People who take sleeping pills often hope that sleeping pills will increase their sleep enough to have more energy during the day. They may hope that sleeping pills will improve their long-term health. Sleeping pill effects are the opposite of what people hope.

Whereas, life and death are often our primary concern, I would like first to discuss the darkest aspects of sleeping pills:

WARNING: sleeping pills could be dangerous to your health or cause death from cancer, heart disease or other diseases.

For more than 30 years I worked on a risk assessment sleeping pills. I learned that sleeping pills are associated with significantly increased mortality.

This means that people who take sleeping pills die sooner than people who do not use sleeping pills.

I first became interested when I saw the work of Dr. E. Cuyler Hammond at the American Cancer Society. In 1975 I went to visit the American Cancer Society, the co-operation, which lasted many years.

The CPSI (this was the first of two large studies), in 1959-1960, the American Cancer Society volunteers gave questionnaires to over 1 million Americans, and then down six years later (in more than 98%), whether the participants lived. We found that 50% more who claimed that “often” took sleeping pills had died, compared with the participants of the same age, sex, health status and reported, who “never” took sleeping pills.

To re-assess these risks, the American Cancer Society agreed to ask new questions about the pills the participants a new study entitled “Cancer Prevention Study II and CPSI. In 1982, the American Cancer Society volunteers gave health questionnaires to 1.1 million new participants. Survival of these persons were found in 1988.

In the new study, we again found that people who said they used sleeping pills had significantly higher mortality. Again, people who take sleeping pills a much higher mortality. Even when people were matched on age, sex, race and education, and a total of 32 health risk factors, who take sleeping pills 30 or more times per month were 25% higher mortality rate than those who reported that no sleep pills. However, we find that especially sleeping pills were associated with this risk. Reduced risk of taking sleeping pills, a few times a month, this increased mortality of 10-15%, compared with those without sleeping pills. Sleeping pills appeared unsafe in any amount.

· 25% increased mortality among those with sleeping pills every night
· 10-15% increased mortality among those with sleeping pills, sometimes

Provide a view of the risk of mortality, we observed that the risk of taking sleeping pills 30 or more times per month was much lower than the risk of smoking 1 pack of cigarettes a day when the analysis was carried out in a similar manner.

One cause of death was particularly increased. Among men who have sleeping pills 30 times a month with 7 times the risk of suicide? Women who took sleeping pills 30 times 2 times a month, the risk of suicide. Nevertheless, the suicides are only a small proportion of deaths associated with using sleeping pills. Deaths from other causes, such as common heart disease, cancer, stroke and was also increased among users of a sleeping pill.

Since 2008, fifteen epidemiologic studies from Scandinavia to Japan, found that the use of sleeping pills anticipated increased risk of mortality. Three of these studies have been explicitly stated that the use of sleeping pills anticipated increased risk of death from cancer. That does not mean that other studies found no cancer risk. Probably they were just too small to check for cancer as a specific cause of death. Incidentally, these studies mainly covered the use of older sleeping pills such as barbiturates and benzodiazepines such as flurazepam (Dalmane), triazolam (Halcion) and temazepam (Restoril).

1.A. New sleeping pills cause cancer in animals

Epidemiological studies were only statistical accident, or sleeping pills really cause cancer? Recently, the Food and Drug Administration (FDA) began making available on the Internet some of their papers for review of the newer sleeping approved for marketing in the United States since 1998. You can find these documents through the U.S. Food & Drug Administration is an online service, drugs @ FDA.

To my surprise, I discovered that rats and mice given high doses of zaleplon (Sonata), eszopiclone (Lunesta) as part of zopiclone, and ramelteon (Rozerem) cancer. Available information was a little vague to be sure, but it seems that these new sleeping pills all caused cancer in animals. I’m no expert on the experiments of this type, but the FDA reviewers thought some of the results were disturbing. One of the reasons I’m not sure I understand these results is that I can not find that the companies have published some details in the medical literature. It is possible that the producers do not want to understand these experiments with cancer. These drugs also broken chromosomes, which is well-known specific chemical mechanism by which drugs cause cancer.

There were also some older and confusing information zolpidem (Ambien). Although one of the old records seem to say that animals zolpidem, which was developed three kinds of cancer, the new labeling approved for an enlarged version of zolpidem (Ambien CR) states that no evidence of carcinogenic potential was observed in either mice or rats. I would like to know how the company figures are not owe people a warning.

1.B. Evidence that sleeping pills cause cancer in humans

Between 2005 and 2006, some new sleeping pills have been marketed in the U.S.. Industry hoped hypnotics increase revenues by several billion dollars annually. Because the company wanted to Food and Drug Administration (FDA) approval to sell their drugs for long-term consumption made a greater long-term study of use than ever was before. Summaries of these randomizing controlled clinical trials can be found on the FDA website for zaleplon (Sonata), eszopiclone (Lunesta) and ramelteon (Rozerem). It turned out that because zaleplon in comparison with zolpidem as well as with placebo, zolpidem was little data available as well.

I must admit that it is difficult to understand the details of these controlled trials from the data that FDA has available, but fortunately I was convinced the FDA to review their files. According to the FDA were 9 new types of skin cancers and four other types of cancer in study participants randomized to sleep, but no new cancers among those who only received a placebo. Even the fact that there were more than 2 times as much exposure to sleeping pills, it seems that it suggests that new sleeping pills caused cancer. The best estimate would be that the incidence of cancer participants randomized pills, has been lucky enough volunteers who received placebo. Because these data come from randomizing comparisons seem to be evidence that new sleeping pills (as a group) cause cancer, skin cancer, at least. The data are not sufficient to establish that any specific sleeping pill or symbols linked to cancer and other research.

Let us put together the epidemiological data, animal data, and data from a combination of controlled clinical trials for 4 drugs. It turns out that a patient who has a new sleeping pill, is likely to be increasing their risk of cancer. I feel that my patients should be warned of this risk, even though the scientific evidence is not refined or entirely conclusive.

As the risk of new cancer pills and sleeping pills and older compared? I know that more evidence from animal studies and clinical trials randomizing the new sleeping pills cause cancer than older sleeping pills. This does not mean that older pills are safer: just that I found less information about their risk of cancer from clinical studies and animal experiments. On the other hand, epidemiological studies have shown higher mortality and higher cancer mortality rates are collected mainly older sleeping pills than any of the newer ones (with the exception of zolpidem) became available. In short, I really do not know whether newer or older sleep now greater risk of cancer.

1.c. More lethal risks of sleeping

As a young medical student in his first year of training, one of the first things I learned in our laboratory was that the student kindest way to “put an animal in hibernation” has been consistently administer the barbiturate pentobarbital. A little later I learned that pentobarbital has been prescribed almost automatically as sleeping pill for patients in hospital (in a sublethal dose, hopefully.) Related drugs are used to carry out the death penalty. Any medical student knows that these drugs can kill.

Doctors have a pretty complete understanding of how to sleep, such as pentobarbital to kill animals. These drugs bind protein molecules called GABA receptors on the surface of nerve cells. Same protein receptor molecules bind together with the chemical neurotransmitter called GABA, which gives them their name. Barbiturates and other sleeping pills accentuate the GABA effect, causing receptor molecules, chloride ions enter the nerve cells. Since chloride ions are negatively charged, they do inside the nerve cells more negatively polarized, which is less likely that nerve cells to fire (produce nerve activity). When nerve cells that stimulate the respiratory muscles are prevented from firing action potentials of GABA and sleeping pills, the animal stops breathing. When he stops breathing, dies within minutes from lack of oxygen in the lungs. There is no doubt that the same mechanisms to explain how the barbiturates to kill people who have too high a dose, either accidentally or with suicidal intent.

In 1970, a new group of sleeping pills have become popular, chemical molecules, which are named benzodiazepines. The first was sold as sedatives chlordiazepoxide (Librium) and diazepam (Valium). Soon the benzodiazepine flurazepam (Dalmane), marketed as a sleeping pill, and flurazepam soon dominated the market. The main advantage is that benzodiazepines are less likely to produce acute overdose deaths than barbiturates. For the past 15 years, most of the new benzodiazepine agonists have been sleeping, which means that the chemical molecules are classified as benzodiazepines, but act on the same receptors. All these drugs seem to have less risk than barbiturates, but it is still possible that a single dose of the newer sleeping pills are sometimes fatal.

Suicide, accidental overdose and cancer are probably the most common ways to kill the sleeping pills, but other ways are poorly understood and less well documented. Here are some of the other possible mechanisms.

All sleeping pills may cause a “hangover”, which means that not only reduce the action potential of our brain cells during sleep, but may also reduce the activity of brain cells during the day. That we can be sleepy and less alert, confused, weak and during the day. We will discuss the psychological consequences of hangover later, but here I have mentioned people to survive. Falls are more common in older people who use hypnotics. Patients given Lunesta, 10% of accidents were compared with 6% placebo in one study, and specifically falls more in common with Lunesta. Because some studies show that people who are responsible for automobile accidents are unusually likely to have to sleep in the blood, it is thought that a hangover can often cause car accidents, as well as other fatal accidents. Recent publicity about the proceedings as a zombie Ambien Sleep Walkers offers some very lively examples.

In the last 20 years, doctors have become concerned about sleep apnea, a condition where breathing pauses during sleep. Doctors believe that sleep apnea may cause death during sleep. Not all studies are in agreement, but some studies have found that when a person with sleep apnea takes sleeping pills, there are more pauses in breathing and the pauses last longer, which could be dangerous. I was surprised to learn the date of FDA, as well-documented is that zolpidem does sleep apnea worse. Because sleeping pills risk apnea worse, many experts recommend that people with apnea, should not be put to sleep. The problem is that almost everyone over 40 has some sleep apnea, and most people over 65 years would meet commonly-used criteria for diagnosis of sleep apnea, therefore, that a large proportion of people with sleeping pills, it is necessary that the apnea worse. After a period of many years ago, which makes sleep apnea worse would be expected to cause high blood pressure, thus increasing the risk of stroke, heart failure and stroke.

A final concern with regard to mortality is how people care for themselves. Since sleeping pills such as sedatives, to reduce concerns about potential threats and risks in our lives, it is possible that the hangover effects on sleep could reduce the attention of people in the care of themselves.