Saturday, September 11, 2010

Peril of the sleeping pill: Users a third more likely to die early

The effect is small in absolute terms and some proper criticisms are expressed below. It would seem to be most likely that the condition causing the insomnia is responsible for the deaths involved rather than the remedy, but, as with epidemiological research generally, it's all just speculation

Popping a pill might seem a small price to pay for a good night’s rest. But experts warn the long-term cost could be far greater. Research shows that those who take sleeping tablets are a third more likely to die prematurely than those who do not.

The figure takes into account factors that can affect longevity, from social class and chronic health conditions to smoking and alcohol use. And, unlike previous research, it also recognises the effects of depression.

With around ten million sleeping pill prescriptions written each in tthe UK and many more tablets sold over the counter, the findings have significant implications for the health and habits of the nation.

Crucially, the study did not distinguish between those who were heavy users and those who only took them occasionally.

Researcher Genevieve Belleville said: ‘These medications aren’t candy and taking them is far from harmless.’

But British experts questioned whether the Canadian study had over-stated the risks. And they stressed that while sleeping pills should be prescribed prudently they still have a place in modern medicine.

Dr Belleville analysed 12 years of data on more than 12,000 Canadians. When all other factors were equal, death rates were found to be significantly higher among sleeping pill users and those taking tablets to ease anxiety. Pills used ranged from over-the-counter antihistamines to powerful prescription-only preparations such as Valium.

After taking into account alcohol and tobacco consumption, physical health, physical activity and depression, Dr Belleville found the drugs were linked to a 36 per cent increase in the risk of death. Pill takers were more likely to succumb to every type of illness, from parasites to cancer, she said.

Writing in the Canadian Journal of Psychiatry, Dr Belleville, of Laval University in Quebec, gave a number of possible explanations for the alarming statistic.

But British sleep experts said that although the Canadians had tried to account for the effect of health problems, marriage breakdowns and other factors, it is likely that these ‘underlying problems’ still skewed the result.

Professor Jim Horne, of Loughborough University, said many of those studied were likely to be very troubled, adding: ‘It is all very well saying people who take these die, but one has to ask what happens if these people don’t take sleeping tablets.

Genevieve Belleville, from Laval University's School of Psychology in Canada, led the study, derived from Canada's National Population Health Survey. The data includes information on people aged 18 to 102, surveyed every two years between 1994 and 2007.

Both sleeping pills and anti-anxiety drugs can affect a person's alertness and co-ordination, which could make them more prone to falls and other accidents. Another theory is that they interfere with the breathing system and affect any breathing problems as the person sleeps. The medicines also work on the central nervous system, possibly increasing the risk of suicide.

Dr Belleville said people should consider a type of talking therapy called cognitive behavioural therapy instead. 'These medications aren't candy, and taking them is far from harmless.

'Given that cognitive behavioural therapies have shown good results in treating insomnia and anxiety, doctors should systematically discuss such therapies with their patients as an option. 'Combining a pharmacological approach in the short-term with psychological treatment is a promising strategy for reducing anxiety and promoting sleep.'

The study was published in the Canadian Journal of Psychiatry.


Obese people don't have a lack of willpower - study reveals it is their brain cells that are to blame

An international study has discovered why some people who eat a high-fat diet remain slim, yet others pile on the weight. Researchers found in some people a high-fat diet causes the brain cells to become insulated from the body. This prevents vital signals, which tell the body to stop eating and to burn calories through exercise, from reaching the brain.

The team from Monash University, Australia, said the findings provide a critical link in addressing the obesity epidemic. Lead author Professor Michael Cowley, said: 'These neuronal circuits regulate eating behaviours and energy expenditure and are a naturally occurring process in the brain. 'The circuits begin to form early in life so that people may have a tendency towards obesity even before they eat their first meal,' he said.

Eating a high fat diet causes more 'insulation' in the nerve cells, and makes it even harder for the brain to help a person lose weight.

Professor Cowley said: 'Obese people are not necessarily lacking willpower. Their brains do not know how full or how much fat they have stored, so the brain does not tell the body to stop refuelling. Subsequently, their body's ability to lose weight is significantly reduced.'

Professor Cowley and his team collaborated with scientists from the Yale School of Medicine in the U.S, as well as teams from Cincinnati, New Jersey, Mexico and Spain.

For a period of four months, the researchers monitored the eating and body composition of groups of mice and rats. They found that those with a neural predisposition to obesity gained 30 per cent more weight compared to six per cent of the group with obesity-resistant cells.


1 comment:

John A said...

Peril of the sleeping pill

Geneviève Belleville, a professor at Université Laval's School of Psychology...

Which explains a lot. I have learned to insist on seeing a psychiatrist rather than a psychologist whenever I am told I will be assigned a new doctor for my depression. The worst was a psychologist who promised to help me overcome my "drug dependency" via the talking cure - my depression is physically based and while diagnosed "only" seven years ago the existence of symptoms has been tracked back over fifty years: mine is not a case of having a relative die or losing a job. Which is also why I rant that such causes of temporary trouble and my life-long difficulty are not differentiated.