Women and Insomnia: Why Prescription Sleep Medications Don’t Work That Well

Experts say lifestyle habits such as regular sleep patterns are more effective ways to deal with insomnia. Ljuba Photo/Getty Images

Researchers say prescription sleep medications appear not to be effective for women who take them longe…

Experts say lifestyle habits such as regular sleep patterns are more effective ways to deal with insomnia. Ljuba Photo/Getty Images
  • Researchers say prescription sleep medications appear not to be effective for women who take them longer than 1 year.
  • Insomnia can affect anyone, but it's more common in women, older adults, and people under stress.
  • Experts recommend lifestyle changes such as regular sleep patterns and no screen time before bed as better ways to manage insomnia.

Prescription sleep medications may not be beneficial for women when taken long term, but experts say more research is needed.

A study published in BMJ Open followed more than 600 women with sleep disturbances. Of them, 238 were taking sleep medications and 447 were not.

After 1 year, the researchers found no difference in sleep disturbance between the participants who took sleeping medications and those who didn’t.

“The use of sleep medications has grown and they are often used over a long period, despite the relative lack of evidence from RCTs (randomized controlled trials),” the study authors write.

“The current observational study does not support use of sleep medications over the long term, as there were no self-reported differences at 1 or 2 years of follow-up comparing sleep medication users with non-users,” they added.

Dr. Virginia Skiba, a senior staff physician at Sterling Heights Sleep Clinic at the Henry Ford Sleep Disorders Center in Michigan, said because the research is an observational study, there are some limitations.

“We have to keep in mind that this is an observational study and not actually looking at women randomly assigned to be taking or not taking a medication,” Skiba told Healthline. “This may mean that women who were on medications felt their sleep quality was worse and decided to take a medication. We also don’t know how often they were taking the sleeping medication and may have only taken in a few times to be part of the study.”

“Nonetheless, it's not a large surprise that sleep was not improved in the group taking medications. Studies that are conducted for approval of sleeping medications are done over a short time. With longer use, there may be some tolerance that develops, although this has not necessarily been shown in studies,” she added.

Dr. Michael J. Sateia, a professor of sleep medicine at Dartmouth College in New Hampshire, agrees.  

“It's no surprise that patients with chronic insomnia on long-term sleep medications do not report significant improvement over time. In clinical practice, these patients often report that the medication is ‘not working.' However, when the suggestion is made that the medication should, therefore, be discontinued, they will often resist,” Sateia told Healthline.

Insomnia and women

Insomnia is the most common form of sleep disturbance, with up to 35 percent of adults affected.

Although it can impact anyone, insomnia is more common in older adults, those under stress, and women.

“Women have much more insomnia than men do. Women typically start developing insomnia patterns starting with adolescence. It also comes around first-time mothers and certainly in menopause there is a lot of disruption to sleep, which are hormonally based,” Dr. Rafael Pelayo, a sleep specialist at Stanford Health Care in California, told Healthline.

Most people have an occasional night of poor sleep. But if sleep difficulties occur frequently for more than 3 months, Skiba said an assessment from a doctor is a good idea.

“If you're having trouble falling asleep (taking more than 30 minutes to fall asleep) or have trouble staying asleep on several nights a week going on for more than 3 months, you may suffer from chronic insomnia. It's best to seek help from an accredited sleep center for an evaluation,” she said.

Keeping a consistent sleep schedule, avoiding screens for 30 minutes before sleep, and skipping caffeine in the afternoon and evening are just some sleep hygiene habits that can improve sleep.

For people experiencing insomnia, medication isn't a first-line treatment. Experts recommend cognitive behavioral therapy (CBT) instead.

“Treatment of chronic insomnia with long-term medication is not the recommended clinical practice (despite its common use in clinical practice). The vast majority of those with chronic insomnia should receive cognitive behavioral therapy,” Sateia said.