Sleeping pills benefit is half placebo
20th December 2012 - Half the benefit of taking sleeping pills comes from the placebo effect, according to a new study.
Researchers from the UK and the US re-analysed data from 13 studies involving 4,378 participants to test how effective medications were at helping people fall asleep compared with the benefit derived from believing they were helping. This data had been submitted by pharmaceutical companies to the US Food and Drug Administration (FDA) for approval of new products.
The clinical trials had looked at the most common type of sleeping pills, known as Z-drugs (non-benzodiazepine hypnotics). These pills are frequently used in the UK and US as a short-term treatment for insomnia with almost £25 million worth of prescriptions handed out in Britain each year.
Some health experts though have questioned whether the benefits of Z-drugs justify their side effects, which can include memory loss, fatigue and impaired balance.
The researchers found that once the placebo effect is discounted, the effect of the medication is of "questionable clinical importance".
Lead author Professor Niroshan Siriwardena, from the School of Health and Social Care at the University of Lincoln, says in a statement: "Our analysis showed that Z-drugs did reduce the length of time it took for subjects to fall asleep, both subjectively and as measured in a sleep lab, but around half of the effect of the drug was a placebo response.
"There was not enough evidence from the trials to show other benefits that might be important to people with sleep problems, such as sleep quality or daytime functioning.
"We know from other studies that around a fifth of people experience side effects from sleeping tablets and one in one hundred older people will have a fall, fracture or road traffic accident after using them."
The study, which appears in the British Medical Journal, concludes that more attention should be paid to psychological treatments for insomnia.
"Psychological treatments for insomnia can work as effectively as sleeping tablets in the short-term and better in the long-term, so we should pay more attention to increasing access to these treatments for patients who might benefit," says Professor Siriwardena.
Professor Adrian Williams, professor of sleep medicine at King's College, London tells us in an email that the findings are "fascinating, and wholly believable" and consistent with other studies showing a similar placebo effect.