It is call to action that has been mentioned on a regular basis. There is a drug on the market that despite repeated requests from the public and medical profession continues to be available. It's called Stilnox, the chemical name being Zolpidem. It's a newer type of sleeping tablet, and has been linked to a number of adverse events, usually related to amnesia after taking it, and has been reported to have led to patients performing acts they have no recollection of the next day.
This I don't refute, and, just as an aside, other sleeping tablets can lead to the same adverse effects. The risk of these events occurring seem to be increased when patients combine Stilnox with alcohol, which is against the recommendations of the manufacturer.
The NRL have raised concerns that Stilnox use is rampant among rugby players, and they feel the medication is being used to achieve a 'high' in players that are subjected to random drug tests, because it is not seen as a performance enhancing drug, hence goes undetected during routine drug screening. Perhaps they are referring to the adverse effects as outlined above. But Stilnox does not act on the same chemicals in the brain as amphetamines, so I am not sure about this.
What really annoys me about this whole debate associating athletes and sleeping tablet use is that we are not addressing the underlying question. Why do elite athletes need to use sleeping tablets like Stilnox at all?
As a clinician who specialises in sleep disorders, I am aware of the high rates of anxiety and sleep problems in elite athletes. While there will always be a temptation for some to misuse substances, by and large elite athletes have sleeping problems because of unrealistic expectations placed on them by their clubs. Athletes become sleep deprived as they attempt to adhere to match timetables, early morning training and jet lag when travelling to and from international events.
What is more rampant within the sporting profession than Stilnox use is a lack of understanding of the impact of 'cheating sleep'. Sleep is often seen as something to trade off against late nights and early morning obligations. This is despite the growing body of evidence which demonstrates convincingly that chronic sleep deprivation leads to a range of health problems, including obesity and cardiac disease.
Take for example the way the AFL match fixture runs in 2014 compared to when I started watching about 30 years ago. Matches can run untill 11pm on a Friday or Saturday night, players travel interstate on a regular basis and must attend early morning training sessions. Or, what about Olympic athletes that travel to other countries and are in the pool or on the track well before jet lag has dissipated, expected to do their very best during hours when they would normally be asleep. Sleep is 'cheated' at the very times that they are under scrutiny to do well. And this is without the added effects of performance anxiety which may also cause temporary insomnia.
So do we ban a drug or educate the sporting profession about the need for restorative sleep? I don't advocate that we use sleeping tablets on anything more than a temporary basis, and always in conjunction with psychological and behavioural strategies. But if external pressures mean physically less time in bed, how do athletes cope? Is this really why the use of sleeping tablets is rife within the sporting profession? And why label an athlete as a drug user when they have legitimate sleep disturbance and need professional help?
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