Getting a good night's sleep is important to life quality and public safety. According to a 2010 review in the "Journal of Clinical Sleep Medicine," sleep disturbances are associated with poor health. A 2010 survey in the same publication showed that sleep deprivation often causes automobile accidents. Sleeping pills, also known as hypnotic drugs, have evolved to become safe and effective ways enhance sleep quality. Yet some issues remain, and more data are needed.
Barbiturate Drugs
Barbital, discovered in 1902, was the first commercially available barbiturate drug. These drugs caused sleepiness in laboratory animals, and they were marketed as treatments for anxiety and insomnia in humans. Barbiturate drugs continue to be used as hypnotics over 100 years after their discovery. For example, a 2009 study in the "European Respiratory Journal" tested the effects of the barbiturate pentobarbital. This drug increased the amount of time needed to arouse subjects from sleep. Thus they were more soundly asleep after taking pentobarbital.
Barbiturates are central nervous system depressants, and they may cause adverse reactions. A 2005 review in "Neuropsychiatric Disease and Treatment" stated that the drugs are often associated with tolerance, dependence, overdose and abuse. Because of these side effects, barbiturates have gradually been replaced by other, safer hypnotics. For example, a 2008 review by the AARP indicated that barbiturates were no longer among the most prescribed drugs.
Benzodiazepine Drugs
Chlordiazepoxide, invented in 1955, was the first commercially available benzodiazepine drug. These drugs cause sedation and relaxation. They have been marketed as treatments for anxiety and insomnia. Clinicians continue to prescribe benzodiazepines more than 50 years after their invention. For example, a 2006 review in the journal "Neurology" recommended the benzodiazepine clonazepam for the treatment of certain sleep disorders.
Benzodiazepines also cause many unwanted reactions. A 2010 review in "Psychiatria Danubina" stated that the drugs have a negative impact on memory, mood and coordination. These effects may prevent people from safely driving while taking benzodiazepines. Because of these side effects, newer "nonbenzodiazepine" drugs have recently appeared on the AARP list of most prescribed drugs.
Nonbenzodiazepine Drugs
Zolpidem, tested in 1983, was the first commercially available nonbenzodiazepine drug recommended for insomnia. These drugs have gained notoriety for being safer and more effective hypnotics than previous medications. For example, a 2008 review published in "Postgraduate Medicine" suggested that nonbenzodiazepines were less likely to cause "hangover" effects like daytime sleepiness. In fact, a 2009 review in "Advances in Therapy" stated that the nonbenzodiazepine eszopiclone is the first hypnotic approved by the FDA without heavy restrictions being placed on its use.
While nonbenzodiazepines are effective hypnotics, they may increase mortality rates. A 2008 review in the "Journal of Sleep Research" indicated that drugs like zolpidem and eszopiclone can cause skin cancer in laboratory animals. These effects occurred only at unusually large doses, but caution must be exercised when taking any hypnotic medication.
References
- "Journal of Clinical Sleep Medicine"; Sleep...; C. M. Baldwin et al.; April 15, 2010
- "Journal of Clinical Sleep Medicine"; Sleep quality...; F. Pizza et al.; February 15, 2010
- "European Respiratory Journal"; Effects of...; M. Eikermann et al.; December 23, 2009
- "Neuropsychiatric Disease..."; History of ...; F. Lopez-Munoz et al.; December 2005
- "Neurology"; Update on the pharmacology...; J. F. Gagnon et al.; September 12, 2006
