Colin Snow
Sleep disorders and deprivation are a growing epidemic in the United States, with about 50-70 million Americans suffering from these conditions. While insomnia is the most common sleep disorder, affecting up to 50% of adults, the use of prescription sleep aids has been relatively low, with estimates ranging from 4% to 8.4% of adults. However, recent reports suggest that the use of sleep medications may be on the rise, with millions of Americans, especially women and older adults, turning to pills to get a good night's sleep. While sleep aids can provide relief, health experts advise caution due to possible side effects and encourage exploring alternative treatments like cognitive behavioral therapy and lifestyle changes.
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What You'll Learn
Insomnia and stress
Insomnia is a common sleep disorder characterised by persistent difficulty with sleep onset, maintenance, consolidation, or overall quality. It is often linked to stress and anxiety. While insomnia symptoms may begin to dissipate once the stressful situation ends and stress subsides, some people fall into a cyclical pattern of sleep loss and daytime anxiety that can contribute to stress.
Research from 2021 found that 84% of Americans experienced significant stress. In a more recent national survey, 44% of adults said that stress had caused sleepless nights at least once in the previous month. Stress and sleepless nights are closely linked, and those experiencing chronic stress may experience a decrease in the amount of time spent in deep sleep, and disruptions during REM sleep.
The risk for insomnia is greater in women and older adults. In 2020, research found that 1 in 10 women took sleeping medications regularly, compared to men, who were less likely to take sleeping medications. Sleeping pill use increased with age, with 5.6% of people between the ages of 18 to 44 taking sleeping medications, compared to 11.9% of people 65 and older.
Stress and insomnia share a reciprocal relationship, and understanding and addressing one of these issues can often lead to improvements for the other. Simple stress relief techniques can help people sleep better and feel calmer. These include gentle breathing and progressive muscle relaxation, yoga, tai chi, and meditation.
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Older adults and women
Sleep is an essential part of a healthy life, with a good night's rest benefiting one's brain, mood, and overall health. However, about a third of adults in the United States do not get enough sleep. While insomnia is the most common sleep complaint, it is interesting to note that the use of prescription sleep aids is relatively low. This could be because insomnia patients are often encouraged to try cognitive behavioural therapy or lifestyle changes such as avoiding nicotine and caffeine, instead of medication.
That being said, the use of sleep medication has been on the rise in the US, with millions of Americans taking sleeping pills regularly. A report from the National Center for Health Statistics, part of the Centers for Disease Control and Prevention, found that 18 percent of US adults use some type of medication to help them sleep. This includes those who take sleep medication most nights (6 percent), every night (2 percent), or some nights (10 percent).
The reasons for the higher prevalence of sleep medication use among older adults and women are multifaceted. For older adults, certain medications for other health conditions can interrupt their sleep. For example, an older adult with heart failure may be prescribed a diuretic, which can disrupt sleep due to frequent urination. Additionally, older adults may experience more sleep disturbances due to factors such as changing sleep patterns, medical conditions, or the side effects of medications.
In the case of women, insomnia is more prevalent, and women are more often diagnosed with mental health conditions that can contribute to sleep difficulties. Stress also plays a significant role, with research showing that 84% of Americans experienced significant stress, and two-thirds of adults reporting sleep loss due to stress. As women often shoulder a disproportionate burden of family and financial responsibilities, they may be more susceptible to stress-related sleep issues.
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Side effects
While the exact percentage of Americans using sleep medication is unclear, estimates range from 5.6% to 11.9%. The use of sleep medication is more prevalent among women and older adults. For instance, in 2020, 10.2% of women and 6.6% of men took sleep medication. Additionally, 5.6% of people between the ages of 18 and 44 took sleep medication, compared to 11.9% of people aged 65 and above.
When it comes to the side effects of sleep medication, health experts advise against their long-term use due to potential adverse reactions and interference with other medications. Here are some specific side effects to be aware of:
Dizziness and Lightheadedness: These side effects can increase the risk of falls, especially in older adults. This is a significant concern, as highlighted by a 2022 study that showed an 86% reduction in sleep medication use among participants aged 80 and older, who are more susceptible to fall-related injuries.
Interference with Other Medications: Sleep medications may interact with other drugs an individual is taking, leading to unpredictable side effects or reduced effectiveness of one or both treatments.
Dependence and Tolerance: While not a direct side effect, the long-term use of sleep medications can lead to dependence, where an individual feels they cannot sleep without the aid. Additionally, tolerance may develop over time, requiring higher doses to achieve the same effect.
Cognitive and Behavioral Changes: In some cases, sleep medications may cause cognitive impairments, such as confusion, memory loss, or attention deficits. They may also affect an individual's behavior, leading to personality changes or increased irritability.
Daytime Sleepiness and Impaired Motor Skills: Some sleep medications may cause residual sleepiness the following day, impairing an individual's ability to drive or operate heavy machinery safely.
It is important to note that side effects can vary depending on the specific medication and the individual taking it. Always consult a healthcare professional before starting any sleep medication to ensure you are informed about potential side effects and how to manage them.
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Non-medicinal sleep aids
According to the CDC, about 8.4% of American adults take sleep medications most nights. The use of sleep medication has doubled in the US, with millions of Americans regularly taking sleeping pills. The trend is most pronounced in women and older adults.
Now, onto non-medicinal sleep aids:
Natural Sleep Aids
"It's not always necessary to get a prescription for a sleep aid," says Gamaldo of Johns Hopkins Medicine. She recommends trying natural ways to adjust your sleeping habits first. Here are some non-medicinal sleep aids to consider:
- Avoid screens before bed: The light from smartphones and other screens interferes with sleep. If you need to get up at night, use a flashlight instead of turning on the lights.
- Drink warm milk, chamomile tea, or tart cherry juice: These drinks have been associated with chemicals that can induce sleepiness and improve your sleep-wake transition. Chamomile tea is also believed to have flavonoids that interact with benzodiazepine receptors in the brain.
- Exercise: Moderate aerobic exercise boosts the amount of nourishing slow-wave (deep) sleep you get. However, avoid exercising within two hours of bedtime, as it can release endorphins and raise your core body temperature, making it harder to fall asleep.
- Melatonin supplements: Melatonin is a hormone naturally released in the brain before we feel sleepy. It regulates the body's circadian rhythms and may improve sleep latency, increase feelings of sleepiness, and prolong sleep.
- Sleep in layers: Adjust your bedtime temperature as needed to make yourself more comfortable.
- Valerian: Valerian is an herbal extract and a natural supplement for managing anxiety and insomnia. It may reduce the time needed to fall asleep and improve sleep quality without causing morning grogginess. However, there is limited evidence supporting its effectiveness, and some people report a stimulating effect.
- Kava: Kava is an herbal remedy used for stress, anxiety relief, and insomnia. It may induce relaxation without hindering memory or motor function, but research findings are conflicting.
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Prescription sleep aids
According to a 2023 report from the National Center for Health Statistics, part of the Centers for Disease Control and Prevention (CDC), about 18% of U.S. adults use some type of medication to help them sleep. This includes 6% who take sleep medication most nights, 2% who take it every night, and 10% who take it some nights. The use of sleep medication is more common among women than men, and it increases with age.
Data from the CDC's National Health and Nutrition Examination Survey showed that the use of prescription sleep aids varied among different demographic groups. Non-Hispanic white adults reported higher use of sleep aids (4.7%) compared to non-Hispanic black (2.5%) and Mexican-American adults (2.0%). Additionally, adult women (5.0%) were more likely to use prescription sleep aids than adult men (3.1%). The percentage of adults using prescription sleep aids also increased with age and education level.
While the use of prescription sleep aids has been on the rise in the U.S., a 2022 study published in the Journal of Clinical Sleep Medicine found a 31% reduction in their use from 2013 to 2018. This decrease was even more pronounced among individuals aged 80 and older, who were 86% less likely to use FDA-approved sleep medications by the end of the study period. The COVID-19 pandemic may have influenced this trend, as medical and public health groups have strongly discouraged the use of sleep medications due to their side effects.
It is important to note that prescription sleep aids are just one treatment option for insomnia. Cognitive behavioural therapy (CBT) is an effective long-term treatment that involves modifying attitudes, beliefs, and behaviours that negatively impact sleep. Additionally, lifestyle changes such as avoiding nicotine and caffeine, and sticking to a consistent sleep schedule, can also help improve sleep quality.
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Frequently asked questions
Around 8% of Americans used prescription sleep medication in 2022, while 11% used non-medicinal sleep aids.
It is estimated that millions of Americans, or about 8.4% of the population, use sleep medicine. However, some sources state that nearly one in five Americans (18%) use sleep medicine.
In general, men are less likely to take sleep medicine than women. Among men, 3.1% use prescription sleep aids, with the highest-income men being the least likely to take sleep medicine.
Women are more likely to use sleep medicine than men. About 5% of women use prescription sleep aids, and 1 in 10 women take sleep medication regularly.
Older adults are more likely to take sleep medicine. Among people aged 65 and older, 11.9% take sleep medication.
