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Collop, Bruno, and Yurcheshen praise Kripke for raising the issue of sleeping pill harm.
"One part of the Kripke study I really did like is when they point out that part of the problem with hypnotics is they are really best for people with acute, short episodes of insomnia," Yurcheshen says. "Very few insomnia drugs are approved for long-term daily use. And so it is fair to say that the long-term safety of these drugs has never been explored for use in that way."
Collop says she personally is "torn whether hypnotics are good or bad." She notes that it can be harmful to be dependent on hypnotic sleeping pills for a long period of time. They can help a person who is having a hard time falling asleep for some specific reason.
"These sleeping pills are mostly for short-term use," she says. "So the ideal patient would be someone with a very high stress level for some reason, such as the recent loss of loved one or a divorce, or for a traveler adjusting to a new time zone. This should be for a limited time period and only as needed, not on a nightly basis. In such situations these drugs are appropriate and effective."
Bruno notes that hypnotic sleeping pills affect the quality of sleep. When used too often, he says, "people don't feel as restored after sleeping with them."
He also points out that many hypnotic sleeping pills are habit forming. "For those at risk of addiction, or with other addictions, they can be dangerous," he says. "And most of these drugs increase the effects of alcohol."
Sleeping Pill Alternatives
It may sound surprising, but sleeping pills are not the best way to treat insomnia. The drugs clearly help people with short-term trouble getting to sleep. But for most insomnia sufferers, they are not the answer.
"It is pretty miserable not to be able to sleep," Collop says.
Bruno says that even when he prescribes hypnotic sleeping pills, he educates patients on proper sleep hygiene.
"This means basic education about the importance of a regular bedtime, a regular time to wake, avoiding naps, avoiding extreme physical exercise in the evening, and saving the bedroom for sleep," he says.
Kripke and all of the other experts agree that a form of short-term psychotherapy -- cognitive behavioral therapy or CBT -- is surprisingly effective for people with chronic insomnia.
Collop says it's time to see a sleep specialist if you have tried sleeping pills and they don't work any more. Looking for another brand of sleeping pill will not work.