
Sleep disorders such as insomnia can be treated with over-the-counter or prescription drugs, including sleeping pills. Sleeping pills work in different ways, with some causing drowsiness, while others silence the area of the brain that keeps you alert. While they can be effective, sleeping pills can also cause side effects such as constipation, muscle weakness, and digestive problems. They can also lead to dependence, with insomnia potentially worsening if an individual stops taking the medication. It is recommended that sleeping pills are combined with cognitive-behavioral therapies and good sleep practices for optimal results.
| Characteristics | Values |
|---|---|
| How they work | Sleeping pills cause drowsiness and relaxation, and some also silence the area of the brain that keeps you alert. |
| Types | Over-the-counter, prescription, and natural sleep aids. |
| Ingredients/drugs | Antihistamines, melatonin, valerian, benzodiazepines, gabapentin enacarbil, pramipexole, ropinirole, rotigotine, alprazolam, clonazepam, diazepam, estazolam, orazepam, temazepam, methylphenidate, modafinil, pitolisant, sodium oxybate, antidepressants, antianxiety medications, orexin receptor antagonists, suvorexant, lemborexant, daridorexant, quetiapine, olanzapine, risperidone, doxepin, amitriptyline, nortriptyline, trazodone, mirtazepine, ramelteon, eszopiclone, zolpidem |
| Side effects | Headache, dizziness, nausea, dry mouth, constipation or diarrhea, muscle weakness, digestive problems, worsened snoring and sleep apnea, dependence, hangover effect, confusion, parasomnia, decreased awareness and alertness, worsening depression, suicidal thoughts, complex sleep behaviors, sleep paralysis |
| Precautions | Should be used in combination with good sleep practices and/or behavioral treatments, do not take with alcohol, may interact with other medicines, do not drive or operate heavy machinery after taking |
| Treatment plan | Consult a healthcare provider to determine the best treatment plan, including non-drug treatments and behavioral changes |
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What You'll Learn

Prescription vs. over-the-counter sleep aids
Sleep is essential for overall health, and many people experience trouble sleeping at some point in their lives. Sleep aids are available over the counter or by prescription, and they can help with occasional sleeplessness or long-term sleep problems. Before taking any sleep medication, it is important to talk to a healthcare provider to understand the options, benefits, and risks.
Over-the-counter (OTC) sleep aids are easily accessible without a prescription and can be useful for short-term sleep issues. They are typically meant for occasional use and are not recommended for long-term chronic insomnia. OTC sleep aids contain various ingredients, such as antihistamines, melatonin, or valerian. Antihistamines, such as diphenhydramine and doxylamine, work by blocking histamines that cause alertness, making you feel drowsy. However, they may also cause side effects like daytime grogginess, blurred vision, confusion, and constipation. Melatonin is a hormone that naturally regulates the sleep-wake cycle, and valerian has a calming effect on the nervous system.
Prescription sleep aids, on the other hand, are recommended by a healthcare provider and may be suggested for more persistent or chronic sleep issues. These medications work in different ways, including stimulating chemicals in the brain, such as GABA, which leads to sedation, muscle relaxation, and reduced anxiety. Benzodiazepines are an example of prescription sleep aids. While they can be effective, prescription sleep aids are typically not intended for long-term use, and it is important to regularly evaluate their efficacy with a healthcare provider. Additionally, stopping prescription sleep medication suddenly may cause insomnia to return or worsen, so it is important to consult a doctor before discontinuing use.
Both OTC and prescription sleep aids can cause side effects, and it is important to be aware of these before taking any sleep medication. Some common side effects include constipation, muscle weakness, digestive problems, and daytime drowsiness. These side effects can impact daily tasks and activities, so caution is advised when taking any sleep medicine. Consulting a healthcare provider can help determine the most suitable treatment plan, which may include nondrug treatments, behavioural changes, or cognitive behavioural therapy (CBT) alongside or instead of sleep aids.
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Natural sleep aids
Sleep is incredibly important for your health. It helps your body and brain function properly, improving your learning, memory, decision-making, and even creativity. Unfortunately, many people don't get enough sleep each night, with around 20% of adults experiencing occasional symptoms of insomnia.
- Melatonin: Melatonin is a hormone that your body produces naturally to signal to your brain that it's time to sleep. Melatonin levels naturally rise in the evening and fall in the morning. Melatonin supplements have become a popular sleep aid, especially for those experiencing jet lag or trouble falling or staying asleep. While melatonin is generally safe for healthy adults, it can cause side effects such as headaches, dizziness, and nausea. It's recommended to take 1-3 milligrams 2 hours before bed.
- Valerian Root: Valerian is a perennial plant that has been used as a sleep aid for hundreds of years. It is believed to help with sleep by raising levels of GABA, which boosts relaxation. Valerian is considered safe in the short term but may cause headaches and stomachaches in some people. The recommended dose is 300-600 milligrams up to 2 hours before bed, or you can brew 2-3 grams of the dried root in a cup of water.
- Cannabidiol (CBD): CBD is a compound found in marijuana and hemp plants that doesn't cause a high. It has been shown to reduce anxiety and improve sleep quality. However, it may cause side effects such as tiredness and nausea in some people. The recommended dose is 25-175 milligrams per day, but more research is needed to determine the optimal dosage.
- Magnesium: Magnesium is a mineral that has been found to promote better sleep. While the specific mechanisms are not yet fully understood, it is believed to have a calming effect on the body and brain.
- Lavender: The scent of lavender is known for its calming and relaxing properties, which can help prepare the body and mind for sleep.
- Herbal Teas: Herbal teas, such as chamomile and passionflower, can help relax the body and mind, preparing you for a good night's sleep.
- Tart Cherry Juice: While there isn't much scientific proof, some people find that drinking tart cherry juice before bed helps improve their sleep.
- Limit Screen Time: The light from smartphones, laptops, and TVs can interfere with sleep by disrupting the natural release of melatonin. It's recommended to limit screen time before bed and to use a flashlight instead of turning on the lights if you need to get up during the night.
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Side effects
Sleeping pills are often prescribed to treat insomnia and other sleep disorders. While they can be effective in aiding sleep, they can also cause various side effects, some of which can be serious. It is important to be aware of these side effects before taking any sleep medication.
One of the most common side effects of sleeping pills is drowsiness and fatigue during the day. This can impact your ability to drive, work, or perform daily tasks. You may also experience dizziness, confusion, and balance problems. In addition, some people may experience digestive issues such as constipation, diarrhoea, gas, heartburn, and nausea.
Sleeping pills can also cause muscle weakness and worsen snoring and sleep apnea. In some cases, they can lead to parasomnia, a sleep disorder where people may walk, eat, talk, or even drive while still mostly asleep. This can be dangerous and may result in injuries. Additionally, long-term use of sleep aids can lead to dependency and rebound insomnia when trying to stop taking them.
For older adults, sleeping pills can pose special risks. The drugs may stay in their bodies longer, increasing the likelihood of side effects such as confusion, memory issues, and balance problems, which can further increase the risk of falls and hip fractures. Therefore, older adults are typically advised to try non-drug treatments first, as there may be safer alternatives to improve their sleep.
Some sleeping pills, such as benzodiazepines, can cause more serious side effects, including depression, particularly in patients with liver and kidney disease. Additionally, certain prescription sleep medications, like BELSOMRA, may cause decreased awareness and alertness the morning after taking them. In rare cases, they can also lead to worsening depression or even suicidal thoughts and actions. It is important to carefully follow the instructions provided by your doctor when taking any sleep medication and to report any negative side effects.
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Daytime sleepiness
Sleep medications can cause daytime sleepiness, with around 8 out of 10 people experiencing a hangover effect the day after taking sleep medicine. This can include feeling drowsy, having muddled thinking, and experiencing dizziness or balance problems. These effects can negatively impact your ability to drive, work, or go to school, so it's important to use caution when taking sleep medicine.
Some sleep medications are more likely to cause daytime sleepiness than others. For example, trazodone, a drug used to treat anxiety and depression, can cause drowsiness and is therefore often prescribed at low doses to help with sleep. Other medications, such as ramelteon, tend to cause fewer side effects but may not work as well for some people.
It's important to note that sleep medications are typically used for a short time and work best in combination with good sleep practices and behavioural treatments. Non-drug therapies, such as cognitive behavioural therapy (CBT), may be more effective in improving sleep in the long term. Additionally, over-the-counter sleep aids and natural remedies, such as melatonin and valerian, are also available and may help reduce daytime sleepiness caused by sleep medications.
If you are experiencing daytime sleepiness due to sleep medications, it is recommended to talk to your doctor about adjusting your medication or exploring alternative treatments.
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Non-drug treatments
Sleep difficulties can affect your emotional and physical health, memory, concentration, and mood, and they can increase your risk for depression, obesity, type 2 diabetes, heart disease, and high blood pressure. While medications are available for treating sleep disorders, they are usually prescribed for short-term use. Non-drug treatments are often the best way to improve sleep, especially for people over 65.
Cognitive Behavioral Therapy for Insomnia (CBT-I)
CBT-I is a non-drug treatment that targets behavioral, cognitive, and physiological factors that perpetuate insomnia. It aims to modify and alter maladaptive behaviors and distorted beliefs about sleep and insomnia. CBT-I can be delivered in different formats, such as face-to-face individual or group therapy, or digitally delivered self-help formats. It has been shown to have a positive impact on insomnia and its comorbid symptoms.
Light Therapy
The human circadian system is sensitive to short-wavelength (blue) light, and exposure to light in the evening can delay sleep onset. Therefore, reducing exposure to light in the evening and increasing exposure to light in the early morning can help regulate sleep onset. Additionally, ocular exposure to bright light can phase shift the circadian rhythms, making it a potential treatment for circadian-related sleep disorders.
Exercise
Regular exercise has been shown to have positive effects on psychological and physical health, and it can also help improve sleep. Studies have suggested that exercise is efficacious in treating patients with insomnia.
Natural Remedies
Some natural remedies that can help improve sleep include:
- Melatonin supplements: Melatonin is a hormone that is naturally released in the brain a few hours before we feel sleepy. Unnatural light exposure from phones, laptops, or TVs can prevent its release, making it hard to fall asleep. Melatonin supplements are available over the counter and can help regulate sleep. However, it is important to consistently buy the same brand and avoid unknown sources, as the dosages and ingredients may vary.
- Valerian supplements: Valerian is another natural supplement that can help with sleep.
- Chinese herbal medicine: Some studies have shown that Chinese herbal medicine can be effective in treating insomnia.
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Frequently asked questions
Sleeping pills are medications used to treat sleep disorders like insomnia. They can help you fall asleep and stay asleep if you're prone to waking up in the middle of the night.
Each type of sleeping pill works differently. Some cause drowsiness, while others silence the area of the brain that keeps you alert. Over-the-counter (OTC) sleeping pills often contain antihistamines, which block histamines that cause alertness. Prescription medications like Benzodiazepines stimulate a chemical in the brain called GABA, leading to sedation, muscle relaxation, and reduced anxiety.
Sleeping pills can cause various side effects, including constipation, muscle weakness, digestive problems, and worsened snoring or sleep apnea. They may also cause a hangover effect the next day, with symptoms like drowsiness, muddled thinking, and dizziness. Additionally, long-term use can lead to dependence, and stopping the medication may result in worsened insomnia.
Yes, in many cases, non-drug treatments and behavioral changes can be effective in improving sleep. Cognitive-behavioral therapy (CBT) is often recommended in combination with medication. Additionally, natural sleep aids like melatonin and valerian can promote sleep, although their effectiveness may vary, and they can also have side effects.






















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