Americans are taking sleeping pills like never before, fueled by frenetic work days that do not go gently into a great night's sleep, and lulled by a surge of advertising that promises safe slumber with minimal side effects.

About 42 million sleeping pill prescriptions were filled last year, according to the research company IMS Health, up nearly 60 percent since 2000.

But some experts worry that the drugs are being oversubscribed without sufficient regard to known, if rare, side effects or the implications of long-term use. And they fear doctors may be ignoring other conditions, like depression, that might be the cause of sleeplessness.

Although the newer drugs are not believed to carry the same risk of dependence as older ones like barbiturates, some researchers have reported what is called the "next day" effect, a continued sleepiness hours after awakening from a drug-induced slumber.

Fully 10 percent of Americans report that they regularly struggle to get to sleep or to stay asleep throughout the night. And more and more are turning to a new generation of sleep aids like Ambien, the bestseller, and its newest competitor, Lunesta. In the last year, much of the advertising surge has been a result of competition from Lunesta, which the drug maker Sepracor introduced last April to compete with Ambien. Through November Sepracor led the sleeping pill advertising field, spending more than $185 million, according to figures from TNS Media Intelligence, which did not have final figures for December.

In response, Sanofi-Aventis, marketing both Ambien and its controlled-release version, Ambien CR, spent $107 million from last January through November, according to TNS. That was nearly double its ad spending on Ambien in 2004.

Even the most infrequent U.S. television viewers would have trouble missing the Lunesta ads, which feature a Luna moth fluttering around the bed of a peaceful sleeper. Jacobs says that in one hour of primetime television the other night, he saw three ads for sleeping pills.

"You've got the patient population being bombarded with advertising on TV," Jacobs says. "You've got increased advertising to physicians. You've got a formula for sales going up dramatically."

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Last updated: 03/09/2006 - 06:40 PM