What are the long-term risks of sleeping medications?
The definition of insomnia is rather complex, but usually involves a prolonged period when the person can not sleep - usually over 30 minutes or several awakenings during the night - for at least a month followed. Sleep dissatisfaction and difficulty performing activities on the following day are also part of the criteria. (1)
In a study done in the city of São Paulo and published in 2013, it is reported that about 15% of 1042 people surveyed had insomnia (2). On the other hand, about four out of every hundred paulistanos, according to another study, use sedatives or sleeping pills. Considering Greater São Paulo, this is equivalent to about one million two hundred thousand people (3).
The main sleeping medications are benzodiazepines (those sold in packages with a black belt) and Z drugs, in Brazil, zolpidem and zopiclone are marketed - it is recalled that, in a pharmacy, these drugs may have several brands but, under the trade name, in smaller letters, the chemical name can always be seen. Benzodiazepines were developed from the mid-1950s onwards in the last century, while Z-drugs have a more recent origin since the 1980s (4,5).
Before the existence of these medications, they were widely used the barbiturates group, which presented high risks when used in larger amounts. Thus, a major advantage of benzodiazepines and Z-drugs is that they are very safe and, if ingested in large quantities, generally do not carry the risk of death. Thus, from the 1960s, benzodiazepines became the preferred drugs as tranquillizers and sleep inducers.
However, despite the safety of these drugs (benzodiazepines) in relation to life risks, in the short term, they have a number of potentially dangerous side effects. Thus, early in treatment, they increase the risk of falls and impair motor coordination and memory. Accidents indirectly related to their use involve injuries due to falls, impairments in activities that require coordination (such as driving) and forgetfulness (some even commit illicit acts and erase them from memory). In addition, they are abused by some people, especially by individuals who already use other drugs, such as heroin.
In the long run, there may be a decrease in effects on motor coordination, but negative effects on memory tend to remain. In addition, there is a study that suggests that prolonged use may be related to the development of dementia (6) - similar to Alzheimer's disease, with behavioral changes and a progressive reduction in the capacity to remember, especially recent events - or Alzheimer's disease.
Z drugs appear to be a bit safer, but there is evidence that even they can cause problems of balance and motor coordination, especially if their effects are measured over the night that people took these drugs
Although there are no definitive findings, researchers studying the consequences of using benzodiazepines recommend that they be used for up to two weeks in a row. It is also recommended that if they are not used in people over sixty or sixty-five (8).
What to do in case of insomnia?
When someone has insomnia, you should consult a specialist (usually psychiatrist or neurologist). The professional will do an investigation of insomnia, which may appear alone or be caused by pictures such as depression, anxiety, or various types of clinical illness.In those cases in which insomnia has a specific cause, this cause should be treated and, as a likely consequence, insomnia will be cured or improved. In other cases, when there is no disease explaining insomnia, in addition to the use of short-term medications, sleep hygiene techniques can be used, which are also effective and have no side effects. They are:
1. Go to bed only when you are very sleepy, unable to keep awake. It is not enough to be tired. Meanwhile, watching TV, reading a book, browsing a magazine or listening to music. Always quiet activities, which relax. Thrilling movies, very busy songs, activities like washing dishes or sweeping the house can make the person even more awake.
2. If you wake up in the middle of the night and do not fall asleep in 15 to 20 minutes, do as in 1.
3. Aerobic physical exercises several times a week
4. Take a light snack before bedtime.
5. No smoking and no coffee in the afternoon.
6. Never try to "force" sleep: the more you try, the more you wake up.
7. For some people, it helps to take a warm bath before bedtime.
8. Get up early, even on holidays and weekends.
9. Do not over sleep, even if you have slept badly at night.
10. Do not take naps during the day.
"Drinking lots of fluids and doing certain exercises help prevent the most common type of fainting" How long did the faintness last. - The state in which the patient woke up (confused, with some weak limb or localized numbness, had urine or feces on his clothes, did some bruising.) - What the fainting was doing before losing the senses.
The practice of physical activities is essential to maintain quality of life, helping to lose weight and still bringing disposition to the day to day. However, the benefits of exercise are not limited only to physical well-being, but also work well for the brain. The Frontiers in Neuroscience has published a study based on several previously published theses, arguing that constant practice of physical exercises at light and moderate levels causes the formation of new neurons.
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