Herbie Murray
Sleeping pills are mostly considered safe, but they carry some known side effects and pose a risk to your health. Sleeping pills are usually reserved for those with diagnosed insomnia and are meant to be used for short-term relief of sleeplessness. While the majority of sleeping pills have not been linked to liver injury, certain over-the-counter sleep aids have been associated with liver damage.
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What You'll Learn
Sleeping pills are mostly safe but carry some side effects
Over-the-counter sleep medication is generally safer, but it should still be taken as directed, as misuse can lead to dangerous side effects. For example, a 2015 study linked the regular, long-term use of over-the-counter sleep medicines containing diphenhydramine, such as Benadryl and Tylenol PM, to an increased risk of dementia. Anticholinergic drugs, such as diphenhydramine, block the activity of acetylcholine, a brain chemical involved in muscle activation and brain functions like alertness, learning, and memory. In men with prostate conditions, these drugs can also cause urinary retention or problems fully emptying the bladder.
Benzodiazepines, a class of drugs used to treat insomnia and anxiety, can be potentially addictive and cause side effects like memory and attention problems. Nonbenzodiazepines, such as Ambien and Lunesta, have a shorter half-life, resulting in fewer side effects than benzodiazepines, but they are also less effective at maintaining sleep. However, some nonbenzodiazepines have been linked to dangerous and complex sleep-related behaviours, such as sleepwalking and sleep-driving, leading to rare but serious injuries and even deaths.
While sleeping pills can be habit-forming, there are non-addictive alternatives available, such as Rozerem, which affects the brain hormone melatonin, and Silenor, a low-dose form of the antidepressant doxepin. Most sleeping pills have not been linked to liver injury, and a population-based study in Iceland found no cases of drug-induced liver injury attributed to sleeping aids, despite the common use of zopiclone and zolpidem in the country.
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Prescription sleeping pills must be taken with caution
Sleeping pills can also interfere with normal breathing and be dangerous for people with certain chronic lung problems such as asthma, emphysema, or chronic obstructive pulmonary disease (COPD). Common side effects of prescription sleeping pills include a burning or tingling sensation in the hands, arms, feet, or legs. In addition, nonbenzodiazepines are associated with dangerous and complex sleep-related behaviours, such as sleepwalking and sleep-driving. The Food and Drug Administration (FDA) has issued a warning about "rare but serious injuries and deaths" from sleep-walking or sleep-driving while taking certain medications.
Over-the-counter sleep medication is generally safer, but it is still important to take them as directed, as they can also carry risks and cause side effects. For example, 'P.M.' medicines like Tylenol, Aleve, Excedrin, and ZzzQuil have been linked to liver damage, ulcers, and kidney damage when misused or taken for too long. Anticholinergic drugs, such as diphenhydramine, found in Benadryl and Tylenol PM, block the activity of acetylcholine, a brain chemical involved in muscle activation and brain functions like alertness, learning, and memory. Regular, long-term use of these drugs has been linked to an increased risk of dementia.
Therefore, it is important to speak with your doctor before taking any sleeping aid to ensure it is safe for you, even if it is available over the counter. Sleeping pills are typically recommended for short-term relief of sleeplessness and should be used under a doctor's supervision.
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Over-the-counter sleep aids are safer but carry risks
While over-the-counter (OTC) sleep aids are generally safer than prescription sleeping pills, they still carry risks and may cause side effects. OTC sleep aids are widely available without a prescription, making them easily accessible to those experiencing insomnia or sleeplessness. However, it is important to recognise that these aids are not without potential drawbacks.
One of the most common antihistamines found in OTC sleep aids is diphenhydramine, which is present in popular medications like Benadryl and Tylenol PM. While these medications can help induce drowsiness and improve sleep, they have been linked to an increased risk of dementia in regular, long-term users. A 2015 study published in JAMA Internal Medicine found that individuals who took these drugs about once every three days or more had a 54% higher risk of dementia compared to non-users.
Additionally, diphenhydramine is an anticholinergic drug, which blocks the activity of acetylcholine, a brain chemical involved in muscle activation and cognitive functions like alertness, learning, and memory. This can lead to side effects such as confusion, memory issues, and balance problems, particularly in older adults. Anticholinergic drugs can also cause urinary retention or difficulties fully emptying the bladder, especially in men with prostate conditions.
Other potential risks of OTC sleep aids include constipation or diarrhoea, muscle weakness, digestive problems, worsening of snoring and sleep apnea, and rebound insomnia when trying to stop the medication. Furthermore, sleep aids can interact with other medications and may cause dependency or addiction if used consistently. It is always advisable to consult a healthcare provider before taking any sleep aid, even if it is available over the counter, to ensure safe and appropriate use.
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Sleeping pills can be habit-forming and cause dependence
While sleeping pills can be effective in helping with sleep problems in the short term, they can be habit-forming and cause dependence. Sleeping pills are typically used for a short time only to help with insomnia. However, using them for too long can create dependence and other problems. Benzodiazepines, a common type of sleeping pill, are potentially addictive and can cause issues with memory and attention. Similarly, barbiturates, another group of sedative-hypnotic drugs, can be habit-forming and may lead to physical dependence over time.
The risk of habit formation and dependence is not limited to prescription sleeping pills. Over-the-counter (OTC) sleep aids can also cause dependence and have been linked to serious side effects. For example, OTC sleep aids such as Benadryl and Tylenol PM contain diphenhydramine, an anticholinergic drug that blocks the activity of acetylcholine, a brain chemical involved in muscle activation and brain functions like alertness, learning, and memory. Regular, long-term use of these OTC sleep medicines has been associated with an increased risk of dementia.
Additionally, the side effects of OTC sleep aids can trigger a "prescribing cascade," where new medications are introduced to address issues caused by the original sleep medicine, leading to a buildup of medications and their respective side effects. Furthermore, misuse of OTC sleep aids has been associated with potentially dangerous side effects, including liver damage, ulcers, and kidney damage.
It is important to note that not all sleeping pills are equally habit-forming. Newer medications like Ambien, Lunesta, and Sonata are less likely than benzodiazepines to be habit-forming, but they can still cause physical dependence over time. Rozerem, another sleep aid, acts differently from other sleep medicines by affecting the brain hormone melatonin, and it is not addictive. Silenor, a low-dose form of the antidepressant doxepin, is another non-addictive sleep medicine option.
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Studies have linked long-term use of OTC sleep meds to serious side effects
Sleeping pills are mostly considered safe, but they carry some known side effects, which can pose a risk to your health. While the majority of sleeping pills have not been linked to liver injury, long-term use of over-the-counter (OTC) sleep medications has been linked to serious side effects.
The Link Between Long-Term Use of OTC Sleep Meds and Serious Side Effects
A recent study published in the American Journal of Geriatric Psychiatry found that roughly one in three adults aged 65 to 80 use OTC sleep medications at least occasionally. This is concerning because studies have linked the regular, long-term use of these drugs to potentially serious side effects.
Diphenhydramine and Anticholinergic Effects
Many OTC sleep aids, such as Benadryl and Tylenol PM, contain diphenhydramine, an anticholinergic drug. Anticholinergic drugs block the activity of acetylcholine, a brain chemical involved in muscle activation and brain functions like alertness, learning, and memory. The side effects of these drugs can also lead to a "prescribing cascade," where additional medications are prescribed to manage the side effects of the original drug, increasing the number of medications and their side effects.
Increased Risk of Dementia
A 2015 study published in JAMA Internal Medicine found that regular use of diphenhydramine-containing medications over a 10-year period was associated with a significantly increased risk of dementia. Individuals who took these drugs about once every three days or more had a 54% higher risk of dementia compared to non-users. However, it's important to note that the links between these OTC drugs and dementia are not conclusive, and more research is needed.
Other Potential Side Effects
In addition to the risks mentioned above, OTC sleep aids can also cause other problems, such as liver damage, ulcers, or kidney damage if misused or taken for too long. Health experts recommend taking these medications for no more than two weeks to avoid potential dangers. Prescription sleep aids also carry their own risks and should be taken with caution, preferably under a doctor's supervision.
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Frequently asked questions
The majority of sleeping pills have not been linked to liver injury, either in the form of clinically apparent acute liver injury or in causing transient serum enzyme elevations. However, some over-the-counter sleep aids, such as Tylenol PM, have been associated with liver damage.
Sleeping pills can have various side effects, including daytime grogginess, sleepwalking, and sleep-driving. They can also be habit-forming and cause problems with memory and attention.
Sleeping pills are usually reserved for those with diagnosed insomnia or trouble falling asleep, staying asleep, or waking up too early at least three nights per week over a period of three months.
Yes, there are several over-the-counter alternatives to prescription sleeping pills, including antihistamines like Benadryl and melatonin supplements. However, it is important to speak with a doctor before taking any sleep aids to ensure they are safe for you.
