[Health Column] How to Properly Use Sleeping Pills

Medicine has a reason for existence the moment it is created. Sleeping pills are medicines made to help people sleep well. However, recently, there has been ongoing controversy about whether taking sleeping pills is safe or unsafe. All medicines are safe when used properly and unsafe when not used properly. Are blood pressure medicine or headache medicine safe? These two are also safe medicines when used correctly, but can be dangerous if overdosed. Similarly, before discussing whether sleeping pills are safe medicines, it is important to know how to use sleeping pills properly.

The first method is to know whether it is a situation where sleeping pills should be used or not. This requires expert judgment and advice, but generally, assuming 7 hours of sleep per day, if one spends the remaining 17 hours actively without lying down, maintains appropriate bedtimes and wake-up times, and has no special reasons such as snoring, sleep apnea, or other sleep disorders that cause insomnia but still cannot sleep well or wakes up frequently, it is likely a situation where one cannot fall asleep well without the help of sleeping pills. In other words, before deciding whether to take sleeping pills, one should check if they have established regular lifestyle habits.

The second is to distinguish between difficulty falling asleep and frequent waking during sleep. Medicines used for sleep include those for difficulty falling asleep and those for frequent waking during the night. If a person who falls asleep easily but wakes frequently uses only medicine that helps with falling asleep, the uncomfortable symptoms may not be resolved even after taking the medicine, and the dosage of sleeping pills may increase continuously. Therefore, using medicine appropriate to the individual's symptoms can prevent unnecessary increases in medication dosage.

The third is to take sleeping pills not at the time you want to sleep but at the time you should sleep. It is commonly known that sleeping pills should be taken 30 minutes before sleep. However, many insomnia patients tend to take sleeping pills early because they want to fall asleep quickly. According to the body's rhythm, after sleeping 7 hours, one should be active for 17 hours to feel sleepy again, so if waking up at 6 a.m., going to bed around 11 p.m. is the correct habit. However, if sleeping pills are taken and one lies down starting at 9 p.m., it is not yet time to feel sleepy, so falling asleep easily is difficult. Sleeping pills are not anesthetics. Taking medicine at any time does not induce sleep; it must be taken according to the time when sleepiness occurs. Rather than '30 minutes before sleep,' taking sleeping pills '7 hours before the morning wake-up time' can increase effectiveness.

Lastly, one must let go of the obsession that they must sleep. The reason for taking sleeping pills is to sleep. If one obsessively thinks that they must sleep, the burden about sleep increases, making it harder to fall asleep. This leads to dependence on sleeping pills. To reduce the dosage and use sleeping pills properly, one must let go of the obsession with sleep. In many cases, sleep is not the cause but the result. It is much more common to be unable to sleep because of a bad mood than to have a bad mood because of lack of sleep. Sleeping well does not solve everything in life. Sleep is very important, but sleep is just sleep.

Sleeping well without using sleeping pills is naturally a good thing. However, insomnia is also a disease. When a disease occurs, it is better to consider which is more advantageous for quality of life and health: controlling symptoms with appropriate medicine or enduring the disease without medicine. Rather than avoiding sleeping pills unconditionally, it is better to seek help from a sleep disorder specialist to discuss whether the current situation requires sleeping pills, which sleeping pills to use if needed, and how to use them properly, and then make a decision.

Seok-Hoon Jung, Professor, Department of Psychiatry, Asan Medical Center, Seoul