PETER MOORE: Sleep that costs £1 a minute

IN the 21st century everything must be instant. With more than 100 channels on TV, the iPlayer, DVDs, downloads and hard drive recordings instant entertainment is always available.

We do not even need to get out of the chair to change channels.

We can Skype friends and family around the world and shops are open all hours.

So shouldn't any discomfort in daily life also have a quick fix?

One of the commonest 'quick fixes' demanded is 'a quick fix to help me sleep'.

There is a widespread belief that sleeping tablets will send you to sleep immediately: 'Something to knock me out, please, doc'.

This belief had been fostered in drama from Shakespeare, through Gilbert and Sullivan to modern TV thrillers.

The only drugs which will 'knock you out' instantly are the general anaesthetics.

These can only be given by injection or gas and Michael Jackson's doctor demonstrated the dangers of using general anaesthetics for insomnia.

Doctors have known for years that there is no pill which will send you straight to sleep but we now have another large study to ram home the point.

In the first half of the 20th century doctors prescribed barbiturates.

These were as good as any other sleeping pill but were fatal in even a small overdose; they killed Marilyn Monroe.

In the 1960s, the 'benzodiazepines' were hailed as the new, safe sleeping pill.

These included mogadon (nitrazepam), valium (diazepam) and Temazepam.

Unfortunately, they proved to be highly addictive.

In the 1980s, a new group of drugs were released including zopiclone and zolpidem.

These were called the cyclopyrrolone group but were nicknamed the 'Z' drugs.

Again these were hailed as the new, safe sleeping tablet.

Predictably they also turned out to be addictive and are widely abused by addicts.

To quote Pete Seeger: "When will they ever learn?"

Now British researchers have looked at all the data on more than 4,000 patients sent to the FDA about the 'Z' drugs.

The FDA is the American Food and Drugs Administration which has to approve all medication before it is allowed on the American market.

The data included everything the drug companies had to provide by law, not just the research they choose to publish.

It looked at objective measurements of sleep using both 'polysomnography', measuring the electrical activity of the brain, and the patient's subjective impression of how they slept.

Taking a pill before going to bed does improve sleep, but this occurs for dummy tablets as well as real sleeping tablets.

And this effect is seen measuring the electrical activity as well as people's impression so it is a real effect.

People taking just the dummy pill fell asleep 19 minutes quicker than patients not taking any pill.

If you believe a tablet will help, it will help.

When the 'Z' drugs were compared to dummy tablets, people taking the real sleeping tablets said that they fell asleep seven minutes quicker although the difference in the brain activity suggested it was, on average, 22 minutes.

It was impossible to show any other advantages for people taking the active sleeping tablet. So they do help a little, but 'not a lot'.

The 'Z' drugs are not free of other problems.

They are addictive and can cause drowsiness the following day.

They have been detected in the blood of drivers following road accidents.

And there are better ways to improve sleep than reaching for a pill.

Ensure the room is warm and dark with a comfortable bed, don't go to bed on an empty stomach but don't have a heavy meal, avoid caffeine and read a gentle book.

Daytime exercise is also important, but not just before going to bed.

Lack of sleep can be due to other problems such as depression or alcohol abuse.

So, is it really worth asking for a sleeping tablet with all the dangers just for that extra seven minutes of sleep? If you pay for your prescription that is more than £1 a minute.

If all else fails, try reading one of my columns — you'll be sleep before the end and they're not addictive.