Gina Johnson
Sleep aids and sleeping pills are medications that can help treat insomnia and other sleep disorders. They are available over the counter (OTC) or by prescription. OTC sleep aids often contain antihistamines, which can cause drowsiness, while prescription pills are stronger and may include antidepressants, benzodiazepines, and Z-drugs like zolpidem (Ambien) and eszopiclone (Lunesta). Natural sleep aids, such as melatonin and valerian, are also popular but can interfere with other medications. While sleeping pills can provide temporary relief, they are not a cure for insomnia and may lead to dependence and addiction. It is important to consult a healthcare provider before taking any sleep aids to understand their potential side effects and risks.
| Characteristics | Values |
|---|---|
| Availability | Over-the-counter (OTC), natural supplements, or by prescription |
| Types | Antidepressants, Barbiturates, Benzodiazepines (Benzos), Non-Benzodiazepine (Non-BZD) or Z-drugs, Melatonin, Valerian, Antihistamines |
| Effectiveness | Treat insomnia, make you feel drowsy and relaxed, reduce anxiety, promote sound sleep |
| Side Effects | Constipation, muscle weakness, prolonged drowsiness, headache, muscle aches, dry mouth, trouble concentrating, dizziness, unsteadiness, rebound insomnia, withdrawal symptoms, addiction |
| Precautions | Check with a healthcare provider, read medication materials, only take as directed, allow time to adjust |
| Alternatives | Non-drug therapies like cognitive behavioral therapy (CBT), natural sleep aids like melatonin, valerian, chamomile tea |
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What You'll Learn
OTC sleep aids and supplements
Over-the-counter (OTC) sleep aids and supplements are easily accessible, and no prescription is required to purchase them. However, it is recommended that you consult a healthcare provider before taking them as they can interfere with other medications or aggravate certain health conditions. OTC sleep aids often contain antihistamines, which can cause drowsiness. Common antihistamines include diphenhydramine and doxylamine succinate, which can cause side effects such as dry mouth, blurred vision, constipation, and trouble urinating.
Natural sleep aids like melatonin, valerian, and CBD are also available as supplements. Melatonin is a hormone that promotes sleep by influencing when you fall asleep and wake up. Valerian has a calming effect on the nervous system, aiding relaxation and sleep. Research suggests that melatonin can be helpful for individuals who have difficulty falling asleep and those with jet lag. However, it is unclear if it is effective for general insomnia. While these supplements are not regulated as strictly as other medications, they can still cause side effects such as headaches, dizziness, and nausea.
It is important to note that OTC sleep aids and supplements may result in daytime grogginess and can increase the effects of alcohol or other sleep medications. While they are generally not addictive, your body can develop a tolerance over time, requiring higher doses for the same effect. Therefore, it is crucial to never exceed the recommended dose on the packaging.
For extreme insomnia, a healthcare provider may prescribe short-term sleep aids, such as benzodiazepines or Z-drugs like zolpidem (Ambien) and eszopiclone (Lunesta). However, prescription sleep medications are typically not recommended for long-term use due to the risk of dependence and addiction.
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Prescription sleeping pills
Prescription sleep medications work in different ways. Benzodiazepines, for example, stimulate a chemical in the brain called GABA, leading to sedation, muscle relaxation, and reduced anxiety. They can be addictive, so healthcare providers only prescribe them for short periods. Z-drugs, such as zolpidem (Ambien) and eszopiclone (Lunesta), work by slowing down brain activity. However, they may cause parasomnia, a disruptive sleep disorder where individuals may sleepwalk, eat, talk, or even drive while mostly asleep.
Sleeping pills can cause various side effects, including constipation, muscle weakness, and a hangover effect the following day. Approximately 8 out of 10 people experience this hangover effect, feeling drowsy and having muddled thinking. These daytime effects can negatively impact daily activities, so caution is advised when taking sleep medicine.
It is important to consult a healthcare provider before taking any sleep aids, especially when considering prescription medication. They will determine the appropriate prescription and monitor its effects. Additionally, it is crucial to avoid mixing sleep aids with other sedatives or alcohol due to the risk of overdosing.
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Natural sleep aids
While over-the-counter and prescription sleep aids are easily accessible, they can cause side effects and interfere with other medications. Natural sleep aids, on the other hand, are often preferred as they tend to have fewer side effects and are generally safer.
Melatonin
Melatonin is a hormone naturally produced by the body in response to reduced light exposure. It signals to your brain that it's time to sleep. Melatonin supplements have become a popular natural sleep aid, helping people fall asleep faster and improve overall sleep quality. They are available over the counter, but it's important to be aware that they are unregulated and can have side effects or interfere with other medications.
Valerian
Valerian is a natural supplement that has a calming effect on the nervous system, promoting better sleep. It can be found in over-the-counter sleep aids or taken as a standalone supplement.
Magnesium and Lavender
Magnesium and lavender are also mentioned as potential natural sleep aids, but less information is provided about their effectiveness or how they work.
Cannabinoids
With the legalization of medical and recreational cannabis in many places, there is growing interest in the sleep-promoting properties of cannabinoids. THC and CBD, alone or in combination, have been found to help some people fall asleep, stay asleep, and improve sleep quality. However, marijuana and THC products can create dependence, and withdrawal can aggravate sleep problems. CBD has been found to relieve anxiety and improve sleep quality, but more research is needed to routinely recommend it for sleep disorders, and it is not recommended for pregnant or nursing people.
Other Tips for Better Sleep
In addition to natural supplements, there are behavioural adjustments you can make to improve your sleep:
- Avoid working out within two hours of bedtime, as it can raise your core body temperature, signalling to your body that it's time to be awake and active.
- Avoid the use of smartphones or other screens before bed, as the light interferes with sleep. If you need to get up during the night, use a flashlight instead of turning on the lights.
- Sleep in layers so you can adjust your bedtime temperature as needed.
- Avoid alcohol, which can interfere with sleep. Instead, try warm milk, chamomile tea, or tart cherry juice. While there isn't much scientific proof that these drinks improve sleep, there are no harmful side effects, and they can be a good alternative for those seeking treatment without drug interactions.
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Side effects and risks
Sleep aid pills can cause a range of side effects, from constipation to muscle weakness. Some sleep aid pills may also lead to digestive problems, including gas, heartburn, and nausea. They can also worsen snoring and sleep apnea. Sleeping pills can also cause a hangover effect, with approximately 8 out of 10 people experiencing this the day after taking sleep medicine.
Sleeping pills can be habit-forming, and it is possible to develop a tolerance over time, leading to an increased dosage or abuse of the medication. This can result in more severe side effects. In addition, sleep aid pills can cause a "rebound" effect, where insomnia returns worse than before if the medication is stopped. This effect can also take months to go away. It is important to gradually reduce the dosage of sleeping pills and not stop them abruptly to minimize the risk of rebound insomnia.
Sleeping pills can also cause dangerous behaviours, such as sleepwalking, sleep eating, sleep talking, and even sleep driving. These behaviours can be more common with increased dosage and are particularly associated with Z-drugs, a type of non-benzodiazepine sleeping pill. Other rare but serious side effects include allergic reactions and nocturnal behaviours, which should be addressed with a healthcare provider immediately.
Older adults are more susceptible to the side effects of sleeping pills, which can include confusion, memory issues, and balance problems, increasing the risk of falls and hip fractures. Therefore, it is recommended that older adults try non-drug treatments first, as there may be safer ways to improve sleep.
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Addiction and withdrawal
Sleep aids and pills can be helpful for those who have trouble sleeping, but they can also be addictive. Addiction to sleeping pills can develop quickly, especially if they are used for a long time or in high doses. This is known as physical dependence, which can lead to tolerance, where higher doses are required to achieve the same sedative effect. The risk of physical dependence increases with the duration of use, and even a few weeks of regular consumption can lead to dependence. Older types of sleeping pills, such as benzodiazepines, are more likely to cause addiction. Newer sleeping pills like Ambien, Lunesta, and Sonata, often called "Z-drugs", seem to be less physically addictive but may foster psychological addiction.
Withdrawal symptoms can occur when people suddenly stop using sleeping pills or sedatives. These symptoms can start within a few hours or even weeks after stopping the medication. Typical withdrawal symptoms include trouble sleeping, restlessness, anxiety, shivering, and dizziness. To avoid a relapse, it is important to keep withdrawal symptoms to a minimum when stopping the medication. This can be done by gradually reducing the dose over several weeks before stopping the medication completely. This strategy is known as tapering and can help mitigate withdrawal symptoms and facilitate a smoother transition to natural sleep patterns. Medical professionals may also address specific symptoms such as hypersomnia, anxiety, irritability, and physical discomfort during the tapering process.
In cases of established dependence, medical detoxification may be necessary. Psychological dependence on sleeping pills is also a significant concern and can manifest without physical addiction. Cognitive-behavioral therapy is often recommended to help manage cravings and address the underlying thought patterns contributing to the dependence. Therapeutic support is crucial in helping individuals understand the risks associated with long-term use of sleeping pills.
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Frequently asked questions
Sleep aid pills are medications that can help you fall asleep and relieve stress and anxiety. They are available over the counter (OTC) or by prescription.
Sleep aid pills make you feel drowsy and relaxed. Some pills also silence the area of your brain that keeps you alert.
Sleep aid pills can have various side effects, including confusion, daytime sleepiness, parasomnia, constipation, difficulty urinating, dry mouth or throat, decreased sexual drive, and weight gain. Sleep aid pills can also be habit-forming and cause withdrawal symptoms when stopped abruptly.
Yes, sleep aid pills can be addictive. Many people may not realise they have an addiction until they try to quit, and discontinuing the medication can cause withdrawal symptoms and worsen insomnia.
Alternatives to sleep aid pills include natural sleep aids such as melatonin and valerian, as well as non-drug therapies like cognitive behavioural therapy (CBT). Lifestyle adjustments such as limiting caffeine intake and practicing good sleep hygiene can also help improve sleep.
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