Doctors and the Sleeping Pill Question

The use of sleeping pills is on the rise, with 8 percent of Americans now using them at least a few nights a week. By some folks’ lights this is not a good thing. Doctors are too quick on the draw with the prescription pad, is a complaint I often hear.

But I’ve had more experience with doctors of the opposite persuasion, who declare they don’t do sleeping pills at all.

Some doctors are comfortable prescribing sleeping pills and others aren'tThe use of sleeping pills is on the rise, with 8 percent of Americans now using them at least a few nights a week. By some folks’ lights this is not a good thing. Doctors are too quick on the draw with the prescription pad, is a complaint I often hear.

But I’ve had more experience with doctors of the opposite persuasion, who declare they don’t do sleeping pills at all. I’ve moved quite a few times over the years and had to change health plans and doctors, and I’ve come across several of these pharmacological Puritans. The minute I mention even occasional use of sleeping pills for insomnia and ask for a prescription, I morph into Hester Prynne with a scarlet letter on my chest: “A” for Ambien.

I know these drugs have their downsides, and there are certainly reasons to avoid them. Arguably there are better ways to deal with insomnia over the long term. But if a prescription is simply not on the table for discussion, I have to wonder what century these doctors think they’re living in.

One Woman’s Experience

I met May as I was conducting interviews for my book. A soft-spoken retired mathematics professor, May had reported sleep problems to her doctors for years. One advised going to a mental health clinic, but aside from poor sleep she wasn’t having any problems so she didn’t pursue it. Another suggested taking Benadryl, but May had read that antihistamines had negative side effects so she decided not to do it. A third doctor simply checked a box for sleep problems on his patient history form and moved on.

One year May took matters into her own hands. “I took my cat’s Valium,” she said. “My cat was prescribed Valium and since he slept all the time, I tried taking them. Not every night, though — I’ve read too much about getting addicted. I took them just about five times a month. They were 2 mg tablets and I would break them in half.” One milligram of Valium – hardly enough to make a wombat blink – taken every five or six days was all it took to give May the best year’s sleep of her life.

Where, oh where, is the harm in that? I know some people are prone to abusing sleeping pills, and physicians are rightfully leery of prescribing them to patients they suspect might take that path. But May would be the last person to use pills unwisely, and after years of treating her as a patient, her doctors should have known that.

A Different Approach

Humor, I sometimes think, might be a way to avoid the awkwardness of raising the issue of sleeping pills with new GPs. The minute the doctor walks into the consulting room, I announce my credentials as a pharmacological conservative. “The truth is,” I tell the doctor, “I don’t like drugs. My mother was a Christian Scientist so I grew up thinking they were evil. I’ll never ask for an antibiotic. When I get a cold, not even Tylenol crosses my lips. But when it comes to getting to sleep, pure thoughts don’t always suffice …”

I’m sleeping a lot better these days, so I don’t feel the need for as many sleeping pills as before. But I don’t have much patience for pharmacological Puritans. If a doctor responds to my request for a prescription with a lecture, our relationship is history. I’m out the door.