Miya Pearson
Sleep disturbances are common, with 50 to 70 million people in the United States experiencing chronic sleep or wakefulness conditions. While there are many different types of sleeping pills available, both over-the-counter and prescription, providers don't typically recommend using them long-term due to the risk of dependence and addiction. Newer prescription medications on the market include orexin receptor antagonists, such as suvorexant (Belsomra), lemborexant (Dayvigo), and daridorexant (Quviviq). These medications have been FDA-approved for treating insomnia characterized by trouble falling and staying asleep.
| Characteristics | Values |
|---|---|
| New sleeping pills on the market | QUVIVIQ® (daridorexant), suvorexant (Belsomra), lemborexant (Dayvigo), doxepin (Silenor), Ramelteon (Rozerem), estazolam (Prosom) |
| How they work | QUVIVIQ is thought to work by turning down overactive wake signals, one of the biological causes of insomnia. Orexin receptor antagonists like suvorexant, lemborexant, and daridorexant block orexin receptors in the brain, which are thought to play a role in wakefulness. Ramelteon is a melatonin antagonist and may help a person fall asleep by affecting melatonin receptors and positively impacting circadian rhythms. |
| Benefits | QUVIVIQ has been clinically proven to help adults with insomnia get more sleep. Suvorexant, lemborexant, and daridorexant have been FDA-approved for treating insomnia. Doxepin is FDA-approved for treating insomnia characterized by difficulty staying asleep. Ramelteon can be prescribed for longer-term use due to its low likelihood of misuse or dependency. |
| Side effects | QUVIVIQ may cause decreased awareness and alertness the morning after taking it, and sleepiness during the day. Daridorexant has been associated with headaches. Ramelteon can cause side effects and allergic reactions. Doxepin and other antidepressants may have many potential side effects. |
| Precautions | QUVIVIQ should not be taken if you fall asleep often at unexpected times (narcolepsy) or if you are allergic to it. It should be taken every night within 30 minutes of bedtime and when you can stay in bed for at least 7 hours. Ramelteon should not be taken in more than a single 8 mg dose daily. Doxepin and other antidepressants should be used cautiously due to potential side effects. Sleeping pills should not be used long-term due to risks of dependence and addiction, and they may worsen snoring and sleep apnea. |
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What You'll Learn
Prescription vs. over-the-counter sleeping pills
Sleep disturbances are common, with an estimated 50 to 70 million people in the United States experiencing chronic sleep or wakefulness conditions. A range of prescription medications can help people fall asleep, stay asleep, or both. However, many of these medications carry risks of side effects, misuse, and dependency. Some sleep medications interact with other substances, including other medications, alcohol, and vitamin supplements.
Prescription sleeping pills are stronger than over-the-counter ones. Providers don't typically recommend using prescription sleeping pills long-term because they're not a cure for insomnia and there's a risk of dependence and addiction. They may help in some cases, but providers will usually only prescribe them for short-term relief. Benzodiazepines, for instance, can be addictive and are only recommended for short-term use (less than four weeks). To lower the risk of addiction, healthcare providers may prescribe Z-drugs instead, such as zolpidem (Ambien) or eszopiclone (Lunesta).
Over-the-counter sleep aids include melatonin, diphenhydramine (Benadryl), or doxylamine succinate (Unisom SleepTabs, Robitussin Nighttime Cough DM, and Vicks Nyquil D Cold and Flu Nighttime Relief). Melatonin supplements are widely available over the counter and can be a good choice for regulating your sleep-wake cycle after jet lag. Most OTC sleeping pills contain antihistamines, which work by blocking histamines that cause alertness.
If you're considering taking a sleep aid, consult your pharmacist or doctor first. They can help you determine the cause of your sleep disorder and make the best treatment decision based on your current medication and medical history. Often, nondrug treatments and behavioral changes are all you need for improved sleep.
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Side effects of sleeping pills
Sleeping pills can cause a range of side effects, from mild to severe. Some common side effects include constipation, diarrhoea, muscle weakness, and digestive problems such as gas, heartburn, and nausea. They can also worsen snoring and sleep apnea. It is important to note that sleeping pills can be habit-forming and lead to dependence, especially with prolonged use. This means that when you stop taking them, your insomnia may return or even worsen, a phenomenon known as rebound insomnia.
Additionally, sleeping pills can interfere with normal breathing and be dangerous for people with certain chronic lung problems such as asthma, emphysema, or chronic obstructive pulmonary disease (COPD). They may also cause allergic reactions and increase the risk of falls and hip fractures, especially in older adults, due to confusion and memory issues.
Furthermore, mixing sleeping pills with alcohol or other medications can lead to a deadly overdose. Combining sleep aids with alcohol or other sedatives can increase the effects of these substances, and there is also a risk of parasomnia, a disruptive sleep disorder where individuals may engage in dangerous behaviours while mostly asleep.
It is always advisable to consult a doctor before starting any sleep medication to ensure safe use and avoid potential interactions with other substances or health conditions.
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Safety concerns and risks of addiction
Sleeping pills are often associated with safety concerns and risks of addiction, which can be a significant issue for individuals struggling with sleep disorders or insomnia. While these medications can be effective in treating sleep problems, it is crucial to be aware of the potential risks involved.
One of the primary safety concerns with sleeping pills is their potential for misuse and addiction. Prescription sleeping pills, such as barbiturates, benzodiazepines (benzos), and Z-drugs like zolpidem (Ambien) and eszopiclone (Lunesta), are designed to be stronger than over-the-counter options. While they can be beneficial for short-term relief, healthcare providers typically do not recommend their long-term use due to the risk of dependence and addiction. Benzodiazepines, in particular, can lead to substance use disorders, so they are generally prescribed only for a limited duration.
Additionally, sleeping pills have been associated with various side effects that can impact an individual's daily functioning. Some people may experience daytime drowsiness or confusion, affecting their ability to perform tasks that require alertness and concentration. In some cases, parasomnia, a disruptive sleep disorder, may occur, leading to dangerous behaviours such as sleepwalking, eating, talking, or even driving while not fully awake. Sedatives, including some sleeping pills, can also worsen snoring and sleep apnea, a potentially life-threatening condition.
The interaction of sleeping pills with other substances is another safety concern. Mixing sleep aids with other sedatives or alcohol can increase the risk of overdosing. Additionally, certain sleep medications may interact with other medications, alcohol, or vitamin supplements, further complicating their effects on the body. It is always advisable to consult a doctor before starting any new sleep medication to ensure safe usage and avoid potential adverse reactions.
While sleeping pills can provide temporary relief from sleep issues, addressing the underlying causes of sleep disturbances through non-drug therapies, such as cognitive behavioural therapy (CBT), may offer a more sustainable and safer solution in the long run. Natural sleep aids, such as melatonin and valerian supplements, are also available and may be preferred by those seeking alternatives with potentially fewer side effects. However, even natural remedies should be used cautiously and under the guidance of a healthcare professional to ensure safe and effective use.
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Newer medications: QUVIVIQ (daridorexant)
QUVIVIQ (daridorexant) is a newer prescription medication for adults who have trouble falling asleep or staying asleep (insomnia). It belongs to a class of drugs called orexin receptor antagonists, which work by blocking orexin receptors in the brain associated with wakefulness. Unlike traditional insomnia medications, QUVIVIQ does not sedate the brain; instead, it is designed to be taken every night to help individuals achieve consistent, better sleep by reducing overactive wake signals.
QUVIVIQ has been clinically proven to help adults with insomnia sleep better. In clinical trials, improvements were observed after just one week of nightly use, with further enhancements noticed over 3-4 weeks. The medication should be taken within 30 minutes of bedtime and when one can stay in bed for at least 7 hours, as directed by a doctor.
As with other sleep aids, QUVIVIQ may cause side effects. The morning after taking QUVIVIQ, individuals may experience decreased awareness and alertness, impacting their ability to drive safely and think clearly. Daytime sleepiness may also occur, increasing the risk of falls. QUVIVIQ may also cause headaches, a common side effect of newer medications.
It is important to consult a healthcare provider before taking QUVIVIQ, especially for those with narcolepsy or allergies to any of the medication's ingredients. Additionally, individuals should discuss their full medical history with their healthcare provider to ensure safe and effective use.
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Natural sleep aids
While there are prescription medications available to help with sleep, natural sleep aids are also an option for those who want to avoid the potential side effects and addictive nature of sleeping pills.
Other natural sleep aids include magnesium, valerian root, and lavender. Some studies have also found that CBD and THC, compounds of the cannabis plant, can help people fall asleep and improve sleep quality. However, marijuana and THC products can be addictive, and withdrawal can aggravate sleep problems.
There are also behavioural adjustments you can make to improve your sleep, such as avoiding screen time and exercise close to bedtime, and keeping the lights off when getting up at night.
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Frequently asked questions
Yes, there are a few new sleeping pills on the market, including QUVIVIQ (daridorexant), suvorexant (Belsomra), lemborexant (Dayvigo), and ramelteon (Rozerem).
QUVIVIQ (daridorexant) is a prescription medicine for adults who have trouble falling asleep or staying asleep (insomnia). It is designed to be taken every night to help individuals get consistent, better sleep.
Unlike some other insomnia medications that sedate the brain, QUVIVIQ is thought to work by turning down overactive wake signals, one of the biological causes of insomnia.
The morning after you take QUVIVIQ, your ability to drive safely and think clearly may be decreased. You may also experience sleepiness during the day, which may increase your risk of falls.
Suvorexant (Belsomra), lemborexant (Dayvigo), and ramelteon (Rozerem) are some other new sleeping pills that have been FDA-approved for treating insomnia. These medications work by blocking orexin receptors in the brain, which are thought to play a role in wakefulness.
