You Are 3 Times As Likely To Die if You Take Sleeping Pills
The Atlantic reports on a new study:
RESULTS: Those prescribed fewer than 18 doses of sleeping pills a year were more than 3.5 times as likely to die as those in the control group. Moreover, the risk of death of moderate (18 to 132 doses) and heavy users (132+ doses) were four and five times greater than that of non-users, indicating that the risk level rose in tandem with increasing doses. Heavy users were also at higher risk of developing several types of cancer.
CONCLUSION: Sleeping pills are associated with a more than threefold increase in mortality risk, even if seldom used.
The past few years I’ve grown more and more skeptical of our medical culture.
When you “feel bad” in some way you’re supposed to go to the doctor. Usually they just write you a prescription and then like magic the medicine is supposed to make you better.
Instead what seems to happen instead in most cases is the medicine — if you’re lucky — treats the symptoms while perhaps causing a few side effects of its own. Meanwhile deep down you’re still sick — and the doctor may or may not care. Instead he’s content with you just coming in more than you need to so that he can overcharge your insurance company for a bunch of tests you don’t really need but he has to do in order to cover his butt from malpractice lawsuits.
Meanwhile we supposedly have a crisis in healthcare costs. More like we have a crisis in people thinking that other people should be responsible for maintaining their health and well-being.
So if I don’t take sleeping pills, there’s a 1 in 3 chance I’ll be immortal?
I was actually going to mention that. It’s one of those copy-edit sort of comments, but yeah, the risk of death is pretty much 100 percent. it’s risk of early death, and even then “three times higher” might well mean “from probability 0.001 to probability 0.003″.
No, it means that there’s a 100% chance you still won’t understand statistics.
OK, I know, I know – you were joking – and so am I.
The lesson here is probably “never grab a falling statistic.” The drugs mentioned are chemically radically different — they have different mechanisms of action, they’re very different chemically. The likelihood that all of them have similar side effects is pretty slim.
On the other hand, there’s one thing we can be certain is common among everyone taking sleeping pills: insomnia. And sure enough, insomnia is associated with early mortality.
This study appears to be a little bit like discovering that people taking chemotherapy drugs, of whatever class or type, are more likely to die of cancer than the general population.
As someone with chronic insomnia who either takes sleeping pills or does not sleep. I’ll take the risk. I went 10 years without getting a decent night’s sleep. It’s a special kind of hell, to be awake at 4 a.m., know you have to be up in three hours and not be able to sleep, no matter how tired you are.
Two things.
First, nobody escapes mortality. We all have exactly the same risk of undergoing death. It’s just a matter of when. We all get one each episode of personal death.
Second, at some point in the aging process, you run up against conditions where, in order to maintain some semblance of physical or mental normality, you might have to turn to long term pain managemant drugs, or tranquilizers, or sleep medications. It is a trade off; quality of life for some imagined longevity.
Early death is not a desired outcome, which is really what the mortality stats speak to. But that final slide into home base, worn out, completely broke, and being happy to have played the game is not enhanced by a prolonged period of physical and mental agony after that final inning. It is really about risk/reward and that is an entirely individual assessement.
What I’m concerned about with sleeping drugs is the flat-out insanity; the bizarre behavior associated with them. It’s getting so there’s little difference between someone on Ambien and someone on LSD. “WARNING: You might dance naked on top of your neighbor’s car.”
You all want to say that death is inevitable? Well, so is sleep. It’s sleep, people: a pretty simple affair. If you’re having trouble with it cut something OUT of your life – coffee or other junk foods. The most important thing I’ve discovered is that with just about any biological problem I have I need to remove something from my life, not add something. But that’s not what the pharmaceutical companies want you to think.
So in other words, you’re saying that the increased risk of death is from the increase probability that you’ll get shot by a cop, fall off a bridge, or run under a train?
There is a 100% chance if you follow the First Lady’s nutritional advice you will die.
Well, likewise, doctors are terrified that you might be the one that sues. I had a condition and the poor regular doctor gave me the standard treatment- which triggered a series of “transient ischemic attacks”- which is medical parlance for small strokes that don’t kill you. After that, hunting from specialist to specialist to fix the problem, I was told to not open medical records. Doctors fussed at me, or refused to take me as a patient if I showed up with opened files. At the time, I just thought it was b/c they were asses. When I finally had it all put together by an ER doctor- that this treatment had triggered strokes that had well, damaged my brain and rendered me somewhat unemployable- it was a miserable decade later. But- I had that decade. I am alive.
By my readings, I was going to have a major stroke, and probably die right there and then, from the untreated condition that she had guessed at. She was brilliant- b/c I certainly didn’t present with the real problem as a top complaint. She had to figure out what was going on, and write three scrips for all the conditions, and find two specialists. She did this off a $22 cash office visit, b/c she worked ER to pay for a family clinic with her husband, that charged reasonable fees.
I wish the first doctor had told me what was going on. I worked in a textbook store. I’d looked up every treatment along the way. I was conversant with the mortality rates associated with each condition, and with each protocol of treatment. I liked her- she was a good doctor. She had saved my life. The treatment was the difference between being dinged and scratched- or totalled and buried. I think the doctors were all treating me like a hot potato, not a decent human being attempting to get enough help to get enough well. I think they were all trying to not get sued.
I know when I worked in healthcare, there were serious discussions amongst the staff- to go for the RN, go for the BSN–people tried to estimate their risk for having a license number, for being sued, for being called up to testify at trial, for losing their ability to work in their field. They tried to estimate their abilities and skills, to see if they could fulfill their duties.
These are responsible, caring, conscientious people, in general.
And, they are reasonable about being afraid of being sued. John Edwards made millions persuading ignorant jurors that responsible doctors were damaging infants.
Doctors have to know statistics inside and out.
Their records get audited by insurance companies, by state regulatory agencies, possibly by a hospital audit committee- or two or three. Their records, if they are in a group practice- get audited by their peers. They might have their records inspected by their licensing committee. They aren’t freely moving athletes, they are practicing a shadow-play, with every action up on a screen, in very real, very intrusive, ways. Obama making threatening noises about “best practices” is just five more layers of the regulation and inspection these guys already live with. At some point, the suit becomes a velcro suit- can’t move at all.
You can have a discussion with a doctor and blow off the need for a test. They look surprised, usually, when you do. If you understand what you’re not finding out- that you don’t need to know something entirely and why- they get kind of relieved.
But like any other guild they fight like hell having the patients, their customers, from seeing how effective they are.
David Swindle – I’m not impressed by the results you cite. Magazines want to make money and in some cases the way they do it is by running scare articles. This sounds like just such an article. I think Charlie Martin @2 is onto the real problem here: What was the health, age, sex, race and income characteristics of the experimental group compared to the control group? If those are not matched properly, you can get bizzarre results that magazines can use to sell their publications.
Follow the links all the way back to who published the study, and you find the Scripps clinic. They are in the business of helping people with sleep problems. So there could be a tad bit of self-promotion (“you may die if you take sleep meds, so come to our clinic for the alternative”). Kind of like Ford publishing a study of how dangerous bicycles are.
Yes, but that doesn’t mean they’re wrong. No one who suffers from chronic insomnia should take sleeping pills without *first* doing an overnight test to check for sleep apnea, which is known to massively increase mortality risks. I have a feeling that undiagnosed apnea might explain a big chunk of the disparity this study found.
I think it also contributed to their not controlling for co-morbid conditions. They typically see people who have sleep disorders not attributable to other, more common causes such as anxiety. Any primary care doctor could have looked at the design of this study and told them they were missing a big part of the picture, but they literally don’t see it.
Anyone find causation? Wake me when they do.
Keep sleeping, TWS.
This article is flawed. They failed to control for co-morbid conditions that would be associated with death and sleeping pill use. One that jumps to mind is serious mental illness such as bipolar disorder and depression, both of which are associated with higher rates of death (suicide) and sleeping pill use. I’m sure there are many more other serious illnesses that cause sleeplessness as well- maybe most of them. Even if the disease itself doesn’t cause sleeplessness, worrying about it could- which would lead to sleeping pill use.
It’s kind of like saying high medical bills cause death. Well, they’re associated with it, but unless you have cardiac arrest from opening the statement, it’s only correlative, not causal.
The medical article was well written and informative.
Dana found the most important limitation. They tried to control for comorbid conditions but could not use data for psychiatric diagnosis because of legal restrictions.
David Swindle, well whatever your personal issues are.