Sleeping pills: efficiency and alternatives
In the face of insomnia, many of our fellow citizens resort to sleeping pills. In France, nearly 200 million boxes are sold every year, and a third of people over 65 are regular consumers. That’s one of the reasons we created the Dreem headband: to provide an effective and safe alternative to sleeping pills. It is indeed quite possible to fight against insomnia without sleeping pills.
History of sleeping pills
The oldest sleeping pills are “barbiturates“. They were discovered in the early twentieth century. Today recognized as highly toxic, they are almost no longer used.
“Benzodiazepines” were until recently the most common sleeping pills. These molecules have anxiolytic and sedative properties. They decrease overall neuronal activity and cause drowsiness.
But how do these molecules work?
First, a little reminder. There is a very common chemical messenger in the brain, whose role is to attach to neurons to reduce their activity. It’s the GABA. As a reference inhibitory neurotransmitter, it slows down nerve transmission and prevents neuronal hyperactivity (anxiety is neuronal hyperactivity). It thus promotes calm and relaxation.
As a neurotransmitter, GABA is released by one neuron and binds to the GABA receptors of another neuron. By attaching itself, it triggers the opening of the “Chloride channel” in the middle of the receiver. Chloride ions, naturally present in the extracellular fluid, will then take this channel and penetrate inside the neuron. Charged negatively, these ions modify the electrical charge of the neuron. Thus polarized, it becomes less “excitable” because less sensitive to other stimulations. Its activity slows down: it is inhibited.
What about benzodiazepines?
Benzodiazepines have the ability to also bind with GABA receptors (at a reception site very close to that of the GABA neurotransmitter).
In doing so, they amplify the action of the GABA neurotransmitter: by increasing the opening frequency of the Chloride channel, they allow more chloride ions to penetrate inside the neuron. This decreases the neuronal activity more sharply!
The more an individual absorbs benzodiazepines, the stronger the inhibition of the nervous system.
How effective are these sleeping pills?
The effectiveness of benzodiazepines is known to induce and maintain sleep. Because they persist for a long time in the body, they are also useful for fighting nighttime awakenings.
Here are the existing side effects, however:
- a decrease in the amount of deep sleep and REM sleep
- sleepiness issues and dizziness during the day
- increased risk of depression and memory loss
- physical dependence accompanied by a strong psychological component, even with so-called therapeutic doses or short-term treatment.
- What are the alternatives? What are the “new” sleeping pills?
Other molecules have been developed to try to reduce these side effects. They work in the same mode as benzodiazepines, that is, by interacting with the GABA receptor.
These include zolpidem (Stilnox), effective against sleep onset insomnia, or molecules called “anti-orexins” (Belsomra), which limit nighttime awakenings.
Today these molecules are favored, to the point that they take the lead in the market. But the discovery of side effects is only a matter of time. Recently, a study also indicated the persistence of zolpidem in the blood in the morning. This leads to a loss of vigilance, which is all the more dangerous since they come out of nowhere. Women, who evacuate toxins less quickly, would be particularly at risk.
Research is continuing to find sleeping pills that give a natural structure of sleep, without side effects.
What about melatonin?
Rather on trend at the moment, melatonin is a hormone naturally produced by our body. Sometimes called “sleep hormone”, it reacts to light. Moreover, the body produces it mainly at night.
Synthesized and sold in tablet form, it is used today to fight against insomnia. The advantage is that it has no sedative effect like sleeping pills. But unfortunately, doubts remain.
Is melatonin really effective?
While some studies show a clear improvement of sleep onset in their volunteers, this is not the case for all. Indeed, taking melatonin seems more effective when its presence in the body is at its lowest, either in the afternoon or early evening. That is to say at times when it is not yet sleeping time. What a shame…
In fact, since melatonin is mainly a hormone regulating biological rhythms (including sleep), it would be especially useful for sleep disorders caused by bad biological rhythms: jet lag or night work, for example. Or even, for the minority of people (often elderly) who do not produce enough naturally, or not at the right time.
On its safety: it may interact with other medical treatments, such as anticoagulants. Even today, we do not know much about its long-term effects. It is, therefore, necessary to use it over a limited time period.
In all cases, sleeping pills tackle the symptoms of insomnia, but not what causes it. While they are useful in cases of acute and punctual insomnia, we do not advise to take them in the long-term. Taking molecules that modify the functioning of our neuronal processes is indeed far from innocuous. Chronic insomnia requires first and foremost a thorough work on our sleep habits. And even punctually, there are other solutions than drugs to sleep better.
To improve one’s sleep, one must first understand it. If the Dreem headband does not replace the consultation of a sleep doctor in cases of severe insomnia, it can nevertheless allow you to accurately track your sleep and help you adjust your lifestyle with the help of personalized advice.
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