Friday, December 21, 2012

Some benefit from sleeping pills 'comes from placebo effect'

This is an unsurprising surprise.  Something similar could be said of most medications.  I myself take Ambien (aka Stilnox) before bed and I still have unpleasant memories of the night I forgot to take it.  It was hours later that I realized what I had done.  It's certainly more than a placebo for me

Half of the benefit of taking sleeping pills comes from the placebo effect, a new study has concluded.

A team of international researchers, including from Britain, found the effectiveness of a range of common sleeping tablets were of “questionable clinical importance”.

Their study, published in the British Medical Journal, questioned hypnotic pills, commonly known as Z-drugs, after re-analysing more than a dozen clinical trials.

Academics from the University of Lincoln, Harvard Medical School and University of Connecticut, found drugs such as Sonata and Ambien worked once the placebo effect was taken into account.

"Our analysis showed that Z-drugs did reduce the length of time taken for subjects to fall asleep,” said Prof Niroshan Siriwardena, from the the University of Lincoln's School of Health and Social Care.  “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.”

Prof Siriwardena, who led the study, added: “We know from other studies that around a fifth of people experience side-effects from sleeping tablets and one in 100 older people will have a fall, fracture or road traffic accident after using them.

“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."

Doctors write millions of prescriptions for Z-drugs every year as a short-term treatment for insomnia.

Medical experts have reported that their use has increased in recent years as many users believe they are a safer alternative to tranquillisers.

But some doctors questioned whether the benefits of Z-drugs justify their side-effects, such as memory loss, fatigue or impaired balance.

In their study, researchers used data submitted by pharmaceutical companies to the US Food and Drug Administration (FDA) for approval of new products.

The information was contained in 13 clinical trials, with more than 4,300 participants, that also had 65 “comparisons”.

The FDA collates results from both published and unpublished studies, enabling researchers to avoid common types of bias that undermine sponsored trials.

Their findings indicated that “once the placebo effect is discounted, the drug effect is of questionable clinical importance”.

Prof Siriwardena said future studies of sleeping tablets should investigate a broader range of outcomes, not just time taken to fall asleep.

Pharmaceutical companies, he added, should be “more transparent in disclosing results from their studies so that researchers can independently analyse their results”.


Sunday lunch with family boosts childrens' fruit and vegetable consumption: study

Mothers do seem to have strong convictions in favour of the  consumption of "greens" so I have no doubt that this is generally true

Families should eat Sunday lunch together, researchers have said, after finding that children who ate with their parents just once a week consume more fruit and vegetables.

Researchers found that children who ate with their parents at least once a week consumed more than one extra portion of fruit and vegetables when compared with those who never ate as a family.

It is thought that parents and siblings setting an example and making mealtimes a social occasion encouraged children to eat more healthily.

Cutting up fruit and vegetables for children, and parents who consume a healthy diet also boosted the intake of children, it was found.

A study of 2,300 primary school children in deprived areas of London found that more than six in ten do not eat the recommended five portions of different fruit and vegetables a day, a total of around 400g.

The findings by Leeds University were published in the in the British Medical Journal's Journal of Epidemiology & Community Health.

Children who ate a family meal together at a table every day consumed 125g or 1.5 more portions of fruit and vegetables on average than children who never ate with their families.

Even those who reported eating together only once or twice a week consumed 95g or 1.2 more portions than those who never ate together.

Professor Janet Cade, of the University's School of Food Science and Nutrition, who supervised the study, said: "Even if it's just one family meal a week, when children eat together with parents or older siblings they learn about eating.

"Watching the way their parents or siblings eat and the different types of food they eat is pivotal in creating their own food habits and preferences.

"There are more benefits to having a family meal together than just the family's health. They provide conversational time for families, incentives to plan a meal, and an ideal environment for parents to model good manners and behaviour."

PhD student, Meaghan Christian, who conducted the study, said: "Modern life often prevents the whole family from sitting round the dinner table, but this research shows that even just Sunday lunch round the table can help improve the diets of our families.

"Since dietary habits are established in childhood, the importance of promoting the family meal needs to be more prominent in public health campaigns.

"Future work could be aimed at improving parental intake or encouraging parents to cut up or buy snack-sized fruit and vegetables."

It is estimated that one in ten children in the UK aged 2-10 is obese. In the last four years the Department of Health has spent over £3.3million on the 5 A Day campaign and a further £75 million on the Change4Life campaign, designed to encourage families to improve their lifestyle through diet and exercise.


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