HEALTH

I wanna be sedated

The insomnia epidemic is now affecting kids

NANCY MACDONALD January 23 2006
HEALTH

I wanna be sedated

The insomnia epidemic is now affecting kids

NANCY MACDONALD January 23 2006

*Mark Rumsfield's name and identifying details have been changed to protect the individual's privacy.

Mark Rumsfield, a student in Montreal, is trapped in an awful sleep cycle. It begins innocuously, says the 25-year-old, but quickly spirals into a pattern of sleepless nights and wrecked days. “It starts by not falling asleep until 3 a.m., then progresses to 4, 5, 6, until you hit 10 a.m. You force yourself to wake up and go about your day, even if you’ve slept for an hour—or not at all. Somehow you make it through the day, then you face the same problem when night falls.”

Rumsfield is not alone: one in seven Canadians has trouble falling, or staying, asleep, according to Statistics Canada. The agency reports that while insomnia is more prevalent among those with pre-existing health problems (such as arthritis or asthma), neither disease nor stress is a requisite factor. Indeed now, as never before, sleeplessness is being considered a unique disorder, and prescriptions for drugs to combat it have risen as a result. Some believe this reflects a broader new consumer receptivity to the medicalization of lifestyle and the use of prescription drugs to enhance life, abetted, at least in part, by a parallel increase in pharma-marketing.

It’s estimated that the global sleep disorder market, whose worth already tops US$4 billion, will climb to more than $11 billion within a decade. Currently leading the pharmaceutical pack is Ambien, a prescription medicine produced by Paris-based SanofiAventis that works by inhibiting the firing of brain cells and thus lulling the mind to sleep. But in October, Sanofi will lose its exclusive patent, and consumers’ options will increase, including an offering from the U.S. giant

Pfizer, whose ad campaign, analysts predict, will be of Viagra-like proportions.

Rumsfield was first prescribed sleeping pills while in junior high. He’s been a “sporadic” user ever since. In fact, it’s his demographic that accounts for much of the increase. The number of young adults under 45 taking sleep aids in the United States doubled from 2000 to 2004, according to Medco Health Solutions

(an American company that administers prescription drug plans). Still more dramatic is the increased use by young people aged 10 to 19, which rose by more than 85 per cent.

These statistics raise myriad concerns. What’s not known are the long-term effects of sleep medication: there are few critical, extended evaluations of drugs like Ambien. Sleeping pills were conceived as stop-gap measures to guide patients back to normal circadian rhythms, and drug trials to test their efficacy and side effects traditionally last six weeks or less. But some patients use the drugs for months, even years. And though the medications have been approved for children, their impact on that population is not known.

Some physicians say that kids have always had trouble getting to sleep and that, like untying shoelaces, they need to learn how to relax their minds—perhaps with a bit of parental prodding. “A big part is behaviour and behaviour management,” says Dr. David F. Smith, medical director of the general pediatric clinic at the B.C. Children’s Hospital in Vancouver. “In practice I see a lot of kids who end up with a sleep debt simply because their parents don’t put them to bed and insist they stay in their bedroom.”

For some young people, it’s no more complicated than learning to block the barrage of stimulants like video games, cellphones and instant messaging. But others are kept awake by the powerful drugs that combat attention deficit and hyperactivity disorder (ADHD). About 15 per cent of children prescribed sleep aids are also taking pills to combat ADHD, according to Medco. Rumsfield, too, uses sleeping pills to counteract his Ritalin—meaning he, like many kids and young adults, is taking stimulants by day and depressants by night.

For some parents, it’s worth the risk: aside from the obvious psychological damage brought on by chronic insomnia, studies suggest that it can contribute to a host of other illnesses. The Harvard Women’s Health Watch recently linked sleep deprivation to weight gain and hypertension, and noted that it can decrease the immune system’s ability to ward off illness. Sleeplessness has also been cited

as a trigger for depression. What’s more, a recent study by Princeton psychologist and Nobel laureate, Daniel Kahneman, found that happiness is affected by the quality of people’s sleep—more than by any other factor, including income.

Drug companies are not the only ones cashing in on the insomnia epidemic. For makers of mattresses and bedding, it also spells opportunity, and has created a new growth industry—with products such as “memory foam” mattresses and sweat-wicking pillows. But more and more of the sleep-deprived are opting for a sure thing—medication—and are quite content to hop into bed each night with Big Pharma. M

The use of sleep aids by children aged 10 to 19 has risen by more than 85 per cent, in some cases to counteract Ritalin