Miya Pearson
Sleep is an essential part of a healthy life, but for many, it doesn't come easy. Sleep aids and pills are a common solution for those struggling with sleep, but how do they work? Sleeping pills are medicines designed to help people fall asleep or stay asleep, and they come in many forms, from over-the-counter antihistamines to prescription benzodiazepines. While they can be effective in the short term, they are not a cure for insomnia and can have side effects and risks, including dependency and addiction. Understanding how these pills work to induce sleep is crucial for those considering their use.
| Characteristics | Values |
|---|---|
| Purpose | Help people fall asleep and stay asleep |
| Target condition | Insomnia |
| Types | Prescription, Over-the-counter, Antidepressants, Barbiturates, Benzodiazepines (benzos), Non-benzodiazepine (Non-BZD) or Z-drugs, Melatonin, Herbal medicines |
| Mechanism | Work on the GABA receptors in the brain to control alertness and relaxation, Block histamines that cause alertness |
| Dosage | 10 to 25 or 50 milligrams |
| Side effects | Daytime sleepiness, Confusion, Parasomnia (sleepwalking, eating, talking, etc.), Dependence, Addiction, Withdrawal symptoms, Rebound insomnia, Constipation, Dry mouth, Decreased sexual drive, Weight gain |
| Precautions | Avoid mixing with other sedatives or alcohol, Not recommended for long-term use, Not suitable for children, Consult a doctor before use |
| Alternatives | Cognitive behavioral therapy (CBT), Relaxation techniques (meditation, breathing exercises, muscle relaxation) |
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What You'll Learn
How do sleep pills work on the brain?
Sleep medications work on the brain to promote drowsiness. They can help people suffering from an inability to get restful sleep, but they do not treat the underlying cause of insomnia. Sleeping pills are available over the counter (OTC) or by prescription.
OTC sleep aids often contain antihistamines, which treat allergies but can also make you drowsy. Prescription sleeping pills are stronger than OTC pills and are recommended for short-term relief only, as there is a risk of dependence and addiction.
Prescription sleeping pills work on the GABA receptors in the brain, which help control our level of alertness or relaxation. Selective GABA medications target a specific type of GABA receptor, believed to be dedicated to promoting sleep. They are thought to be safer than older drugs like benzodiazepines, with less potential for addiction and milder side effects. However, selective GABA medicines can still have side effects, and they are not recommended for long-term use.
Some prescription sleep medicines may cause parasomnia, a disruptive sleep disorder where people may sleepwalk, eat, talk, or even drive without being fully awake. This can be dangerous, and most people do not remember doing these things after they wake up. Benzodiazepines, in particular, can be addictive and lead to substance use disorders, so they are typically only prescribed for short periods.
Non-benzodiazepine (Non-BZD) or Z-drugs are fast-acting sleeping pills that induce sleepiness, calm anxiety, and promote sound sleep. They are the most frequently prescribed class of sleep medications due to their minimal side effects and low potential for drug tolerance and addiction. This class includes Zolpidem, Ambien, and Zopiclone.
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What are the side effects?
Sleeping pills can cause a range of side effects, from mild to severe and undesirable. It is important to note that not everyone can safely take sleeping pills, and they could affect other medications or cause serious side effects. If you are considering taking a sleeping pill, it is recommended that you consult your doctor first to ensure it is safe for you.
Some common side effects of sleeping pills include constipation, diarrhoea, muscle weakness, and digestive problems such as gas, heartburn, and nausea. Sleeping pills can also worsen snoring and sleep apnea. Additionally, they can cause a hangover effect, with approximately 8 out of 10 people experiencing drowsiness or sleepiness during the day after taking the medication. This can impact activities that require alertness, such as driving.
Sleeping pills can also lead to dependence and addiction. With long-term use, individuals may develop a tolerance and increase their dosage, resulting in more severe side effects and rebound insomnia when trying to stop. It is important to gradually reduce the dosage under the guidance of a healthcare provider to minimise the risk of rebound insomnia and withdrawal symptoms.
For older adults, sleeping pills can have more pronounced effects, including confusion, memory issues, and balance problems, which can increase the risk of falls and accidents. Pregnant or breastfeeding individuals should also avoid taking sleeping pills.
In rare cases, sleeping pills can induce parasomnias, which are complex sleep behaviours where individuals may sleepwalk, eat, talk, drive, or engage in other activities while asleep and unaware. These behaviours can be dangerous and may lead to serious accidents or injuries.
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How to stop taking them
How to stop taking sleeping pills
Sleeping pills can lead to dependence and addiction. Abruptly quitting sleeping pills can make the withdrawal process more intense and difficult. Withdrawal symptoms can include trouble sleeping, restlessness, anxiety, shivering, dizziness, seizures, and hallucinations. It is important to keep in mind that the withdrawal symptoms may vary from person to person based on factors such as the severity and length of addiction.
If you want to stop taking sleeping pills, it is recommended to gradually reduce the dose with the guidance of a doctor. This process is called "tapering off" and can take a few weeks or months. It is important to keep withdrawal symptoms to a minimum to avoid relapsing. Therapeutic support and psychological support can help with this process.
There are alternative treatments for insomnia such as cognitive behavioral therapy (CBT) and natural sleep aids like melatonin and valerian supplements.
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Over-the-counter vs prescription
Over-the-counter (OTC) sleep medications are available without a prescription to anyone over the age of 18 at drugstores and other retail locations. They often contain antihistamines, which can cause drowsiness by blocking histamines, the substances in your body that cause alertness. Common ingredients in antihistamines include diphenhydramine and doxylamine. Examples of OTC sleep medications include Benadryl Allergy®, Advil PM®, Tylenol PM®, and Unisom SleepTabs.
OTC sleep aids should be taken at a low dose for a short time and users should stay in touch with their healthcare provider about any side effects. They are generally safe but come with some risks. For example, older adults may experience confusion and falls as side effects. Additionally, some OTC sleep aids contain other medications, such as pain relievers, which users may not be aware of. Furthermore, supplements, such as melatonin and valerian root, are not regulated by the FDA, so there is no guarantee of what is in the pill.
Prescription sleeping pills, on the other hand, are stronger than OTC sleep medications and are only available with a prescription from a healthcare provider. They are typically only recommended for short-term relief as they are not a cure for insomnia and carry a risk of dependence and addiction. Types of prescription sleeping pills include antidepressants, barbiturates, benzodiazepines (also known as benzos), and Z-drugs, such as zolpidem (Ambien®) and eszopiclone (Lunesta®).
Z-drugs are fast-acting, taking effect within 30 minutes, and can induce sleepiness, calm anxiety, and promote sound sleep without leaving you feeling groggy in the morning. They are the most frequently prescribed due to their minimal side effects and low potential for drug tolerance and addiction. Melatonin is another prescription medication that mimics the natural melatonin hormone in the brain, which stimulates sleep onset.
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Natural sleep aids
Some natural sleep aids contain cannabinoids, namely THC and CBD. Some studies suggest that these compounds help some people fall asleep, stay asleep, and enjoy higher-quality sleep. Marijuana, a drug created from the cannabis plant, is known to help people fall asleep more easily. However, marijuana and THC products can create dependence, and withdrawal from them can aggravate sleep problems. CBD has been found to relieve anxiety and act as a natural sleep aid. A review of 34 studies concluded that CBD could help alleviate insomnia symptoms when used alone or with equal amounts of THC. It is important to note that CBD is still classified as a controlled substance in some states, and its legality may vary.
Melatonin is another popular natural sleep aid. It is a hormone naturally produced by the body to signal to the brain that it is time to sleep. Melatonin supplements have been found to improve sleep quality and reduce the time needed to fall asleep. However, melatonin can reduce the effectiveness of some medications and produce unwanted side effects when combined with others. It may not be recommended for people who have received organ transplants or experience depression or seizure disorders.
Other natural sleep aids include magnesium, valerian root, and lavender. It is important to consult a doctor before starting any new supplement, as natural does not always mean safe for everyone. Some supplements may interact with certain allergies, conditions, or medications. Additionally, natural sleep aids are classified as dietary supplements and are not regulated as strictly as medications.
Some general tips for improving sleep include avoiding screen time before bed, maintaining a consistent sleep schedule, and creating a comfortable sleep environment in terms of temperature and lighting.
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Frequently asked questions
Sleeping pills are medications that treat insomnia, restless sleep, or difficulty falling asleep. They are available over the counter (OTC) or by prescription.
Sleep pills work on the chemicals in your brain that regulate your sleep-wake cycle. They target the GABA receptors in the brain, which help control our level of alertness or relaxation.
Sleep pills can cause side effects such as drowsiness during the day, confusion, parasomnia, constipation, difficulty urinating, dry mouth or throat, decreased sexual drive, and possible weight gain. They can also lead to dependence and addiction.
Yes, there are non-drug therapies such as cognitive behavioral therapy (CBT), meditation, breathing exercises, and muscle relaxation techniques that can help improve sleep quality. Natural sleep aids like melatonin and valerian supplements are also available.
It is important to consult a healthcare provider before taking any sleep medication. Sleep pills should be used for a short duration at the lowest effective dose to minimise the risk of side effects and dependence. They are not a cure for insomnia and should not be the only solution for improving sleep.
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