Colin Snow
Sleep disturbances are common, with 50 to 70 million people in the United States experiencing chronic sleep or wakefulness conditions. While sleeping pills can provide short-term relief from insomnia, they also carry risks of side effects, misuse, and dependency. There are many different types of sleeping pills available, both over-the-counter and prescription, and it's important to consult a doctor before taking any sleep medication to ensure safe use and avoid potential interactions with other substances or medications. This is especially true for older adults, who may experience more side effects and are typically advised to explore non-drug treatments first. Natural remedies such as melatonin and valerian supplements are also options to consider, but even these over-the-counter aids can have side effects and should be used with caution.
| Characteristics | Values |
|---|---|
| Types of sleeping pills | Over-the-counter, Prescription |
| Natural remedies | Melatonin, Valerian |
| Over-the-counter examples | Benadryl Allergy, Advil PM, Tylenol PM |
| Prescription examples | Zolpidem, Sonata, Lunesta, Restoril, Ramelteon, Doxepin, Lemborexant, Daridorexant |
| Risks | Addiction, Dependence, Side effects, Overdose, Parasomnia, Worsening of other conditions |
| Precautions | Consult a doctor, Avoid mixing with other substances, Avoid long-term use |
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What You'll Learn
Natural sleep remedies
While sleeping pills can help with sleep, they are not always the best option. People over 65, in particular, should try non-drug treatments first. Sleeping pills can have side effects such as confusion, memory issues, and balance problems. They can also be addictive.
There are many natural sleep remedies that can be effective in promoting healthy sleep. Here are some suggestions:
- Melatonin is a hormone that is naturally released in the brain by the pineal gland about four hours before we feel sleepy. Melatonin supplements are available over the counter and can help reduce the time it takes to fall asleep and increase sleep duration. However, melatonin is unregulated and untested for long-term use, and some people report feeling groggy or depressed after taking it.
- Valerian is an herb that is said to aid relaxation and sleep. It is one of the leading natural supplements for managing anxiety and insomnia. However, there is limited evidence supporting its effectiveness in treating insomnia.
- Magnesium is another natural sleep aid that can help promote healthy sleep.
- Chamomile is a popular herbal sleep remedy that has been used for centuries. German chamomile is typically consumed as a tea, while Roman chamomile can be taken as a tincture due to its bitter taste. Both types are said to have a calming effect, helping people feel relaxed and more prepared for sleep. However, there is currently insufficient evidence to support its use in treating insomnia.
- Passionflower, or Passiflora incarnata, is a herbal remedy for insomnia that has shown promising results in animal studies. In one human study, participants who drank passionflower tea one hour before bed for a week reported improved sleep quality compared to those who drank a placebo tea.
- Lavender supplements have also been suggested as a natural sleep aid, although more research is needed to confirm their effectiveness.
- Tryptophan is an amino acid that can be found in foods such as turkey, cheese, nuts, beans, eggs, and milk. It is not available as a natural supplement, but consuming foods rich in tryptophan or its derivative 5-HTP can help boost serotonin levels, promoting feelings of calmness and sleepiness.
In addition to natural sleep aids, developing good sleep habits is crucial for healthy sleep. This includes avoiding exposure to bright lights from electronic devices before bed, maintaining a cool bedroom temperature, and refraining from working out within two hours of bedtime.
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Prescription vs over-the-counter
When it comes to sleep aids, there are a variety of options available, from natural remedies to over-the-counter choices and prescription medications. The best option for an individual depends on their specific circumstances and needs.
Over-the-counter sleep aids are easily accessible without a prescription and can include natural remedies like melatonin, which is a hormone that the body naturally produces to promote sleep, and valerian, an herb that aids relaxation and sleep. Other over-the-counter options include antihistamines such as diphenhydramine (Benadryl) and doxylamine succinate (Unisom SleepTabs, etc.). While these options are convenient, it is important to consult a healthcare provider before taking them, as they can interfere with other medications or aggravate certain health conditions.
Prescription sleeping pills, on the other hand, are stronger than over-the-counter ones and require a prescription from a healthcare provider. These include benzodiazepines, Z-drugs like zolpidem (Ambien) and eszopiclone (Lunesta), and melatonin receptor agonists such as ramelteon (Rozerem). While these medications can be effective for short-term relief, they are not recommended for long-term use due to the risk of dependence and addiction. Benzodiazepines, for example, can cause sedation that lasts into the following day, and there is a risk of building up a tolerance, requiring higher doses over time. Additionally, prescription sleeping pills can have side effects such as constipation, muscle weakness, and balance problems, which can negatively impact daily tasks.
In conclusion, while both over-the-counter and prescription sleep aids are available, it is important to consult a healthcare professional to determine the best course of treatment based on individual needs. Nondrug treatments and behavioural changes should also be considered before resorting to medication. It is worth noting that sleep issues are common among people with heart disease, and older adults are generally advised to explore non-drug treatments first due to the special risks associated with their age group.
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Side effects and risks
While sleeping pills can be effective in aiding sleep, they also come with certain side effects and risks that users should be aware of. Firstly, it is important to note that sleeping pills can cause dependency and addiction, especially when used long-term. Healthcare providers typically prescribe sleeping pills for short-term relief and advise against prolonged use due to the risk of developing a substance use disorder. Benzodiazepines, for example, are a type of prescription sleeping pill that can lead to addiction if misused.
Sleeping pills can also cause parasomnia, a disruptive sleep disorder where individuals engage in dangerous behaviours while mostly still asleep. People taking certain sleeping pills may sleepwalk, eat, talk, or even drive without being fully awake and aware of their actions. Additionally, these pills can worsen pre-existing conditions such as snoring and sleep apnea, which can be life-threatening.
Another important consideration is the interaction of sleeping pills with other substances. Mixing sleeping pills with alcohol or other sedatives can lead to a potentially fatal overdose. Sleeping pills may also interact with other medications, including pain medications, muscle relaxants, and vitamin supplements, increasing the risk of serious side effects. It is crucial to consult a healthcare provider and disclose your full medical history before taking any sleep aids to ensure safe usage.
Furthermore, sleeping pills can cause various side effects, including dizziness, nausea, headaches, dry mouth, constipation, and confusion. Elderly individuals are more susceptible to these side effects, as well as balance problems, which can increase their risk of falling and sustaining injuries. Additionally, certain sleeping pills may cause allergic reactions, and some, like Lunesta, can worsen depression or trigger suicidal thoughts.
Overall, while sleeping pills can provide temporary relief from sleep issues, they should be used with caution and under the guidance of a healthcare provider to mitigate potential side effects and risks. It is also important to explore alternative treatments and lifestyle changes, such as improving sleep habits and addressing any underlying medical conditions, to promote healthy sleep in the long term.
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Addiction and misuse
Sleeping pills can be addictive and are prone to misuse. Healthcare providers do not recommend their long-term use due to the risk of dependence and addiction. Benzodiazepines, for instance, can be addictive and lead to substance use disorder. Similarly, temazepam, which has the brand name Restoril, is a benzodiazepine that can cause dependency and addiction if a person misuses it.
Z-drugs, including zolpidem-containing medications, also carry a risk of dependency. Zaleplon (Sonata) has a high likelihood of misuse and also carries a risk of dependency. People taking Z-drugs may sleepwalk, eat, take medications, talk, or even drive while unaware of their actions. They may appear awake, but their brain is not fully alert. Most people do not remember doing these things after they wake up.
Sleeping pills can also cause parasomnia, a disruptive sleep disorder that can lead to dangerous behaviors. Mixing sleep aids with other sedatives or alcohol can result in a deadly overdose. Older adults are more susceptible to the sedative effects and side effects of sleeping pills, including confusion, memory issues, and balance problems, which can increase the risk of falls and hip fractures.
Over-the-counter sleep aids, such as melatonin and antihistamines, can also cause side effects like headaches, dizziness, and nausea. It is recommended that individuals consult a healthcare provider before taking any sleep aids, including supplements, as they can interfere with other medications or aggravate existing health conditions.
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Safe discontinuation
Sleeping pills are prescription medications that contain tranquilizers to treat insomnia, restless sleep, or difficulty falling asleep. While short-term use of sleeping pills is acceptable, they should not be used continuously over an extended period to avoid adverse side effects and the risk of dependence and addiction.
If you have been taking sleeping pills for a long time, it is important to consult your healthcare provider about how to discontinue their use safely. Safe discontinuation of sleeping pills typically involves gradually reducing the dosage over time, also known as "tapering". This process should be done under the guidance of a doctor, who may recommend therapeutic support or brief motivating contacts to help manage withdrawal symptoms.
Withdrawal symptoms can occur when sleeping pills are stopped abruptly, and these symptoms can be similar to those that the medication was originally intended to treat. For example, rebound insomnia, or a worsening of insomnia, may occur after stopping sleep aids. Other common withdrawal symptoms include trouble sleeping, restlessness, anxiety, shivering, dizziness, and feeling faint.
It is important to be cautious when discontinuing sleeping pills, as the process may take months. Abrupt discontinuation or going "cold turkey" is not recommended due to the risk of withdrawal symptoms and the potential for the vicious cycle of restarting sleep aid use to relieve these symptoms. Additionally, mixing sleep aids with other sedatives or alcohol can lead to the possibility of a dangerous overdose.
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Frequently asked questions
Some sleeping pills that are often prescribed include eszopiclone, doxepin, zolpidem, zaleplon, and temazepam. Melatonin and valerian are natural alternatives.
Sleeping pills can have side effects and safety risks. They should be taken only after consulting a healthcare provider and discussing your medical history. They are not recommended for long-term use due to the risk of dependence and addiction. Older adults are more susceptible to side effects and should explore non-drug treatments first.
Sleeping pills can cause dizziness, nausea, drowsiness, confusion, memory issues, balance problems, and breathing problems. They may also lead to parasomnia, a sleep disorder where people engage in dangerous behaviours while mostly asleep. Mixing sleeping pills with alcohol or other medications can cause an overdose.
Yes, there are alternatives to sleeping pills. Engaging in healthy sleep habits such as sleeping in a cool, dark room and avoiding distractions and large meals before bed can help improve sleep.
