Trouble sleeping? Nowadays, there's a long list of sleep hacks you can try, from TikTok's sleepy girl mocktail to listening to people crunching foil in an ASMR video. But if sleep continues to elude you, there's always the tried-and-true method: sleeping pills.
There are different prescription sleeping pills used to help a person relax and feel drowsy. The most common are benzodiazepines and antihistamines that promote signals telling your brain it's time to shut down for the night. But like with any drug, sleeping pills have side effects ranging from daytime drowsiness to concentration issues.
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While most side effects of sleeping pills are temporary, there now appears to be one that's more...life-altering. Research published in the Elsevier journal Sleep Health has found a link between sleeping pills and the risk of dying early.
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The study authors examined the mortality risk and life expectancy of 484,916 people (average age was 40.3 years old, with over half being women) from 1994 to 2011. People were surveyed on their sleep quality, how long they slept and if they used sleeping pills. Medical tests ruled out any prior health conditions that could have also affected a person's risk of dying early. Based on their sleep schedule, people were divided into four categories:
People who did not use sleeping pills and regularly slept 6 to 8 hours a night had the lowest mortality risk than people who slept less than 4 hours and over 8 hours. One interesting finding, however, was that people who also slept 6 to 8 hours a night but took sleeping pills had a 55% higher mortality risk than non-users.
"Our results are staggering to say the least. Many people rely on sleeping pills to help them sleep, so it’s a shock to find that taking them may more than double your mortality risk," says Dr. Yu Sun, MD, Ph.D, a researcher at En Chu Kong Hospital in Taiwan who led the study, in a press release.
The authors also observed that sleeping pill users have a shorter life expectancy than non-users. Men's life expectancy was 5.3 years shorter, and women's was 5.7 years shorter. Additionally, sleeping pill users had a higher cancer death rate than nonusers who slept 6 to 8 hours a night.
Related: What One Woman With Chronic Insomnia Does to Sleep Better
Sleep scientists don't know for certain whether it's the sleeping pills that are causing the increased risk of death. Dr. Emma Lin, MD, a pulmonary and sleep medicine physician at ReadyO2, says people who need sleeping pills every night tend to have other health problems, including depression, anxiety or respiratory problems. All three are independently linked to poor health that may contribute to an early death.
Still, if sleeping pills are really to blame, sleep doctors have some explanations for how this could be happening.
First, many sleeping pills are benzodiazepines (think Klonopin or Xanax), a type of medication that slows down activity in your brain. Dr. Ruchir Patel, MD, FACP, a sleep medicine physician and owner of The Insomnia and Sleep Institute of Arizona, says using benzodiazepines for a long time is linked to memory problems and decreased concentration. It may also start to change people's emotional states and behavior.
"These effects can indirectly contribute to increased mortality risk by affecting daily functioning and increasing the likelihood of accidents, especially in older adults," Dr. Patel explains.
There has also been research linking benzodiazepine use with an increase in mortality among people 65 or younger.
People who use benzodiazepines in general also have 66% greater odds of ending up hospitalized or dying, Dr. Patel warns. "When benzodiazepines are combined with non-benzodiazepine receptor agonists, the odds of serious health outcomes nearly quadruple," he says.
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While the study results are concerning, there are some limitations to consider before flushing your pills. First, the authors were only observing people's behavior and how it may affect their mortality risk. The higher death rate could be from an unexplained illness, not the sleeping pills. Second, the study relied on people's recall of their nighttime habits, and memory of events can get fuzzy. Third, while questionnaires were filled out at every annual visit, only the results from the first visit were used in the calculations. It's possible that changes in sleep behavior and the use of sleeping pills changed over time.
Dr. Lin recommends talking with your doctor before you stop taking sleeping pills, explaining, "Stopping by yourself is risky. Certain sleep pills have to be tapered off, or your sleep will become worse."
He adds that when working with patients, he tries to get to the root of what's causing the sleeplessness in the first place: "Is it stress? Is sleep apnea, in that they are not breathing at night? Do they have lung problems which cause them to have trouble breathing when they are in bed? If we know the cause, then we can treat the problem, not cover it up with a pill."
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