New Research on Sleep Medications in Women

Jun 29, 2021 | Dona Locke | @DrDonaLocke | Comments (55)

Why Sleep?

In the HABIT program, one of our topics is addressing sleep quality because of the importance of quality sleep on daily cognitive function. We discuss identifying sleep disorders, such as sleep apnea (you can see our posts here and here about addressing sleep apnea and adjusting to CPAP therapy). But one of the biggest issues is really sleep disturbance (e.g., trouble staying asleep) rather than a medical sleep disorder. It is common for medical providers to provide prescription medication to help with sleep disturbances, which have been shown to have short-term sleep benefits. However, some patients end up on sleep medications on more of a long term basis. There is new research suggesting that sleep medications may not be as effective in the long term.

The Research:

The Study of Women's Health Across the Nation (SWAN) is a long-term cohort study of a diverse sample women living in the USA. From this sample, the researchers compared the self-rated sleep quality of middle aged women who started a prescription sleep medication to that of another group of middle aged women who did not start a sleep medication. At the start of the study, each group reported similar sleep ratings. After 1 year and 2 years the sleep ratings for medication users were not improved and remained similar to the non-medication group.  You can read the full study here if you wish. In this news release on the research, a Neurologist working in a Sleep Disorders Center was quoted, "The problem with using medication to control insomnia symptoms is it provides patients with some relief but the sleep they get on medication is more sedation than sleep."

The Conclusions:

With these results suggesting the lack of long term benefit of prescription sleep medications on sleep quality in middle aged women and the fact that these medications can have side effects (cognitive being one class of side effects), we'd encourage you to discuss your sleep prescription use with your physician to see if you have other options. We've discussed healthy sleep HABITs in this blog before and that may be a start, but habits for healthy sleep can take some time to develop if there is significant insomnia present. Cognitive-behavioral therapy for insomnia (CBT-i) with a trained provider may be an important part of a sleep treatment plan with your physician. To search for a provider, one option is Psychology Today, an online resource with detailed listings for professionals in the US.

We hope this might stimulate a discussion with your physician about sleep and sleep medications and get you on your way to better quality sleep--for your brain health, your emotional health, and your physical health!

Interested in more newsfeed posts like this? Go to the Mild Cognitive Impairment (MCI) blog.

The physical activity is very important, but also I notice that the mental activity for me has made a huge difference. When I was feeling awful I watched TV. I'm not a daytime TV watcher, and watch very little evening TV except a possible movie. I was watching so many hours a day of cable news. So bad for me!!! I was a even sick of watching shows that support my political interests. But daytime TV is so awful. When I sat, and couldn't read because of some vision changes, or could read in a more limited way... after the morning paper I watched TV. What a waste of time for me. Now that I can re-engage in other things it's a huge difference. Also Covid didn't help, and being indoors so much of the time was deadly.

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@lizzier

Margreet that's where I was. I couldn't train my brain off. I tried all of the tricks. Getting up, sitting in a chair and reading until I was really tired, meditation (that always worked for me before), keeping my eyes open in the dark until they closed on their on. melatonin. Stopping the melatonin. Finally I decided no naps during the day no matter how tired I was, drinking plain sleepy time time tea from the super market (a counselor gave me this tip) before I retired, and trying to go to bed at the same general time at night. By 9:00 I was wiped and it finally helped. Naturally since my sleep rhythm was so off I woke early (too early) but I began to regain a bit, a 1/2 hour, then an hour, sometimes only 15 min. But now I'm almost back to normal. Last night I slept 7 hours. Believe me I feel your pain. I'm still waking early between 4:30 and 5:00, but I feel better overall with this added sleep time. Now I can watch a TV show until 10:00 or even 11:00 sometimes. Often I can't. But it was so important to find a way back.We require sleep.

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Thank you

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@lindes

Discussions with my physicians did not result into much! I religiously use CPAP units for more than 20 years, but still cannot sleep more than 4 to 5 hours per night. All those standard things like quiet environment (I live in the middle of a forest, our a dark room (mine is pitch black), seem not to do t for me. But none of my Mayo providers did go any deeper in with my sleep problems. I have a PhD in Biomedical Sciences, and started to do a bit of research, and came up with taking progesterone at night (with fatty foods, to prevent the first path through the liver). Progesterone extended my sleep by an hour or if I am lucky, by two hours per night. I monitor my sleep, and get hardly any deep sleep, and some nights I have no deep sleep at all. That leaves me pretty tired the next day. But luckily, I can take afternoon naps when I am to tired, but i rather sleep during the night, and don't want to waste my daytime hours with sleeping.
What is your recommendation for a person like I to get a decent night sleep in, as I said, talking to my Mayo providers has not done any good for me.

LindeS

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I've had years and years of poor sleep. Nothing worked for me as well. I understand all about brain fog. A year ago, I made a big lifestyle changes. I switched to a vegan diet, started exercising or walking one hour a day (everyday), began meditating 30 minutes a day (everyday), began practicing yoga breathing exercises a couple of times a day for a few minutes each, began working hard to reduce stress in my life. I am 71 years old and retired. Making the changes have been like having a part-time time job. The changes haven't been easy and have been difficult. I don't think it has been any one change that has made the difference, but the combination of all of them.

The rewards and benefits have been excellent for my overall health and brain fitness. The best reward is I can sleep six hours a night without waking up except for turning over in the middle of the night. After six hours of sleep and waking up, I can go back to sleep for another 60 to 90 minutes. Sometimes if I am tired, I can even take a short afternoon nap. I could have never done before without it interfering with my sleep at night.

For extra insurance, I still practice some sleep hygiene techniques I've read about because so many people have written about them helping and although they didn't make a difference before, they can do no harm. They are sleeping in a dark, cool room, going to bed approximately the same time every night (my instinct is to be a night owl though), turning off the TV, computer, cell phone 30 to 60 minutes before bedtime. I don't have to make an effort to get up at the same time every morning, it just happens.

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@sueinmn

Please share how one might find CBT-i in a specific location. I am in a large metropolitan area with access to and insure coverage for four large medical networks. None is familiar with this therapy.
Sue

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@sueinmn hi, I’m also searching for info for CBTi as I’ve been suffering from insomnia for two years. My doc told me about an app CBTi coach, which by the way I found in a Mayo article recently. I’m attaching for your info. When I downloaded the app it shows Software License Agreement with U.S. Dept of Veterans Affairs ???, so not sure if I downloaded the correct app.
https://connect.mayoclinic.org/blog/cancer-education-center/newsfeed-post/missing-your-zs/
I’m willing to try this approach while waiting to get into my sleep disorder doc in Nov.

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@soledad02

@sueinmn hi, I’m also searching for info for CBTi as I’ve been suffering from insomnia for two years. My doc told me about an app CBTi coach, which by the way I found in a Mayo article recently. I’m attaching for your info. When I downloaded the app it shows Software License Agreement with U.S. Dept of Veterans Affairs ???, so not sure if I downloaded the correct app.
https://connect.mayoclinic.org/blog/cancer-education-center/newsfeed-post/missing-your-zs/
I’m willing to try this approach while waiting to get into my sleep disorder doc in Nov.

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Good afternoon.....I just downloaded the CBTi coach. It appears to be traditional and approved techniques. I think the Mayo staff member wrote the review perhaps. Or was involved in the production for the VA. I will give it a go.....and get back to you both.
Chris

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@artscaping

Good afternoon.....I just downloaded the CBTi coach. It appears to be traditional and approved techniques. I think the Mayo staff member wrote the review perhaps. Or was involved in the production for the VA. I will give it a go.....and get back to you both.
Chris

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Chris and @mattie77,
I'm guessing it's the one. I'm looking at trying it too.
Sue

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After reading all of these stories, I feel so much better and knowing that I am not alone. However, that being said, I have been on prescription sleep medication for over 15 years and have now become addicted. I have tried, with A sleep specialist, to wean myself off of the meds but after eight months I could not take it anymore. I was not sleeping at all and had terrible withdrawal symptoms. I was extremely tired all the time but could never go to sleep at night and being a heart patient also I knew that I had to get some rest. I end up literally begging my Dr. to give me back the sleep meds which He finally did. However, because I am 78 he warned me that I could suffer with possible side effects of waking up disoriented or falling. That has never happened to me but now, 15 mg that I have taken for 15 years is no longer working and I cannot get a higher dosage. I am writing this to simply warn you please don’t ever get started on long-term prescription sleep meds. They are as difficult as any illegal drug to stop!!! The medication that I am taking is in a family of benzodiazepines. Look it up! It is hell!

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@lizzier

Boy can I relate to that! That was my problem and for several years during this challenge I had very little to no restorative sleep. I was exhausted. I did talk with my docs and tried some sleep meds, and had an allergic reaction. That's when I started the melatonin that I'm now questioning. I self medicated with that, and never discussed it with my doc. I wasn't hiding it from him, but I just thought it was so harmless that it didn't require discussion. I think we need to be careful of those so called harmless OTC drugs. Finally I just decided on my own to stop it, and I'm so glad that I did. One of the things that you said that jumped out at me was the daytime napping. I was doing the same thing. I couldn't help it. I was exhausted all of the time. When I sat I just fell asleep. I'm guessing that because of how you described yourself that you have a million thoughts going through your head all night long as you try to fall asleep. Two hours of sleep a night was my normal. The primary thing that I have regained from not taking the melatonin is the mental clarity. The brain fog was horrible. I couldn't do anything. I said earlier that I was a crafter, and I am, but I'm a hobby crafter, and do it because I love it and it helps me to express myself creatively. I was actually a social worker in my career, and could hold countless details accurately in my mind. During this period of brain fog I couldn't hold a clear thought. I also believe that I was in denial about my illness. I was so healthy and never believed that I would ever get sick. So when I began to recover I noticed one day that the curtains in my bedroom were too thin to give me much privacy, and I was keeping the shades pulled a lot. I decided that I needed bottom curtains to give me more privacy during the day when the room was light so I could walk around the house w/o pulling the shades closed all of the time. Hang with me because there is a reason that I'm telling this story. During this 4 1/2 years I did absolutely no crafting, and being retired I wasn't in a job. So one day I decided that I would make those lower curtains because I knew exactly what I wanted them to be like, and I knew that I could make nicer custom curtains than I'd buy anyplace. One day I had my husband drive me to the store to buy material for these curtains. By then over a period of several weeks I had measured everything and I knew what I needed. I got the material, brought it home, and it set on my dining room table for weeks and weeks. I was terrified to cut that fabric. I measured and remeasured. I couldn't cut the fabric. Finally in those weeks I admitted to myself what I refused to accept. I was terrified, and so unsure of myself after several years if having very limit activity. When I saw my doc one day after that I recall asking him..."What is this? Is it a syndrome, Is it an illness? Is it a disease?" He said "it's a disease", and my world came crushing down over me. I couldn't deny it any longer but I was able to take an active role in my recovery. Shortly after that I got out the material, measured for the last time, and cut the damn fabric. I now have 4 beautiful bedroom curtains and each morning I open the shades and light comes streaming in. It was the brain fog. I used to hear people use those words, and I had no concept of they meant, none, but now I know what they are talking about. I no longer nap during the day. I'm up at 5:00, and I'm in bed about 10:30. I fall right to sleep, and I'm reclaiming my life. I feel like I'm the luckiest person alive. I'm doing some amazing projects, and I'm regaining a sense of balance again at age 84. I wish this for all of you. Not that you are 84 (ha ha), but that you can regain a sense of balance in your lives.The problem though is that we're all different, and what works for one of us won't work for another. Just don't give up. Keep on searching until you find the "get out of jail free card".

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I became 84 on the 3rd, so besides sleep problems we are both 84. I have always had sleep problems. I remember getting up during the middle of the night when I was a young teenager and would find my father in the kitchen getting a bite of food to eat. It was nice to visit with him . I did not realize that I had a serious problem until I was in my early 30's. I was given sleeping pills . They made me drowsy so I told the doctor (after trying several different types) that I wanted to stop taking the sleeping pill. I do not take naps on a regular basis, I also have narcolepsy and that does mess with my body and mind. I wear the mask at night and sleep about 4-5 hours now a night. Though for years 4 hours was as much as I would sleep. *that extra hour a night has really helped me be able to finish some of my projects, Though I just fell asleep a minute ,ago and had 3 rows of nnnnnnnnnnnnnnn's I do not know how I was able ssssssssssssssssssssssssssssssssss-- there I did it again. I do not know how I was able to add sleep . The only thing I have felt I did was being aware that this was a serious problem. I did quit driving my car when I realized I was falling asleep at home, I also kept very busy with my prllllllllllllllllllllllllllllllllllllllllllllllllllll projects. I still sew, draw, paint, the computer, compiling my personal history. I just keep plugging along and I talk to myself about what I am doing thmllllllllllllllllllllllllllllllllllll, Good luck to all of you. I talk to God and He helps me focus -- tough to do this all and still maintane grace. We will make it .We are strong women. kate,Katie, kay --Katharine.

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Just a note to let everyone know that there is a group on Mayo Clinic Connect dedicated to Sleep Health.

- Sleep Health Group https://connect.mayoclinic.org/group/sleep-health/

See all groups in the Group Directory https://connect.mayoclinic.org/groups/

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@sharonsf

I've had years and years of poor sleep. Nothing worked for me as well. I understand all about brain fog. A year ago, I made a big lifestyle changes. I switched to a vegan diet, started exercising or walking one hour a day (everyday), began meditating 30 minutes a day (everyday), began practicing yoga breathing exercises a couple of times a day for a few minutes each, began working hard to reduce stress in my life. I am 71 years old and retired. Making the changes have been like having a part-time time job. The changes haven't been easy and have been difficult. I don't think it has been any one change that has made the difference, but the combination of all of them.

The rewards and benefits have been excellent for my overall health and brain fitness. The best reward is I can sleep six hours a night without waking up except for turning over in the middle of the night. After six hours of sleep and waking up, I can go back to sleep for another 60 to 90 minutes. Sometimes if I am tired, I can even take a short afternoon nap. I could have never done before without it interfering with my sleep at night.

For extra insurance, I still practice some sleep hygiene techniques I've read about because so many people have written about them helping and although they didn't make a difference before, they can do no harm. They are sleeping in a dark, cool room, going to bed approximately the same time every night (my instinct is to be a night owl though), turning off the TV, computer, cell phone 30 to 60 minutes before bedtime. I don't have to make an effort to get up at the same time every morning, it just happens.

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I could not sleep 6 hours in a row without wetting my bed. I am happy if I can make it 4 hours, but the biggest problem is that I have a hard time to fall asleep again after I woke up. I live semi vegan already, and eat fish for my animal protein only. Physical problems prevent me to exercise an hour a day, or do most Yoga exercises. I meditate daily for many years already.
It is nice tat those changes helped you, but they seem to do nothing for me.

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