This is a review of hypnotic drug risks and benefits, reassessing and updating advice presented to the Commissioner of the Food and Drug Administration (United States FDA). Almost every month, new information appears about the risks of hypnotics (sleeping pills). The most important risks of hypnotics include excess mortality, especially overdose deaths, quiet deaths at night, infections, cancer, depression and suicide, automobile crashes, falls, and other accidents, and hypnotic-withdrawal insomnia. Short-term use of one-two prescriptions is associated with greater risk per dose than long-term use. Hypnotics have usually been prescribed without approved indication, most often with specific contraindications, but even when indicated, there is little or no benefit. The recommended doses objectively increase sleep little if at all, daytime performance is often made worse, not better, and the lack of general health benefits is commonly misrepresented in advertising. Treatments such as the cognitive behavioral treatment of insomnia and bright light treatment of circadian rhythm disorders offer safer and more effective alternative approaches to insomnia.
Daniel F. Kripke, M.D. is a licensed physician certified by the American Board of Psychiatry and Neurology and an Emeritus Professor of Psychiatry at the University of California, San Diego. He also has done research with the Scripps Clinic Viterbi Family Sleep Center. Dr. Kripke was elected a Fellow of the American Psychiatric Association, co-authored hundreds of medical articles and has given invited lectures in 18 countries. In 1973, Dr. Kripke established one of the first sleep clinics in the United States. He treated patients with sleep disorders until retirement from his clinical practice at age 70. Dr. Kripke continues to be active as a researcher and as an advocate for raising awareness of the dangers associated with sleeping pills, particularly hypnotic drugs.
Dr. Kripke’s research has shown that hypnotic drugs, especially certain benzodiazepines and Z drugs with similar actions on the brain, have the potential to cause infection, depression, and are associated with increased risk of death and cancer. Dr. Kripke’s desire in joining Benzodiazepine Information Coalition is to inform the public about the grave risks of these drugs.