STATS ARTICLES 2005

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Kids Using Sleeping Pills
November 20, 2005
Rebecca Goldin and Grace Harris
USA Today avoids hysteria; New York Times hides an opinion with a lot of random stats

USA Today and the New York Times both reported on a recently published Medco Health Solutions study on sleeping medication use. Focusing on the study's findings that adolescent and child usage of prescription sleep medication has increased, the two newspapers published two very different interpretations of the study. USA Today admirably avoided shocking headlines, and thoughtfully analyzed the data from the study. In contrast, the New York Times lumped together the data on sleeping pills with data on over-the-counter sleeping medications, and data on prescription drugs that are not sleeping medications.

The Medco study looked at sleep medication usage from 2000 to 2004 and found that child and adolescent use of prescription sleeping pills increased by 85% over that time period. The number of kids prescribed these pills is small: about 3 in 1000.

USA Today correctly emphasized that adolescents are not becoming addicts. Not only are the numbers of those taking the pills small, but 61% of prescriptions for sleeping pills for children were never refilled, suggesting that the medication was used once or for a short period. USA Today also notes that 39 percent of adolescent users were also taking at least one other behavioral drug. This figure suggests that “many kids getting the pills… have complex health problems, not just insomnia.”

Another important point made by USA Today is that doctors sometimes prescribe antidepressants for children rather than sleeping pills, because the antidepressants have a longer (and therefore more reliable) history. As time goes on, it stands to reason that doctors would become more confident that sleeping pills do not carry big risks, and prescribe them more frequently.

While we laud USA Today’s attempt to keep the risk in perspective, we also note that this conservative interpretation may be underestimating the trend in prescription drug use for young people. If children are already over-medicated (due to overly-aggressive treatment of symptoms that seem like depression, anxiety, ADHD, etc) as some parties have suggested, then the increase in prescribing sleeping pills may be a symptom of a larger problem: instead of dealing with the problem through behavioral and therapeutic means, we drug our kids. We do not necessarily support this thesis, but the Medco data is certainly consistent with it.

In contrast, The New York Times mauled the issue entirely. They begin with the statement that it may never be a good idea for an adolescent to take sleeping pills. After citing various statistics, they contradict their own opinion with expert testimony: “Yet even cautious physicians say there are times when it makes sense to prescribe sleeping pills for children in combination with behavioral strategies in an effort to battle insomnia.”

Sleeping pills-or-not aside, the New York Times confuses the data. The Medco study specifically refers to the number of kids 10-19 taking sleeping medications- these are drugs designed to combat sleeping disorders. The New York Times throws together an assortment of drugs, from true sleeping pills, to antihistamines, anxiety drugs, and high blood pressure drugs. All of these drugs may aid sleep, but only the sleeping pills were part of the Medco results. For flavor, they also toss in a statistic about the percentage of pediatricians who occasionally prescribe over-the-counter cold medicines as sleeping aids. This information, of course, tells us nothing about how many kids were told to take the aids, nor what the trend is.

The reader of the New York Times is left with a lot of data adding up to very little information, either on trends or on the proportion of the problem. They are handed on a platter the idea that “sleeping meds are bad news’ without any discussion of the risks associated with any of the medications they mention. Indeed, even the cited experts don’t seem to concur.

The root cause of the increase in usage of sleeping pills among adolescents and children is unclear. Perhaps doctors are becoming more comfortable prescribing better or more time-tested drugs. Perhaps doctors have always been prescribing sleeping aids to children at these rates but had previously been using surrogate medication whose main use is not to aid sleep. While USA Today did a great job of dampening hysteria over drug-usage rates, neither newspaper was particularly astute at addressing what the problem with prescription sleep medication really is.