Ask Well: Do Sleeping Pills Induce Restorative Sleep?

Q

Is sleep induced by a benzodiazepine counted as restorative sleep?
Reader Question • 489 votes

A
Researchers hate to admit it, but they don’t know enough about sleep to answer this question. Their best guess, several experts said, is that sleep is sleep.

Dr. John Weyl Winkelman, a sleep disorders expert at Massachusetts General Hospital and Harvard Medical School, said if a patient asked him whether medicated sleep was restorative, “I’d say: ‘You tell me.’”

There is quite a bit of evidence about the negative health consequences of insomnia, but researchers don’t know precisely what it is in the brain and body that is “restored” by sleep to aid optimal function. And it is unlikely that any specific stage of sleep is uniquely restorative, said Dr. Daniel J. Buysse, a sleep medicine expert and professor of psychiatry at the University of Pittsburgh.

More sleep, less interrupted sleep, and sleep at the right time of night are all likely to be important, he said.

There are two types of sleep: REM, when people dream, and non-REM, which has light, medium and deep portions. Sleeping pills mainly increase the amount of medium-depth non-REM sleep, Dr. Buysse said.

Medications can help people fall asleep faster and reduce nighttime wakefulness, he said, and those changes are usually considered to contribute to restorative sleep. But different people respond differently.

“Do you feel more rested, more alert, more able to concentrate, less irritable on medication versus off?” Dr. Buysse said. “If all those things are true then I would say it’s more restorative. If a hypnotic drug leaves you feeling hung over or more anxious, if it causes you to order five hickory smoked turkeys on the Internet without remembering, then it’s probably not good.”