Colin Snow
Sleeping pills are medicines designed to help people fall asleep or stay asleep, usually prescribed for short-term use in the treatment of insomnia. While they can be effective, they are not a cure for insomnia and come with certain risks, including the possibility of dependence and addiction. Doctors will usually recommend lifestyle changes or therapy before prescribing sleeping pills, and even then, they are typically prescribed for a few days or weeks at most.
| Characteristics | Values |
|---|---|
| Prescribed by GPs | Yes, but only for a few days or weeks |
| Purpose | Help patients fall asleep or stay asleep |
| Side effects | Dependence, addiction, parasomnia, worsened snoring and sleep apnea |
| Risk factors | Interference with other medications, overdose, unsteadiness, worsened insomnia |
| Alternatives | Lifestyle changes, talk therapy, behavioural treatments, non-drug treatments |
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What You'll Learn
Sleeping pill side effects
Sleeping pills can be an effective short-term solution for sleep problems, but they are not intended as a long-term treatment. Sleeping pills can cause a range of side effects, and it is important to be aware of these before taking them.
Firstly, sleeping pills can cause drowsiness and confusion that lasts into the day, impacting your ability to drive, work, or perform other daily tasks. This can be dangerous, especially for older adults, who may experience falls, broken hips, and car accidents as a result of the slowed reaction times caused by sleeping pills.
Secondly, sleeping pills can cause digestive problems, including constipation, diarrhea, gas, heartburn, and nausea. They can also cause muscle weakness and worsen snoring and sleep apnea, a potentially life-threatening condition.
Additionally, sleeping pills can lead to dependence and addiction. When you take sleeping pills regularly, your body may start to depend on them, and stopping them may cause rebound insomnia, which can be worse than the original condition. Certain sleeping pills, such as benzodiazepines, are potentially addictive and can cause problems with memory and attention.
Furthermore, sleeping pills can cause parasomnias, which are complex sleep behaviors that occur while the person is still mostly asleep. People taking sleeping pills may sleepwalk, eat, talk, take medications, or even drive without being fully awake and aware of their actions. These behaviors can be dangerous and may result in serious consequences.
It is important to consult your healthcare provider before taking sleeping pills, as they can interfere with other medications or health conditions, especially lung diseases, chronic kidney disease, liver disease, or obstructive sleep apnea. Sleeping pills are generally not recommended for children, older adults, pregnant or breastfeeding women, or individuals with certain health conditions.
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Short-term insomnia
If short-term insomnia persists, a GP may recommend cognitive behavioural therapy (CBT), either face-to-face with a therapist or through an online self-help programme. CBT can help to change the thoughts and behaviours that keep one from sleeping.
GPs rarely prescribe sleeping pills to treat insomnia due to their serious side effects and potential for dependence and addiction. However, in some cases, GPs may prescribe sleeping pills for short-term relief. Prescription sleeping pills are typically stronger than over-the-counter ones, and they may help one fall asleep faster and sleep longer by a few minutes.
Some prescription medications that a doctor may prescribe for short-term insomnia relief include:
- Zaleplon (Sonata): may help one fall asleep but does not help maintain sleep; has a risk of dependency and misuse
- Zolpidem (Ambien, Intermezzo, Zolpimist): may help with falling asleep and sleep maintenance; may cause complex sleep behaviours
- Eszopiclone (Lunesta): may help one fall and stay asleep; may cause complex sleep behaviours, such as sleepwalking or driving while asleep; has a risk of misuse and dependency
- Doxepin (Silenor): may help one fall and stay asleep for up to 3 months; available in 3 and 6 mg doses
- Estazolam (Prosom): may help with falling and staying asleep; has a risk of misuse and dependency; typically prescribed in 1 or 2 mg doses
- Triazolam (Halcion): typically prescribed for 7 to 10 days; has a potential for dependency and misuse
- Restoril: available for short-term treatment of insomnia, typically for 7 to 10 days; may cause various side effects and should not be taken by pregnant people
- Temazepam: a benzodiazepine that may be prescribed for short-term relief
- Mirtazapine: an antidepressant that can knock one out
- Zopiclone: may have side effects like short-term memory loss
- Suvorexant: a newer medicine that can be used for longer periods of time than other prescription sleeping pills; blocks chemicals in the brain that keep one awake
- Melatonin: a natural hormone that helps control one's sleep and waking pattern; may improve sleep quality and morning alertness; typically available for people over 55 with poor sleep
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Prescription alternatives
While sleeping pills can be effective in the short term, they are not a cure for insomnia and can have side effects. Healthcare providers generally do not recommend their long-term use due to the risk of dependence and addiction. They can also cause a hangover effect, with around 8 out of 10 people experiencing negative side effects the day after taking sleep medicine.
Some prescription alternatives to sleeping pills include:
- Doxepin, which is available under the brand name Silenor and is recommended for use for up to 3 months.
- Triazolam (Halcion), which is typically prescribed for 7 to 10 days.
- Temazepam, which has the brand name Restoril and is a benzodiazepine. It is usually prescribed for 7 to 10 days.
- Ramelteon (Rozerem) is a melatonin-based medication that can be prescribed for longer-term use.
Non-Prescription Alternatives
Some non-prescription alternatives to sleeping pills include:
- Melatonin supplements, which promote sleep by influencing when you fall asleep and wake up.
- Valerian supplements, which have a natural calming effect on the nervous system.
- Over-the-counter antihistamines, which block histamines that cause alertness. Common ingredients include diphenhydramine and doxylamine.
It is important to note that while these supplements and over-the-counter medications are easily accessible, you should still check with your healthcare provider before taking them as they can interfere with other medications or make health conditions worse.
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Over-the-counter sleep aids
While prescription sleep medication does exist, over-the-counter (OTC) sleep aids are easily accessible and can be bought without a prescription. OTC sleep aids are best used in the short term to overcome a brief bout of sleeplessness or to cope with jet lag. They are not recommended for long-term use or for treating chronic insomnia. Before taking any sleep medication, it is important to talk to a doctor to understand the options, benefits, and risks.
There are several categories of OTC sleep aids:
- Antihistamine-containing sleep aids: These can help if you have congestion and a cough from the flu or an upper respiratory infection. Doxylamine succinate is a sedating antihistamine that can make you drowsy at night, but it can also cause daytime sleepiness, dry mouth, blurry vision, constipation, and trouble urinating. Diphenhydramine is another sedating antihistamine found in many non-prescription sleep and allergy medicines.
- Melatonin: Melatonin is a synthetic version of a hormone naturally produced by the body to regulate the sleep-wake cycle. While it can be bought over the counter, it is not regulated by the Food and Drug Administration as strictly as other medications.
- CBD/cannabidiol: CBD is a derivative of the cannabis plant that does not contain THC, the compound responsible for the "high" associated with marijuana. It is available in multiple forms, including pills, edibles, patches, and creams. While it has been found to relieve anxiety, a common contributor to insomnia, there is currently no conclusive data on its effectiveness as a sleep aid.
It is important to be aware of the side effects and risks associated with OTC sleep aids. They can interfere with other medications or make health conditions worse. Additionally, while they do not typically lead to dependency, the body can develop a tolerance to them over time, requiring higher doses to achieve the same effect.
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Safe cessation
Sleeping pills are medicines designed to help individuals with sleep disorders like insomnia fall asleep and stay asleep. They are also referred to as hypnotics, sleep aids, sleep medicines, tranquilizers, or sedatives. While they can be effective in the short term, they are not a cure for insomnia and are not recommended for long-term use due to the risk of dependence and addiction.
If you have been taking sleeping pills for a while, it is important to consult your healthcare provider about how to stop safely. Abruptly stopping the use of sleeping pills can lead to severe withdrawal symptoms such as anxiety, confusion, convulsions, sweating, tremors, and sleep disturbances. To avoid this, a gradual reduction in dosage over time, known as tapering, is recommended. This process should be undertaken with medical supervision, which can include psychological or therapeutic support, to ensure safety and minimise withdrawal symptoms.
It is crucial to follow your healthcare provider's instructions and only use sleeping pills for the shortest duration possible. If you experience any adverse effects, consult your doctor immediately to prevent the development of physical or emotional dependence.
Additionally, it is important to practice good sleep hygiene by creating a conducive sleep environment, maintaining a consistent sleep schedule, and controlling factors like noise and temperature. This can help improve your sleep quality and reduce your reliance on sleeping pills.
Remember, sleeping pills are typically a short-term solution, and addressing the underlying causes of insomnia or sleep difficulties is crucial for long-term improvement.
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Frequently asked questions
Yes, GPs can prescribe sleeping pills, but they are usually only recommended for short-term use.
Sleeping pills can cause drowsiness, confusion, memory issues, and balance problems. They can also be addictive, especially when taken over a long period of time.
Yes, there are several alternatives to sleeping pills. Doctors might recommend lifestyle changes, talk therapy, or other medications that treat underlying conditions causing insomnia.
Sleeping pills can interfere with other medications and may make existing health conditions worse. They are also not recommended for children, older adults, or individuals with certain pre-existing conditions.
