on them too long, he says. “It’s not unusual to see patients who have been on them for years.”

Siriwardena and Volpi also agree that other types of sleep treatments, such as talk therapy, are underutilized and could be used to help many more patients with sleep issues.

“There are so many things you can try for sleep problems, and cognitive behavioral therapy is one of the best things patients can do to get off of these medication,” Volpi says says.

The manufacturer of Ambien was contacted but declined to comment. The makers of Lunesta and Sonata were contacted but did not respond before publication.

View Article Sources Sources

SOURCES:

Huedo-Medina, T. BMJ, Dec. 17, 2012.

A. Niroshan Siriwardena, MD, PhD, professor of primary and prehospital health care, University of Lincoln, Lincoln, U.K.

David Volpi, MD, sleep specialist, Lenox Hill Hospital’s Head and Neck Institute, Sleep Disorder’s Division, New York.

News release, University of Lincoln.

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You say you are able to function well with fewer than seven hours of sleep. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

Since you usually get too little sleep, please talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have insomnia or other conditions affecting your sleep.

Sleep deprivation can have both short- and long-term consequences. Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's not surprising you feel that you're not functioning at your best today. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

Since you usually get too little sleep, please talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have difficulty sleeping, have insomnia, or have other sleep disorders.

Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's not surprising you feel that you're not functioning at your best today. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

It's good that you usually do get more sleep, since sleep deprivation can have both short- and long-term consequences. Learn more about the health consequences of sleep loss. And if you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

You say you are able to function well with fewer than seven hours of sleep. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

It's good that you usually do get more sleep because sleep deprivation can have both short- and long-term consequences. Learn more about the health consequences of sleep loss. And if you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's not surprising you feel that you're not functioning at your best today. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

Since you usually get less sleep, please talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have difficulty sleeping or have insomnia or other sleep disorders.

Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's wonderful that you got a good night's sleep last night. Many people struggle to do so. Having a good sleep routine often is the key to getting the quality sleep night after night that your body needs for optimal health. Whether your sleep routine involves taking a warm bath, reading a book, or meditating, it's important to keep your bedtime and routine consistent every night and wake up around the same time every morning.

Click here to read more about the importance of sleep. If you're concerned about having trouble falling asleep, staying asleep, or sleeping too much, assess your risk for a sleep disorder.

It's unfortunate you're not functioning at your best today. You say you had a good quantity of sleep last night, but maybe the quality of your sleep is not as good as it could be? Having a good sleep routine — including a consistent bedtime and wake time — often is the key to getting the quality sleep night after night that your body needs for optimal health. Since you usually sleep this amount, if you often aren't feeling your best, you should consider talking to your doctor. Could you have an underlying condition? Are you feeling anxious or depressed? Have you taken medication that disrupted your sleep? Do you or could you have sleep apnea? Or do you naturally require a little bit more sleep?

Although sleep is crucial for optimal health, some research suggests that sleeping too much can also have negative consequences. Learn more about sleep. If you're concerned about having trouble falling asleep, staying asleep, or sleeping too much, assess your risk for a sleep disorder.

It's unfortunate you're not functioning at your best today. You say you had a good quantity of sleep last night, but maybe the quality of your sleep is not as good as it could be? Having a good sleep routine — including a consistent bedtime and wake time — often is the key to getting the quality sleep night after night that your body needs for optimal health. Since you usually sleep longer, if you often aren't feeling your best, you should consider talking to your doctor. Could you have an underlying condition? Are you feeling anxious or depressed? Have you taken medication that disrupted your sleep? Do you or could you have sleep apnea? Or do you naturally require a little bit more sleep?

Although sleep is crucial for optimal health, some research suggests that sleeping too much can also have negative consequences. Learn more about sleep. If you're concerned about having trouble falling asleep, staying asleep, or sleeping too much, assess your risk for a sleep disorder.

It's wonderful that you got a good night's sleep last night. Many people struggle to do so. Having a good sleep routine often is the key to getting the quality sleep night after night that your body needs for optimal health. Whether your sleep routine involves taking a warm bath, reading a book, or meditating, it's also important to keep bedtime consistent and wake up around the same time every morning.

Although sleep is crucial for optimal health, some research suggests that sleeping too much can have negative consequences. Learn more about sleep. If you're concerned about having trouble falling asleep, staying asleep, or sleeping too much, assess your risk for a sleep disorder.

It's unfortunate you're not functioning at your best today. You say you had a good quantity of sleep last night, but maybe the quality of your sleep is not as good as it could be? Having a good sleep routine — including a consistent bedtime and waking up at the same time — often is the key to getting the quality sleep night after night that your body needs for optimal health.

Since you usually get less sleep, please talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have insomnia, another sleep disorder, or conditions affecting your sleep.

Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's wonderful that you got a good night's sleep last night. Many people struggle to do so. Having a good sleep routine often is the key to getting the quality sleep night after night that your body needs for optimal health.

Since you usually get less sleep, talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have insomnia or another sleep disorder or conditions affecting your sleep.

Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

Thank you for signing up for the WebMD Sleep Disorders Newsletter!

You'll find tips and tricks as well as the latest news and research on Sleep Disorders.

View Sources

SOURCES:

Centers for Disease Control and Prevention (CDC). Effect of short sleep duration on daily activities--United States, 2005-2008. MMWR Morb Mortal Wkly Rep 2011; 60:239.

Carskadon, MA, Dement, WC. Normal Human Sleep: An Overview. In: Principles and Practices of Sleep Medicine, Fifth, Kryger, MH, Roth, et al. (Eds), Elsevier Saunders, St. Louis, MO 2011. p.16.

Harvard University: "Sleep, Performance, and Public Safety."

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When Parents Are Too Permissive

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WebMD Feature Reviewed byHansa D. Bhargava, MD

You might think that too-permissive parents are the ones whose kids have no rules, no curfews, no dress code, and no manners. True, but they're not the only ones.

You may be surprised that some of your habits could put you into the "pushover" or permissive parent category, according to experts, even if you think that you're doing everything right with your tweens and teens.

"Many parents today misunderstand their role," says parenting expert Leonard Sax, MD, PhD, a family doctor in Chester County, PA, and author of Girls on the Edge and Boys Adrift. "They often see their role as making sure the son or daughter gets into a top college and protecting the son or daughter from disappointment. They are there, providing the safety net in situations where it might be wiser to let the kid experience the consequences."

Here are five common ways that parents become too permissive, plus how and why you should change your ways.

1. No Routines or Limits

For many parents, life can get too hectic to follow through on their parenting plans, especially if it will take some work to get the kids on board. After a while, their family's lack of routine can result in lazy, spoiled teens or tweens without schedules and responsibilities.

"Everybody knows that they should have rules, routines, habits and socializations," says Laura Kastner, PhD, author of Getting to Calm: Cool-Headed Strategies for Parenting Tweens and Teens, a clinical associate professor of psychiatry at the University of Washington School of Medicine. "But for busy parents, when they finally get home, they don't want to turn their family time into acrimony."

Like it or not, the only way to change the situation is to become less permissive, setting limits for the family.

"If you say, 'We're now going to have bedtime,' the kids will really push back," Kastner says. "You have to be calm, absolutely resolute, and not cave."

If you're married or living with your partner, they have to be on board. "You want your spouse to be on the point as much as possible, because kids will go after the weaker partner," Kastner says. "Once you get past the first two weeks, you're probably on your way."

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