FDA Requires Warning for Most-Prescribed Sleeping Pill
Some people who have relied on Ambien could be tossing and turning again after the federal Food and Drug Administration is requiring a warning that OSF HealthCare Director of Clinical Sleep Medicine, Doctor Kaninika Verma, says is appropriate and necessary.
The FDA’s new warning comes in the wake of 66 reports of rare but serious injuries and deaths resulting from sleepwalking, sleep-driving and other activities done while sleeping such as cooking, eating, even shaving. Ambien, Lunesta, and Sonata are the common names for powerful sleep medicines known as sedative hypnotics that fall under the new requirement for warnings on the boxes of these drugs -- the most prominent FDA warning.
Dr. Verma says in 2013, the FDA reduced recommended dosage because of concerns the medication induced complex activity while a patient was still sleeping.
Sleep specialists such as Verma have been cautious about prescribing the drugs but she says many people have received them from primary care physicians who are typically the first stop for anyone experiencing insomnia.
"A lot of primary care physicians are ordering these medications and prescribing them. So for them to aware of this is important and for them to pause and think about it is important – that these medications are not benign,” she observed.
The medications are used to treat people who have had problems falling or staying asleep. But, Dr. Verma says she has only used them for situationally-induced sleeping problems and not as a long-term solution. In some cases, she says some anxiety-producing events trigger insomnia but it continues because of bad habits.
“If you ask them, ‘do you remember when this started?’ They will have maybe something very small, maybe something very insignificant that may have happened in their life but it caused enough stress to have problems with insomnia and whatever behaviors they picked up to compensate for it they continue those behaviors on and then insomnia continues,” she explained.Dr. Verma says sometimes insomnia is caused by a medical issue but sometimes it’s simply a result of bad habits. In that case, she refers patients to a behavioral therapist.
“To really retrain that brain to shut down when it is supposed to. Pretty much all of these medications that are out there for insomnia are kind of taking care of the symptom but not really tackling the problem.”
Over-the-counter sleep aids
Most products available over-the-counter contain antihistamines and Dr. Verma says most people build up a quick tolerance. In addition, some of those sleep aids can leave you feeling groggy the next day.
Medication interactions are possible as well and have side effects. For example, melatonin can raise blood sugar levels and impacts the effectiveness of diabetes medication.
While late-night eating is usually seen as a sleep disruptor, the Wall Street Journal recent reported on what it calls calls a small but growing number of products marketed to help you get a better night’s sleep. WSJ says Nestlé is testing a rollout of a new chocolate called Goodnight that has magnesium and casein protein it touts as helping put someone to sleep.
Another company called Nightfood has come out with ice cream that has names such as Cookies and Dreams and After Dinner Mint Chip. It doesn't make claims to help promote better sleep other than it promotes its ice cream as a healthier snack that has only 150 calories and a lower glycemic index.
According to The National Sleep Foundation, certain foods and beverages could actually help you fall asleep faster and sleep more soundly. Here are some things it recommends to put on your grocery list for more restful nights:
·Complex carbs including popcorn, oatmeal, or whole-wheat crackers with nut butter are all good choices.
·A Handful of Nuts can increase your blood levels of the hormone that helps regulate the sleep-wake cycle.
·Cottage Cheese has the amino acid tryptophan, which may increase serotonin levels. Serotonin is a brain chemical and low levels of it can contribute to insomnia.
·A Cup of Bedtime Tea that doesn’t have caffeine can be a calming ritual. Chamomile, ginger, and peppermint are calming choices for bedtime.
·Warm Milk is a familiar ritual from most people’s childhood and scientifically, the Sleep Foundation says there may be some link between the tryptophan and melatonin content of milk and improved sleep.
·Fruits can help with insomnia. For example, eating two kiwis before bed can increase your sleep duration by an hour over the course of a month according to the Sleep Foundation. Other fruits and vegetables that are rich in antioxidants (like berries, prunes, raisins, and plums) may have a similar effect by helping to counteract the oxidative stress caused by a sleep disorder.
If you have trouble falling asleep or staying asleep, you should consider seeing a sleep specialist.
Take this short quiz to see if you might be suffering from sleep apnea, a common but serious health risk.