By Nurse Mark
Folks, is it just me, or does anyone else think the Lunesta moth in those seemingly endless television ads is just about the creepiest thing that has ever been on TV? It flits about, visiting unsuspecting victim after victim, looking for all the world like it is sucking out their souls in exchange for sleep – or is it death?
Not only does this glowing, silent, somehow vaguely malevolent moth spook me, the drug that it represents spooks me too. No, let me rephrase that: Lunesta, AKA eszopiclone, is a drug that scares the bejeebers out of me as does it’s stereoisomer zopiclone (Imovane) and it’s cousins zaleplon (Sonata) and zolpidem (Ambien and AmbienCR).
These drugs, known collectively as the “Z-drugs” have been around since the late 1980′s and early 1990′s, and they have been shrouded in controversy since their approval by the FDA.
Many have been critical of the “research” that has been conducted and used to obtain FDA approval. This research is almost always sponsored and conducted by the drug companies themselves, and as one analyst / researcher found:
“Of 56 randomized controlled trials of drug treatments of insomnia which reported the funding source, all but 5 were apparently funded by the industry.”
“the odds ratio for finding results favorable to industry in industry-sponsored trials was 3.6 times as high as in non–industry-sponsored studies”
Others have been critical of the effectiveness of the drugs:
“Sometimes, efficacy data get lost. Lunesta (eszopiclone) was approved in 2004 for chronic insomnia. Sepracor, its manufacturer, began an intense direct-to-consumer advertising campaign — spending more than $750,000 a day in 2007 — featuring a luna moth that transforms frustrated insomniacs into peaceful sleepers. Lunesta sales reached almost $800 million last year . Clinicians who are interested in the drug’s efficacy cannot find efficacy information in the label: it states only that Lunesta is superior to placebo (…).3 The FDA’s medical review provides efficacy data, albeit not until page 306 of the 403-page document. In the longest, largest phase 3 trial, patients in the Lunesta group reported falling asleep an average of 15 minutes faster and sleeping an average of 37 minutes longer than those in the placebo group.”
Wow! A whole 37 more minutes of sleep… at what risk?
Still others are critical of a drug that was initially promoted to be less addictive than the benzodiazepines like Valium that it was intended to replace, but that has turned out to be just as or even more dangerously addictive both psychologically and physically than the older drugs and just as prone to misuse and abuse. It seems that unskilled attempts to stop the use of these drugs can lead to severe rebound insomnia, delerium, seizures, and other problems – especially in older people.
Then there are the now-infamous cases of sleep-driving and other behaviors engaged in by people under the influence of these drugs. For some strange reason the Kennedy family seems to be prone to problems with this drug… Both Kerry and Patrick Kennedy have wrecked their cars while taking this stuff, and others have been known to engage in bizarre eating, sexual, and other behaviors while under the influence, with no memory of their acts afterwards.
That spooks me… But here’s the “topper”:
According to a 2012 study in the British Medical Journal, if you take as little as one or two sleeping pills a month you are statistically three and a half times more likely to die than someone who takes none.
Further, Among patients prescribed hypnotics, cancer incidence was increased for several specific types of cancer, with an overall cancer increase of 35% among those prescribed high doses.
That doesn’t just “spook” me – that scares the bejeebers out of me!
“But dammit!” you say, “I need something to help me sleep – I’m under a lot of stress, and I need my sleep! What good is all this if you can’t help me get some sleep?”
Hmmm… Well, that’s probably what Michael Jackson said to his doctor, and look where that got him…
But I’m not heartless – I understand the need for a good night’s sleep, and I have suffered as everyone has from restless nights of poor sleep. There are alternatives. Safe alternatives. Effective alternatives. More natural alternatives.
Everyone has of course heard of Melatonin as a sleep aid. Melatonin is a hormone decreases with age. Melatonin is a potent antioxidant that helps regulate Circadian rhythms. It should be used in almost all cases of insomnia. Melatonin is also an an “anti stress” hormone. 1-3 mg can be 45 minutes before bed. It can be increased in 3 mg increments as needed for sleep. Melatonin is only effective for sleep onset insomnia when a person has low melatonin levels. This occurs more commonly in older people.
Another natural substance that we have found to be very effective is called Kavinace. Kavinace potentiates GABA, one of the main inhibitory neurotransmitters. Higher GABA levels can relieve anxiety and promote restful sleep. This supplement works incredibly well as a sleep aid and anti-anxiety formula for people who are low in GABA and we have many patients and customers who swear by it.
Both Dr. Myatt and I use kavinace and melatonin every night and we find them very effective. Yes, we do sometimes awaken through the night, as does almost every normal person, but we find that these two supplements are important to ensuring that we get a full, refreshing nigh’s sleep.
And no spooky little glowing moths flitting around in our bedroom…
References and further reading:
Daniel F. Kripke, M.D., Who Should Sponsor Sleep Disorders Pharmaceutical Trials? J Clin Sleep Med. 2007 December 15; 3(7): 671–673.
Lisa M. Schwartz, M.D., and Steven Woloshin, M.D., Lost in Transmission — FDA Drug Information That Never Reaches Clinicians. N Engl J Med 2009; 361:1717-1720, October 29, 2009
Hypnotic dependence: zolpidem and zopiclone too”. Prescrire Int 10 (51): 15. February 2001.
Wong CP, Chiu PK, Chu LW (September 2005). “Zopiclone withdrawal: an unusual cause of delirium in the elderly”. Age Ageing 34 (5): 526–7.
Jones IR, Sullivan G (January 1998). “Physical dependence on zopiclone: case reports”. BMJ 316 (7125): 117. PMC 2665371.
Aranko, K; Henriksson, M; Hublin, C; Seppäläinen, Am (Jul 1991). “Misuse of zopiclone and convulsions during withdrawal.”. Pharmacopsychiatry 24 (4): 138–40.
Kerry Kennedy DUI Arrest Likely Caused by Sleep Driving — Just Like Cousin Patrick’s Capitol Hill Crash (Updated) , Forbes 7/14/12.
FDA Says Pills Can Cause ‘Sleep-Driving’ The Associated Press, Wednesday, March 14, 2007
“Hypnotics’ association with mortality or cancer: a matched cohort study,” British Medical Journal.
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