Body & Fitness

Are sleeping pills mother’s new little helpers?

Kathy Twomey fell into bed exhausted after another busy day juggling work with childcare for her two children under three years old.

But instead of falling asleep, Kathy stayed awake – all night and for the next three consecutive nights. “I just had so much on my plate that I couldn’t switch off. I’d get into bed and my mind would be racing about things I had to get done the next day,” she says.

Kathy, a journalist, had returned to work part-time after maternity leave. “I regularly put in 12-hour days and worked at home on my days off.”

“Somehow the adrenaline kicked in during the day and I did all that was required of me at work, but when I got home everything fell apart.”

“I was moody and tearful, and I’d bicker with my husband. I wasn’t depressed, just sleep-deprived, and felt if I could get a couple of good nights of sleep I’d be able hold everything together.”

Desperate after three months of sleep problems, Kathy – who lives in South London with her accountant husband John (50), and daughters Sarah, now 12, and Flora (9) – went to her GP in tears. He prescribed sleeping pills.

Kathy (45), was prescribed zopiclone  – one of the so-called Z drugs, which work by releasing a brain chemical called Gaba. It acts as a natural ‘nerve-calmer’, reducing anxiety and inducing sleepiness. other Z drugs include zaleplon and zolpidem.

“The pills worked really well, “says Kathy. “I’d take them 50 minutes before bed and they’d induce normal sleep –  I was still able to get up at night if the children woke up. The next day I felt refreshed and able to cope.”

“Some friends were horrified when I admitted taking sleeping pills, but at the time I didn’t see the problem. I thought it was better than drinking a bottle of wine every night to switch off as some people did.”

“When I went back after a month to ask for a repeat prescription, my GP handed me one and said: “Here you go. Here’s mummy’s little helpers.” She described them as a crutch to get me through my days. I was grateful and agreed with her.”

Kathy relied on zopiclone for the next four years and admits she was ‘probably addicted’ – fortunately, she was able to wean herself off them over a year. She is just one of a growing number of women given sleeping pills to cope with hectic lifestyles – experts are increasingly concerned the drugs are becoming the modern day equivalent of the original mother’s little helper, the drug Valium.

Doctors are being successfully sued by patients who have been given long-term prescriptions of addictive tranquillisers. The fear is that a similar pattern is emerging with sleeping pills.

This was widely prescribed for anxiety, but the drug is addictive, with countless thousands who took them long term suffering physical and psychological damage.

Last week, it was reported that  doctors are being successfully sued by patients who’d been given long-term prescriptions of addictive tranquillisers, known as benzodiazepines.

The fear is that a similar pattern is emerging with Z drugs. As well as being potentially addictive, Zopiclone’s side-effects can include nausea, vomiting, dizziness, confusion, depression and hallucinations.

“Z drugs are not that different from benzodiazepines,” says Professor Allan Young, chairman of the Royal College of Psychiatrist’s Psycho Pharmacology Group.

“They’re not prescribed for daytime use as Valium was, but they are still prescribed too freely for too long. The mother’s little helper problem is still with us.”

Insomnia, which is defined as difficulty getting to sleep or staying asleep for long enough to feel refreshed the next morning, affects up to one in three of us at some point, according to a study of patients in GP practices by Keele University in 2007.

The researchers found the problem was significantly more common in women than men and suggested this was because women are more likely to consult their GPs about sleep problems. Insomnia is a growing problem, says Dr Dev Banerjee, a consultant sleep physician, who runs three private sleep clinics in the West oidlands. ‘It can be associated with stress, anxiety or being in pain. People with sleep problems tend to have a lot on their plates. They are juggling jobs and families.

“They’re under a lot of pressure to be available to work 24 hours a day, checking emails before they go to bed. And when they get to bed, they can’t sleep because they have not had any down time to unwind.”

Ten million prescriptions for sleeping pills were written in Britain in 2010, and six million of those were for Z drugs – up by 233,000 on the previous year.

The downsides

The potential side-effects of Z drugs include:

  • Loss of taste

  • Drowsiness

  • Nausea

  • Vomiting

  • Dizziness

  • Dry mouth

  • Headache

  • Diarrhoea

  • Hallucinations

Withdrawal symptoms:

  • Insomnia

  • Anxiety

  • Loss of appetite

  • Tremor

  • Perspiration

  • Tinnitus

This is despite guidance issued by the National Institute for Health and Clinical Excellence (Nice) seven years ago, which recommended non-drug treatments for insomnia such as cognitive behavioural therapy, relaxation techniques and lifestyle changes where possible.

Drugs are meant to be prescribed only in severe cases for short-term use of two to four weeks. This is because of the risk of ‘rebound insomnia’ where the brain develops tolerance to the drugs, so the patient starts to suffer sleeplessness again and needs higher doses to fall asleep.

Yet despite the Nice guidelines, around one in five prescriptions for Z drugs in 2006 were for eight weeks or longer, according to a report published by King’s College London last summer.

“Z drugs are a useful short-term treatment for insomnia, but what we find time and again is that prescriptions are continued and not reviewed,” says Professor Young. “But they don’t work long term and if used in this way the risks outweigh the benefits.”

“Z drugs should not be prescribed as a first-line treatment for insomnia,” says Dr Martin Johnson, GP and trustee of the Patients’ Association.

“GPs should be assessing what is causing sleep problems – drinking too much coffee or smoking before bedtime, for instance.”

“Another big problem is that patients have repeat prescriptions and are not reviewed regularly. Also, people who can’t sleep tend to be really desperate for help. GPs come under a lot of pressure.”

The risk of addiction is very real, says Dr Banerjee. “oany of my patients have tried Z drugs or are still on them and want to come off – which can be difficult.”

Sue Parker (55), a former personal injury lawyer from oldham, Lancs, was prescribed zopiclone in 1997 and is still on it, having experienced severe rebound insomnia.

“When I was first prescribed them I hadn’t been sleeping as I was stressed, anxious about work and my first marriage had broken down,” says Sue.

She was told zopiclone would help her sleep and also help with the withdrawal symptoms from medication for anxiety.

“Life was always so full on and hectic. I found myself just trying to get through each week,” she says.

“If someone had told me the drug was like mother’s little helper  -Valium – I’d have scoffed, but it helped me function normally. At first, it worked like a dream: I slept well and felt calmer and more in control in the day.”

But Sue soon found she needed higher and higher doses. “After three months I started suffering insomnia again. My concentration was shot to pieces and eventually I had to give up my job.”

“I’ve gone from being a successful, outgoing career woman to a recluse who can’t work. The pills I was prescribed for a short-term sleep problem made me ten times worse and destroyed my life”

“By last year I was having to take eight 7.5mg tablets at midnight to get any sleep at all – that’s seven times the recommended daily dose.”

“Even then I would be lucky to get four hours’ sleep. I did worry, but couldn’t bear to give them up.”

“Thankfully, my new GP has helped me reduce my dose gradually to four tablets. I’d like to come off them completely, but I’m struggling as sadly my second husband Dave died from cancer in March.

Ian oilton, project worker with the NHS-funded support scheme the Bristol Tranquilliser Project, says they receive calls from all over the country from people with sleeping pill addiction. “It’s utter hell for them. GPs still see Z drugs as safer alternatives – but they’re not,”he says.

Jim Dobbin oP, chairman of the All Parliamentary Group on Involuntary Tranquilliser Addiction, says: “There has been a culture that someone with sleep problems and/or anxiety will immediately be prescribed sleeping pills.”

“These drugs have been heavily marketed and drug companies want a return on their investment.”

A Department of Health spokesman said: “The Government is determined to reduce addiction to prescription drugs. People should read medicine labels carefully, follow the instructions and contact their GP or chemist immediately if there are worries about any side-effects from their medication.”

Kathy was one of the lucky ones – she weaned herself off the tablets over a year.

“oy life is a lot less stressful since I started working from home,’ she says. ‘But I still take one if I get the odd night when I can’t sleep.”

But Sue is still taking four times the recommended dose 14 years after zoplicone was prescribed.

“I just want to warn other women about the dangers of Z drugs – they’re presented as a safer alternative, but in my experience they are highly addictive and dangerous.”

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