Non-Sensible Sleeping Pill Research

Numerous articles have been recently written on the risk of sleeping pill use, one of which contained potentially earthshattering news. One of the article’s conclusions reads: “Receiving hypnotic prescriptions was associated with greater than threefold increased hazards of death even when prescribed <18 pills/year”.

Considering the estimates that an estimated 6%–10% of US adults took a hypnotic drug for poor sleep in 2010, the potential permutations are enormous. Furthermore, we all know a few physicians we work with that occasionally use hypnotics for shift work. Our patients read and watch the news. When they get wind of this article publishing the alleged lethality of sleeping pills, we need to be prepared to answer for the public concerns of this medical journalistic luridness.

Fortunately there is a clarifying, common sense, logical discussion that brings reason to this mayhem. An article in Emergency Medicine News, 6/2012, takes a realistic view of this on-line published research. This author’s approach to interpreting this study is a method we all should undertake when we encounter these studies that have been produced for ‘shock and awe’ instead of legitimate research-based knowledge dissemination.

Dr Gussow breaks down the article published in the British Medical Journal Open (BMJO) which appears to baselessly purport the incredible risks for anybody even being prescribed a sleeping pill, whether they have taken it or not. You really need to read it just to see how far over the line this paper went when it comes to publishing research conclusions without basing all of them on scientific facts. Dr Gussow states, “Holy moly, if sedatives and hypnotics, taken a dose of 1.5 pills a month, can quadruple one’s risk of death they must be among the most toxic substances known to man. If sleeping pills kill at least four times as many people in the United States as gunshot wounds and automobiles combined, there is an unprecedented and unappreciated ongoing public health catastrophe”; and he is spot on!

We as physicians have an obligation to be current with research in the medical field. Particularly since it affects our patients and ourselves, (depending on where we fit in the subject matter). Our jobs as Hospitalists and Emergency Medicine physicians also require us to make sure the current research presented to the public makes sense and is sensible. To do this we have to be scientifically critical in our interpretations of what is published.

The learning value of this discussion for us is that Dr. Gussow’s article, in combination with the information from the BMJO, brings some utility to this egregious publication. The two articles together total 3 pages. After reading these you will see how the BMJO publishers’ urge to make the news overrode the standard of peer reviewed medical research publications. You can then appreciate his critical analysis of the flawed conclusions presented in the BMJO article. His perspective reveals the unscientifically based deductions that will unfortunately bring the patients in by the hordes asking legitimate questions about their concerns regarding the safety of the hypnotics doctors have prescribed for them. Reading both of these articles will improve your scientific critical thinking while getting you well prepared for the public’s questions.
It will also undoubtedly help everyone sleep better.

References:

1. Gussow, Leon MD., Toxicology Rounds: Sensational Claims Aside, Can Sleeping Pills Really Lead to Earlier Death? Emergency Medicine News: June 2012 – Volume 34 – Issue 6 – p 8 Toxicology Rounds
2. Kripke, D., Langer, R. Kline, L. Hypnotics’ association with mortality or cancer: a matched cohort study BMJ Open doi 10.1136/bmjopen-2012