Excessive use of melatonin for sleep could cause allergies 0:53
(CNN) --
Stories of sleeping pills gone wrong are legendary.
Ask any flight attendant and you'll hear funny stories of people sleepwalking, taking off their clothes, or even getting up and peeing in the next seat.
The use of sleeping pills can also be deadly.
As many as half a million "excess deaths" in the United States were due to the use of sleep aids called sedative-hypnotics, a 2010 study found.
Increases use of melatonin for sleep, study finds, despite possible health harm
People with prescriptions for these sleeping pills, which include zolpidem and temazepam, were four times more likely to die from accidents and health problems related to their use compared to those who did not use these drugs, according to the study.
Even people who took fewer than two sleeping pills a month were three times more likely to die than those who didn't.
If you're using, or thinking about using, a prescription or over-the-counter sleeping pill, what do you need to know to do it safely?
We asked Dr. Jing Wang, an assistant professor of pulmonary, critical care and sleep medicine at Mount Sinai Icahn School of Medicine in New York City.
advertising
CNN: When someone comes to you with insomnia or another sleep disorder and asks for help falling asleep, do you give them a sleeping pill as a first step for immediate relief?
Dr. Jing Wang:
No, definitely not.
We really try very, very hard not to do that.
When someone comes in with insomnia, we take a very thorough sleep and medical history.
It is very important that the person share their personal data so that we can identify what could be the origin of the insomnia.
Is it behavioral or related to medications or medical conditions?
I'll ask them, "What are your hours during the day? What do you do at night?"
to try to find your physical and emotional stressors.
Is this person on a screen all the time at work and at home?
We then focus on how that person prepares for bed: "Do you have routines? Do you have a set bedtime?"
Insomnia is often perpetuated by what we do in response to not being able to sleep.
People get very creative in ways that may not be helpful: they communicate on the phone, check emails or respond to work messages, or sleep with the TV on.
Both expose you to blue light, which sends a signal to your brain to wake up.
From time to time, there will be people who say "I get up and work out", which is definitely not what you want to do!
How does lack of sleep impact human beings?
3:02
CNN: When might a sleep aid be recommended?
Wang:
Our first-line approach is to introduce patients to a form of cognitive behavioral therapy called CBTI, which is specific to insomnia.
Educate patients on healthy sleep behaviors, such as regular bedtimes and wake-up times, keeping screens and blue lights out of the bedroom, doing relaxing things before bed, etc.
It's about the associations our brain makes with our sleep environment and how our behaviors or activities affect that.
If we have someone who is clearly struggling with a very acute onset of insomnia, and there is an identifiable factor or change in their life, then we might have a discussion about a short-term trial of a sleep aid for a few more weeks or a month. or less, and only with regular checkups.
And we set clear expectations about short-term use, because we don't want to just prescribe a sleeping pill and have the person take it for the next 30 years.
We want to get to the root of the problem in a healthier way by fixing what triggers insomnia.
CNN: Why is long-term use of a sleep medication unhealthy?
Wang:
It depends, as people have different responses and can be susceptible in different ways.
Some of these sleep aids can become addictive, making the person feel like he can't sleep without them.
They can be dangerous if mixed with alcohol or certain pain relievers.
Some cause daytime sleepiness and can interfere with driving and other motor activities.
Sedative sleeping pills have been associated with hallucinations and dissociative behaviors.
People have driven cars, cooked food, sleepwalked, and made phone calls, all without remembering when they woke up.
After waking up, people may be susceptible to drowsiness and confusion, like a hangover effect.
CNN: Let's talk about over-the-counter medications. This is a problem?
Wang:
Any medicine is a double-edged sword: it has its uses but it always has side effects.
One of the best pieces of advice I always give patients is to tell them to really try to avoid over-the-counter sleeping pills.
They can have unforeseen side effects, such as making you hyperactive instead of drowsy.
There is a possibility of interaction with prescription sedatives, which patients may also be taking.
And there's always the possibility of misuse or overuse because they think, "Oh, it's over-the-counter, so it's safe."
Take the melatonin.
Some people have reported taking 30 or even 60 milligrams of melatonin and that could be dangerous;
we just don't know yet.
It's not actually regulated, so non-melatonin substances can be mixed into the pill or tablet.
You could get headaches, one of the known side effects of melatonin.
Or you could take it at the wrong time and interfere with your circadian rhythm.
Antihistamines, for example, create dry mouth, dizziness, and a kind of hangover feeling the next day.
They can also have anticholinergic effects, including urinary retention, blurred vision, constipation, and nausea.
Chronic and regular use of these agents has been linked in some studies to an increased risk of dementia.
Finally, the use of over-the-counter sleeping pills can potentially delay considering your sleep problems as a concern and seeking care: "There's no reason for me to see the sleep doctor or talk to my doctor about my sleep problems." I can just keep using an OTC agent."
Why you shouldn't smoke weed before bed 0:51
Sleep