Chapter 5
Recommendations of Experts

In 1979, a distinguished committee of our national Institute of Medicine considered the risks and benefits of hypnotics. Noting concern with the side effects and risks of sleeping pills balanced by the lack of evidence for long-term benefit, this distinguished committee recommended that hypnotics generally be limited to short-term use.[47] In 1983, a Consensus Conference held by the National Institutes of Health on the treatment of insomnia. This group recommended that sleeping pills be used mainly for up to 3 weeks, not chronically.[48] Another consensus conference was held in 1990 to discuss problems of sleep in aging. Complaints of insomnia are much more common among people above age 60 years, and 40-50% of all sleeping pills are taken in the U.S. by people older than 60. This consensus group also recommended only short-term use of sleeping pills.[49] A new committee of the Institute of Medicine concluded in 1997 that the data only supported use of Halcion for two weeks.[50] In the summer of 2005, the National Institutes of Health had a consensus conference[51] about insomnia, which emphasized how little we understand about chronic insomnia. This group of experts concluded that the evidence for CBT therapy for chronic insomnia was better than evidence for long-term use of sleeping pills, though this group of experts did not frankly condemn long-term sleeping pill use. In summary, there is expert consensus that the medical evidence does not support chronic use of sleeping pills.

Most recently, a meta-analysis (combined analysis) of a large number of sleeping pill trials was published in the British Medical Journal, one of the most authoritative medical journals.[52] This analysis, focusing on studies of people with insomnia over 60 years of age, concluded that long-term use of sleeping pills more often does harm than good. This conclusion was reached without considering risks of mortality and cancer, which further tip the likelihood towards harm.

In conclusion, despite the enormous propaganda which results from over half a billion dollars a year spent on sleeping pill marketing, most expert opinion recommends against long-term use of sleeping pills. The opinions voiced in this web book may not be marketed, but most experts without financial ties to the sleeping pill industry had reached the same conclusions even before seeing our 2012 data about mortality and cancer.

Experts have repeatedly concluded that long-term use of sleeping pills is not advisable.

 

There is no convincing scientific evidence that taking any sleeping pill for years benefits sleep even a little.

Endnotes for Chapter 5

47. Institute of Medicine. Sleeping Pills, Insomnia, and Medical Practice. National Academy of Sciences, Washington, D.C., 1979. [return]

48. Consensus Conference. Drugs and insomnia. The use of medications to promote sleep. JAMA. 1984;251(18):2410-2414. [return]

49. Monjan, A. A. Sleep disorders of older people: report of a consensus conference. Hospital and Community Psychiatry 41(7), 743-744. 1990. [return]

50. Committee on Halcion, Institute of Medicine. Halcion: An independent assessment of safety and efficacy data. 1-158. 1997. Washington, D.C., National Academy Press. [return]

51. NIH State-of-the-Science Conference Statement on Manifestations and Management of Chronic Insomnia in Adults, NIH Consensus and State-of-the-Science Statements Volume 22, Number 2, June 13-15, 2005. NIH Office of the Director. Available as a PDF document at the National Institutes of Health’s website, consensus.nih.gov/2005/insomniastatement.pdfLink to a website outside this eBook. [return]

52. Glass, J, Lanctot, KL, Herrmann, N, Sproule, BA, Busto, EU. Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits. BMJ 2005;331:1169Link to a website outside this eBook. [return]