- In this report
- Overview
- Why we can't sleep
- The trouble with drugs
- What you can do
- Sound machines
- Myths about sleep
- Which techniques work best
- Take our interactive quiz
TREATMENTS RATED
Find out which therapies work best for insomnia as well as for other conditions listed in this report.
COST-EFFECTIVE DRUGS
Learn more from our latest Best Buy Drugs report.
LISTEN FOR YOURSELF
Hear the sound machines our panelists tested.
September 2008
The trouble with drugs
For many people, insomnia treatment starts with medicine. But nondrug techniques can also work, and three approaches worked
well for some of our respondents, including the use of sound machines, cognitive behavioral techniques, and sleep routines. Even so, pills remain popular. Last year, 24 million prescriptions
were written for the four best-selling sleep drugs alone, and drugmakers spend hundreds of millions of dollars yearly trying
to persuade Americans to fix their sleep issues with medicines. In fact, the two most heavily advertised drugs last year were
sleep aids Lunesta and Ambien CR, which had a combined direct-to-consumer ad budget of almost $500 million.
Among the 15 percent of respondents who had taken a prescription drug during the preceding month, 38 percent said they’d been on the medication for more than two years. Most sleep drugs are supposed to be taken for no longer than two weeks or so, and continued use could lead to serious side effects or dependency; “rebound” insomnia, in which sleeplessness returns and might actually worsen; memory lapses; and hallucinations. The most commonly reported side effect was daytime drowsiness.
Many people were treating their insomnia with drugs primarily used for other illnesses. Forty-nine percent of pill-takers took antianxiety medications such as alprazolam (Xanax) or antidepressants such as trazodone (Desyrel), which have sleep-inducing properties. A smaller group relied on anticonvulsants such as gabapentin (Neurontin) or pain relievers such as Darvocet.
Forty percent who used drugs took heavily advertised pills such as Ambien, (and Ambien CR), Lunesta, Rozerem, and Sonata, which are marketed exclusively as sleep aids. They pose a lower risk of dependency and addiction and a smaller chance of minor side effects than benzodiazepines and prescription sedatives such as estazolam (the generic version of ProSom) and temazepam (Restoril), which have been around for decades. Still, the newer sleep drugs might cause next-day sleepiness, temporary amnesia, hallucinations, and worse, rare cases of sleepwalking, sleep driving, and sleep eating.
Other respondents used over-the-counter medications such as Nytol, Sominex, Tylenol PM, and Unisom. Promoted as sleep aids, they contain antihistamines, which are primarily used to treat allergies but can also induce drowsiness. But they can cause side effects, including next-day drowsiness, dry mouth, and increased urine retention. And while they might help you fall asleep faster, they might be less effective at helping you sleep longer.
Some studies show that two supplements, melatonin and valerian root, might be mildly effective sleep aids. But they’re not well regulated, and there’s no guarantee that they contain the ingredients listed on their labels.
In general, our survey found that on most nights, over-the-counter drugs and supplements helped 57 percent of the problem sleepers we surveyed. They surpassed behavior therapy and muscle—relaxation techniques but were less effective than prescription drugs and sound machines.
Among the 15 percent of respondents who had taken a prescription drug during the preceding month, 38 percent said they’d been on the medication for more than two years. Most sleep drugs are supposed to be taken for no longer than two weeks or so, and continued use could lead to serious side effects or dependency; “rebound” insomnia, in which sleeplessness returns and might actually worsen; memory lapses; and hallucinations. The most commonly reported side effect was daytime drowsiness.
Many people were treating their insomnia with drugs primarily used for other illnesses. Forty-nine percent of pill-takers took antianxiety medications such as alprazolam (Xanax) or antidepressants such as trazodone (Desyrel), which have sleep-inducing properties. A smaller group relied on anticonvulsants such as gabapentin (Neurontin) or pain relievers such as Darvocet.
Forty percent who used drugs took heavily advertised pills such as Ambien, (and Ambien CR), Lunesta, Rozerem, and Sonata, which are marketed exclusively as sleep aids. They pose a lower risk of dependency and addiction and a smaller chance of minor side effects than benzodiazepines and prescription sedatives such as estazolam (the generic version of ProSom) and temazepam (Restoril), which have been around for decades. Still, the newer sleep drugs might cause next-day sleepiness, temporary amnesia, hallucinations, and worse, rare cases of sleepwalking, sleep driving, and sleep eating.
Other respondents used over-the-counter medications such as Nytol, Sominex, Tylenol PM, and Unisom. Promoted as sleep aids, they contain antihistamines, which are primarily used to treat allergies but can also induce drowsiness. But they can cause side effects, including next-day drowsiness, dry mouth, and increased urine retention. And while they might help you fall asleep faster, they might be less effective at helping you sleep longer.
Some studies show that two supplements, melatonin and valerian root, might be mildly effective sleep aids. But they’re not well regulated, and there’s no guarantee that they contain the ingredients listed on their labels.
In general, our survey found that on most nights, over-the-counter drugs and supplements helped 57 percent of the problem sleepers we surveyed. They surpassed behavior therapy and muscle—relaxation techniques but were less effective than prescription drugs and sound machines.
