Okay, here's a little quiz for you. Recognize any of these names?
- Diazepam.
- Clonazepam.
- Lorazepam.
- Alprazolam.
- Temazepam.
I thought not. How about these?
- Valium aka diazepam.
- Klonipin aka clonazepam.
- Ativan aka lorazepam.
- Xanax aka alprazolam.
- Restoril aka temazepam.
Ah! I thought so. These brand names are so familiar, so much a part of our national consciousness, that most Americans would be able to identify them in their sleep:-)!
Sixty million Americans will be sleep deprived in 2010. I am constantly inundated with requests for medications to "sleep better". Yes, these medications will help you get to sleep. But sleep better? No way!
Here's what happens to your brain on benzodiazepines (benzos)- an umbrella term for the class of drugs above. Ready?
Our brain is a maelstrom of very busy nerve cells chattering away using chemicals that excite or inhibit each other. The mother of all inhibitory chemicals in the brain is GABA and benzos work by "up"ing GABA's effect. Newer drugs like zolpidem (Ambien) also work the same way. So, in theory, a little benzo makes you mellow, a little more makes you sleepy, a little bit more makes you pass out- you get the idea. Reality however is another story.
1) Benzos cut down on your rapid eye movement sleep. That's when you rehearse your daily activities, like how to tie your shoelaces if you are a toddler, how to drive with a stick shift if you are a teenager, or how to hit the ball out of the park if you are Babe Ruth. Being on benzos means you will most likely strike out.
2) Benzos reduce slow wave sleep which is really deep sleep. Since slow wave sleep is important for the consolidation of facts and events, those of you on benzos are going to be less likely to ace that exam or make the right calls on the trading floor.
3) The good news for drug companies is that the more you use benzos, the more you will use benzos. You will need larger doses of them and more often. You may even get to the point (and many people do) where you cannot sleep without them. Addiction and dependence are good for selling drugs on and off the street.
4) Benzos exacerbate sleep disorders like sleep apnea. Sadly, all the increased snoring will bode poorly for your spouse or partner who may then need to go on benzos themselves.
5) Being on benzos long-term can produce memory loss that mimics dementia. True.
6) Chronic benzo use causes daytime sleepiness, reduced concentration, irritability and anxiety. These symptoms occur regardless of dosage.
Gee. The chronic effects of taking benzodiazepines for sleeplessness sounds a LOT like the effects of chronic.... sleeplessness! I rest my case.