Experts have warned that people are accidentally killing themselves while taking common insomnia drugs.
Government health officials in the US have ordered drug makers to add warning labels to certain prescription sleeping pills after a review.
The Food and Drug Administration found rare but serious injuries, including death, in those taking popular medicines.
They included eszopiclone, zaleplon and zolpidem, which are marketed under brand names — and also widely prescribed in the UK.
People taking the medication had reported sleepwalking, sleep driving and engaging in other activities while not fully awake.
Of the 66 reported cases, 20 were fatal and included drowning, falls, car crashes and carbon monoxide poisoning.
Other serious injuries included brain hemorrhages, spine fractures and broken hips from falls.
People had also accidentally overdosed, developed hypothermia, burned themselves, suffered gunshot wounds and attempted or contemplated suicide.
US regulators now require “black box warning labels” on the medication, which are branded as Sonata, Stilnoct and Zimovane in the UK.
Acting FDA Commissioner Ned Sharpless said in a statement: “While these incidents are rare, they are serious and it’s important that patients and health care professionals are aware of the risk.
“These incidents can occur after the first dose of these sleep medicines or after a longer period of treatment, and can occur in patients without any history of these behaviors and even at the lowest recommended doses.”
Known as Z-drugs, these types of sleeping pills were developed to try to overcome some of the problems associated with benzodiazepines, but they act in a very similar way.
They are prescribed for severe problems only and should only be used for a short time in the lowest effective dose.
According to Mind, all Z-drugs can occasionally cause a type of sleepwalking, when you may get up and do things while you are not really awake.
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These include dangerous activities like driving, eating — sometimes raw food — having sex and being violent to your partner in bed.
The National Institute for Health and Care Excellence has issued doctors guidelines on the use of Z-drugs, including zalepon, zolpidem and zopiclone.
Among various warnings, they say doctors should not prescribe a sleeping pill unless non-drug treatments have been unsuccessful.
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