A six-year study of more than a million subjects headed by psychiatrist Daniel Kripke establishes that those who sleep an average of 6-7 hours a night function no worse and have no added health consequences than those getting the mythical 8 hours a night. Indeed, the mild sleep deprivation may extend their life, as well as making them more productive. The myth that we are a nation of zombies walking around bleary-eyed, making more mistakes, having more accidents and showing more emotional instability may be mostly a sales pitch for the lucrative pharmaceutical trade in hypnotics (sleeping pills). (Yahoo! News)
I routinely sleep more like 6 hours a night than 8 during the week, and (although you might argue that I would be the last to know) I don’t feel I suffer for it. If I get down to 4-5 hours, I do see the difference, especially in terms of irritability and especially if I do so for several nights in the same week. (There’s also no such thing as making up a cumulative sleep deficit by sleeping in on the weekend, I am convinced…)
And, in my psychiatric practice, both because of physiological addictiveness and the risk of rebound insomnia, I strictly adhere to the practice of only prescribing sleeping pills for my patients for acute use (less than about two weeks at a stretch, better if used intermittently than consistently). Because of the development of physiological tolerance, most of the medications lose their effectiveness if used for longer anyway, although patients become psychologically dependent on them and physicians often renew their prescriptions indefinitely. If the patient ever tries to go off the medication, indeed they have trouble sleeping and they never sustain their abstention for long, concluding that the drug-free trial confirmed their ongoing need for sleeping medication. However, all it really shows is the phenomenon of rebound insomnia, which would probably abate if they remained drug-free for long enough. And “a poor night’s sleep never killed anyone…”
Newer sleeping pills are marketed as less addictive and effective for lengthier use, but don’t believe it. There are few free lunches in brain chemistry. Zolpidem (Ambien®) and the others are really not very different from the benzodiazepine sleep aids (Halcion®, Dalmane® etc.) they are supplanting, in my opinion. Medications that interact with the benzodiazepine receptor — which all of these medications do — interfere with the acquisition of new learnng while under their influence and, at high doses, can cause the somnambulist activities so much in the news these days, such as “sleep driving” and “sleep eating”. There is nothing special about Ambien in this regard except that it is now so broadly prescribed. Other hypnotic medications do the same thing. At high doses, especially in combination with alcohol, they are respiratory suppressants (read: lethal in overdose), and they accumulate to high levels in the systems of those with impaired ability to metabolize them, such as the medically ill and the elderly. Not benign at all…
But, of course, we can try to compensate for all these hypnotic effects with the daytime-alertness drug that is all the rage these days, modafinil (Provigil®), right?
