In college, when I was living in the dorms, I had a neighbor that I was good friends with who put a lot of effort into school. Often, they’d stay up way later than me to finish projects, complete homework, and study for tests. The next day I’d find out that they went to bed anywhere between midnight and 3am the previous night depending on their workload and energy levels. That was always interesting to me as I never had enough work, or maybe enough drive to complete work at the expense of sleep. But what I found even more interesting was that they were a frequent user of sleeping pills to counteract insomnia. Insomnia is a sleeping disorder which makes it difficult for someone to fall asleep in a reasonable time frame. How could they have trouble falling asleep after they’d been awake so long already? And how could they have trouble falling asleep when they were already running on only 4 hours of sleep from the previous night?

These were only a couple of the thoughts that ran through my mind at the time. But, as I’ve grown and become more interested in optimizing health, I started to wonder if those sleeping pills worked. How effective were they? And what were the side effects? I mean sometimes it takes me 30 minutes to fall asleep so do I need them too? After lots of reading and research, here’s what I discovered.

How Sleeping Pills Work

A long time ago, doctors use to recommend alcohol to help people deal with insomnia and fall asleep quicker. This sounds crazy today since we now have more information on this, but alcohol is a sedative which can make it easier for someone to doze off. But the key here is that dozing off and falling asleep are two different things. Alcohol’s sedative effects help put someone into sedation. From the outside, this looks remarkably like sleep. You can’t really tell any difference between someone who is sedated or sleeping. But on the inside things are vastly different. Sleep studies have shown that the natural sleep cycles, spindles, and waves associated with high-quality sleep are distorted or absent from sedation. And people who are sedated don’t receive many of the benefits that are associated with sleep (increased memory, immune function, creativity, alertness, etc.). Therefore, doctors no longer recommend alcohol to help fight insomnia.

After this change, doctors started to recommend sleeping pills created by pharmaceutical companies. These pills had the same promise of helping people with insomnia fall asleep quicker. But what research later discovered is that these pills had nearly the same effect as alcohol. These pills would quiet the cognitive thoughts in the brain and help put someone into… sedation. And again, sleep studies showed that the natural sleep cycles, spindles, and waves were distorted or absent when compared to natural high-quality sleep. This is especially the case in the deep sleep stage where brain waves are nearly muted during pill use compared to natural sleep. Not only do sleeping pills have a lot in common with how alcohol effects sleep, but they could be worse in some ways.

The Dangers of Sleeping Pills

Sleeping pills come with several short-term side effects. Some of them include grogginess, drowsiness, and reduced energy levels felt the following day. This has been shown to increase your risk of driving while drowsy which leads to an increased risk of motor vehicle accidents.

Short-term Dangers:

  • Increased risk of infection and sickness.
  • Forgetting recently learned information.
  • Grogginess and reduced energy levels.
  • Increased risk of motor vehicle accident from drowsiness.

But sleeping pill users can usually tell that they’re groggy and drowsy from the previous night’s sleep. To counteract this, users will increase their consumption of energy supplements or caffeine throughout the day. This consumption then makes it harder to fall asleep the next night because energy supplements and caffeine can stay in the body for over 8 hours, disrupting the next night’s sleep. So how do users counteract this? With more sleeping pills. Ultimately, your body may develop a tolerance to the pills rendering them not as effective which can cause users to increase their consumption of more pills. This can turn into a vicious cycle of poor sleep. And if this sleeping pill usage continues for years, studies have shown cancer rates rise 30-40% among users as well as a significantly increased risk of mortality.

Long-term Dangers:

  • Developing a tolerance to the pills rendering them ineffective.
  • Up to a 30-40% increased risk of developing cancer within 3 years after usage.
  • Up to 5.6x increased risk of mortality with regular use. Up to 3.6x increased risk with spare use.

Despite all these dangers or effects that sleeping pills cause, what are the benefits? There must be a reason they’re prescribed. Well, the reason is that sleeping pills do work. A little. Nominally. On average, users can see up to 30 minutes more of total sleep while falling asleep around 10 minutes quicker. This may sound helpful but if you put it into perspective, that’s not a whole lot of benefit. If someone suffering from insomnia is falling asleep after 70 minutes, taking these pills can help drop that number to 60 minutes. And if they’re sleeping 5 hours a night, taking these pills can help raise that to 5.5hrs. On average, yes that helps but not by a lot. At best, they’re marginally helpful.

Sleeping Pill Benefits:

  • Increase total sleep time by ~20-30 minutes and fall asleep ~10 minutes quicker on average.

Healthy Alternatives to Better Sleep

After a lot of this research surfaced over the past couple of decades, doctors have changed their tune for the better. In 2016, the American College of Physicians recommended that everyone who’s diagnosed with chronic insomnia should be treated first with cognitive behavioral therapy (CBT-I), not sleeping pills. Cognitive behavioral therapy for insomnia is an individualized, structured approach to combating insomnia through habit change. Really, it’s an approach that helps someone incorporate healthy sleeping techniques into their life that set themself up for a proper night’s sleep. This can involve implementing a sleep schedule by going to bed and waking up at the same time every day. Or it can involve slight changes like decreasing the temperature of your bedroom. Not only can healthy sleeping habits correct most insomnia cases, but they can prevent someone from developing insomnia in the first place. They can also help increase the quality of your sleep which introduces a whole host of benefits like improved immune system functionality, energy levels, attention, focus, memory, and emotional stability. And all of this can be accomplished without the side effects of sleeping pills.

A Few CBT-I Recommendations:

  • Go to bed and wake up at the same time every day including weekends.
  • Only use your bedroom for sleeping so your brain associates the bedroom with sleep and not work.
  • Don’t have a visible clock in the bedroom which may contribute to sleep anxiety.
  • If you’re having trouble falling asleep, get out of bed and do something relaxing like reading, meditating, or stretching. Once the urge to sleep returns, go back to the bedroom and try to sleep again.
  • Avoid taking naps throughout the day which will cause an increased pressure to sleep at night.

After learning all this, it gave me a lot more insight into my friend’s insomnia issue. Because they were going to bed at various times every night, their body wasn’t prepared for sleep. Their melatonin levels, a hormone that helps initiate sleep, weren’t coordinated with their unpredictable bedtime. It’s also possible that they had sleep anxiety which occurs when you’re worried about not being able to fall asleep which in turn makes it harder to fall asleep. It’s even possible that since they were working on their schoolwork in their bed most of the time, their brain had trouble associating the bed with bedtime and not work time. There were many poor sleep habits and lifestyle choices my friend had that were obviously playing a large part in them not being able to fall asleep and stay asleep. And it’s likely that correcting those issues would’ve had a lot more benefit without the side effects of taking sleeping pills.

Final Thoughts

As we’ve seen with numerous medicinal approaches to health issues, the benefits don’t always outweigh the risks. Sleeping pills may help users fall asleep slightly quicker and stay asleep just a little bit longer but at what cost? Grogginess and drowsiness the following day which can increase your risk of a motor vehicle accident. Poorer quality of sleep which can decrease immune system efficiency and memory solidification. Long term risks of usage include a 30-40% increased risk of cancer and dramatically increased risk of mortality. Instead of relying on a pill to solve the issue, doctors are now recommending cognitive behavioral therapy. This approach recommends long-term solutions through healthy habit change. Follow a strict sleep schedule, setup a proper sleep environment, and limit consumption of alcohol, caffeine, and screen time. This will not only help resolve and prevent insomnia, it’ll set you up for your highest-quality sleep. A goal we should all be shooting for.

Looking for 10 more healthy sleep tips you can implement today?

Hey, I am Brandon Zerbe

Welcome to myHealthSciences! My goal has always been to increase quality-of-life with healthy habits that are sustainable, efficient, and effective. I do this by covering topics like Fitness, Nutrition, Sleep, Cognition, Finance and Minimalism. You can read more about me here.