Prescription Sleeping Tablets: Are They Over-The-Counter?

do i need a prescription for sleeping tablets

In the UK, there are two ways to get sleeping pills: by prescription or over the counter. Prescription sleeping pills are typically stronger and used for severe insomnia, whereas over-the-counter sleep aids are milder and promote sleepiness. While over-the-counter sleep aids can be useful for short-term sleep problems, ongoing sleep issues should be addressed with a doctor, who can advise on prescription sleep medication, lifestyle changes, or psychological treatments such as cognitive behavioural therapy.

Characteristics Values
Availability Over the counter or by prescription
Strength Stronger tablets are available by prescription
Use Short-term treatment for severe insomnia
Side effects Metallic taste in the mouth, dry mouth, daytime sleepiness
Addiction Yes, your body can become dependent on it
Duration Prescribed for 2-4 weeks

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Prescription vs over-the-counter sleeping pills

Sleeping pills are available over the counter (OTC), as natural supplements, or by prescription. While they can be effective in helping you fall asleep, it is important to understand the differences between prescription and over-the-counter sleeping pills to make an informed decision about which option is best for you.

Over-the-Counter Sleeping Pills

Over-the-counter sleeping pills are easily accessible without a prescription from a healthcare provider. They are typically antihistamines, which treat allergies but also have a drowsy side effect. Common ingredients in OTC sleeping pills include diphenhydramine and doxylamine. While these pills can be effective for occasional short-term insomnia, they are not a long-term solution for chronic sleep problems. It is important to consult your healthcare provider before taking OTC sleeping pills, as they can interfere with other medications or aggravate existing health conditions.

Natural Sleeping Pills

Natural sleeping pills, such as melatonin and valerian supplements, are also available without a prescription. Melatonin is a hormone naturally produced by the body that promotes sleep. Valerian, on the other hand, is an herb that aids relaxation and sleep. While these natural remedies are easily accessible, it is still important to check with your healthcare provider before taking them to ensure they are safe for you.

Prescription Sleeping Pills

Prescription sleeping pills are stronger than over-the-counter options and require a prescription from a healthcare provider. They are typically recommended for short-term relief of severe insomnia and are not usually prescribed long-term due to the risk of dependence and addiction. Types of prescription sleeping pills include benzodiazepines and non-benzodiazepine Z-drugs like zolpidem (Ambien) and eszopiclone (Lunesta). Benzodiazepines work by stimulating GABA, a chemical in the brain that leads to sedation, muscle relaxation, and reduced anxiety. Z-drugs, on the other hand, work by slowing down brain activity. While they can be effective, prescription sleeping pills also come with a risk of side effects and potential for substance use disorder.

Factors to Consider

When deciding between prescription and over-the-counter sleeping pills, it is important to consider your individual needs and specific circumstances. Consult your healthcare provider to determine the best option for you based on your medical history and the underlying causes of your sleep disorder. It is also important to keep in mind that sleeping pills, whether prescription or over-the-counter, should be used in conjunction with good sleep hygiene practices and should not be relied upon as a long-term solution for insomnia.

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Antihistamines as sleep aids

Antihistamines are a type of medication typically used to treat symptoms of allergies, such as hay fever. However, drowsiness is often a side effect of antihistamines, and they can be purchased over the counter as a sleep aid. Antihistamines can be useful for short-term insomnia, but they are not a cure. They should only be used for one to two weeks and are not recommended for long-term use.

While antihistamines can help you fall asleep, they do not typically improve overall sleep quality. They are long-acting medications, which means their effects last longer, and they are more likely to cause a 'hangover' effect the next day. They may also be slow to act, so they may not make you feel sleepy straight away, and they can lose their effectiveness with continued use.

Antihistamines can also cause side effects such as disorientation, altered mental state, urinary retention, and dry mouth. While these side effects are generally mild, they can pose a risk, especially for older people. Antihistamines have also been linked to sleepwalking and other parasomnias. In some cases, they can even cause hyperactivity, particularly in children.

If you are considering using antihistamines as a sleep aid, it is important to consult your pharmacist or doctor first, especially if you have an enlarged prostate gland, problems urinating, glaucoma, or porphyria. They may also not be suitable for those who are pregnant or breastfeeding.

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Natural sleep aids

In most cases, you will need a prescription to obtain sleeping tablets. Sleeping pills can have serious side effects, and it is possible to become dependent on them. They are usually only prescribed for a few days or a few weeks at most.

However, there are many natural sleep aids that can help you get a good night's sleep. These include:

  • Melatonin supplements: Melatonin is a hormone that is naturally released in the brain four hours before we feel sleepy. Exposure to unnatural light after dark can prevent melatonin release, making it difficult to fall asleep. Melatonin supplements are available over the counter and can help regulate your sleep cycle.
  • Warm milk, chamomile tea, and tart cherry juice: While there is not much scientific proof that these drinks work, they are worth trying if you want a treatment without side effects or drug interactions. Warm milk is believed to be associated with chemicals that simulate the effects of tryptophan on the brain, a chemical building block for serotonin, which is involved in the sleep-wake transition. Chamomile tea is believed to have flavonoids that may interact with benzodiazepine receptors in the brain, which are involved with the sleep-wake transition. Tart cherry juice might support melatonin production and a healthy sleep cycle.
  • Exercise: Physical activity can improve sleep, although researchers are not completely sure why. Moderate aerobic exercise increases the amount of nourishing slow-wave (deep) sleep you get. However, it is important to time your workouts right, as aerobic exercise releases endorphins, which can keep people awake. Try to avoid working out within two hours of bedtime.
  • Keep your room cool: The ideal temperature for your thermostat is between 65 and 72 degrees. If you are going through menopause and experiencing hot flashes, keep your room as cool as possible and wear cotton or breathable fabrics to bed.
  • Limit light exposure: The light from smartphones and other electronic devices interferes with sleep. If you need to get up during the night, use a flashlight instead of turning on the lights. It can take up to 30 minutes to fall back asleep after a bathroom break, which is completely normal.
  • Magnesium: Magnesium is a mineral that plays an important role in many bodily processes, including brain function and heart health. It may help quiet the mind and body, making it easier to fall asleep. Magnesium is known to relax muscles and induce sleep, and it may also help regulate melatonin production.
  • Valerian root: Valerian is an herb native to Asia and Europe, and its root is commonly used as a natural treatment for symptoms of anxiety, depression, and menopause. It is one of the most commonly used sleep-promoting herbal supplements in the United States and Europe. Some studies have shown that valerian root can improve sleep quality and sleep disorder symptoms, especially in menopausal and postmenopausal women. However, other studies have found that valerian's positive effects are negligible. Short-term intake of valerian root appears to be safe for adults, but the safety of long-term use is uncertain.
  • Lavender: The soothing fragrance of lavender is believed to enhance sleep. Several studies suggest that smelling lavender oil shortly before sleep may improve sleep quality in those with or without insomnia. Lavender aromatherapy is considered safe, but oral ingestion of lavender has been linked to nausea, belching, and diarrhea in some cases.
  • Passionflower: Passionflower is a popular herbal remedy for insomnia, and its sleep-promoting effects have been demonstrated in animal studies. However, its effects in humans vary depending on the form consumed. Some studies have found that passionflower tea or extract may slightly improve sleep quality, while others have found no effects. Passionflower intake is generally safe for adults.
  • Glycine: Glycine is an amino acid that plays a role in the nervous system, and it may help improve sleep. It is thought to act in part by lowering body temperature at bedtime, signalling that it is time to sleep. Several studies have found that consuming glycine before bedtime can help people fall asleep faster and improve overall sleep quality.
  • Cannabidiol (CBD): CBD is a compound derived from hemp, and it is featured in many products, including oils and capsules. It contains low amounts of tetrahydrocannabinol (THC), the psychoactive compound in cannabis, so it does not cause the same high as other cannabis products. Some studies have found that CBD can relieve anxiety and act as a natural sleep aid, but more research is needed. CBD is not recommended for people who are pregnant or breastfeeding, and it is classified as a controlled substance in some states.
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Side effects of sleeping tablets

Sleeping tablets can have several side effects, and their use can lead to dependence. While they can be effective in the short term, taking them every night raises questions about safety and potential risks.

Some common side effects of sleeping tablets include:

  • Daytime drowsiness, dizziness, and impaired coordination, which can affect daily functioning.
  • Cognitive impairment, including memory and attention problems.
  • Increased risk of falls and accidents due to dizziness and impaired coordination.
  • Mood changes, such as increased irritability, anxiety, or depression.
  • Withdrawal symptoms when discontinuing long-term use, making it challenging to stop.
  • Burning or tingling sensations in the hands, arms, feet, or legs.
  • Constipation or diarrhoea.
  • Dizziness, lightheadedness, or impaired balance.
  • Gas, heartburn, stomach pain, nausea, or changes in appetite.
  • Uncontrollable shaking.
  • Weird dreams or nightmares.
  • Sleepwalking, sleep talking, sleep eating, and sleep driving.
  • Allergic reactions, such as chest pain, difficulty breathing, itching, rash, hives, irregular heartbeat, or throat-closing sensations.

Sleeping tablets can also cause rebound insomnia, where insomnia symptoms temporarily worsen when trying to stop taking the medication. This can lead to a cycle of dependence on the medication.

It is important to speak to a doctor or healthcare professional before taking any sleeping medication to ensure safe and effective use. They can assess your situation, review your medication, and monitor your progress.

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When to seek medical advice

If you are experiencing insomnia, it is recommended that you try changing your sleeping habits first. This includes:

  • Maintaining a regular sleep-wake schedule, even on weekends.
  • Reducing screen time before bed and limiting light in your bedroom.
  • Exercising regularly, but not within 4-6 hours of bedtime.
  • Avoiding caffeine, alcohol, nicotine, and other drugs, especially close to bedtime.
  • Not napping during the day.
  • Relaxing before bed with activities such as meditation, yoga, or reading.
  • Ensuring your bedroom is comfortable, dark, and quiet.

If these measures do not help, and your insomnia is affecting your daily life and ability to function, it is important to seek medical advice. This is particularly important if your insomnia has lasted for more than three or four weeks.

When you visit your doctor, it is helpful to bring a record of your sleep habits and any questions you have. Your doctor may recommend behavioural therapy, such as cognitive behavioural therapy (CBT), or, in rare cases, prescribe sleeping pills for a short period of time.

Frequently asked questions

It depends on the type of sleeping tablet. In the UK, you can get milder sleeping tablets over the counter, but stronger ones are only available with a prescription.

Over-the-counter sleeping tablets are usually antihistamines, such as diphenhydramine and promethazine. They are also available as herbal remedies, which include ingredients such as valerian root, chamomile, lavender, magnesium, and vitamin B12.

Prescription sleeping tablets are usually "Z drugs", such as zolpidem and zopiclone.

If you are experiencing ongoing sleep problems and over-the-counter sleep aids are not working, you should talk to your doctor. They can help establish the causes of your insomnia and suggest the right solutions, which may include prescription sleep medication, lifestyle changes, or psychological treatments such as cognitive behavioural therapy.

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