Herbie Murray
Sleeping pills are a common intervention for insomnia and other sleep disorders. They are typically used for the short-term treatment of sleep issues and can be effective for many individuals. However, it is important to note that they come with certain risks and side effects. Sleeping pills can be addictive, and overdose is possible, which can sometimes lead to death. The amount of sleeping pills required for an overdose varies depending on the type of medication. Mixing sleeping pills with other substances, such as alcohol or opioids, can increase the risk of overdose and amplify the sedative effects. It is crucial to follow prescribed dosages, avoid mixing with other substances, and consult a healthcare professional before taking sleeping pills.
| Characteristics | Values |
|---|---|
| Number of milligrams to overdose | 200 mg of Sonata |
| Number of milligrams to die | 270 mg |
| Risk factors | Mixing with depressants like benzodiazepines or alcohol, history of substance abuse or mental health disorders, long-term use, high doses |
| Treatment | Activated charcoal, flumazenil, hemodialysis, whole bowel irrigation, stomach pump, fluids, medications |
| Side effects | Parasomnias, next-day drowsiness, dependence, withdrawal symptoms |
| Prevention | Following prescribed dosages, avoiding mixing with alcohol or drugs, storing medication securely, good sleep hygiene practices, behavioural therapies |
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What You'll Learn
Mixing sleeping pills with other drugs or alcohol
Alcohol and sleeping pills are a dangerous combination that can lead to serious adverse effects, including enhanced drowsiness, dizziness, impaired motor control, lowered blood pressure, memory problems, slowed heart rate, and slowed or stopped breathing (respiratory depression). Even a single alcoholic beverage consumed with sleeping pills can be dangerous, and the risk of overdose and fatal consequences increases significantly.
The risk of overdose and death is particularly high when sleeping pills are combined with other CNS depressants. Alcohol, opioids, and benzodiazepines all fall into this category, and their combined effects can be deadly. For example, the combination of benzodiazepines, which are sometimes prescribed for sleep disorders, with opioids can be a deadly mixture. Similarly, barbiturates, which were previously used more frequently for insomnia but are now recognized as highly toxic and dangerous when mixed with alcohol, can lead to drastically slowed or stopped breathing.
The frequent or regular use of both sedative sleeping pills and alcohol can also result in severe and complicated withdrawal symptoms when attempts are made to quit using either substance. Rebound insomnia is likely to develop, and continued sedative-hypnotic treatment may not be a viable option for recovery. Instead, a more behavioral treatment-focused approach may be necessary to address both substance use and any underlying mental health conditions.
It is important to note that sleeping pills themselves carry risks, especially when misused or abused. Overdosing on sleeping pills can lead to accidental death, and intentional overdose is a concern for individuals with suicidal thoughts or tendencies. Mixing sleeping pills with other drugs or alcohol further increases the likelihood of a fatal outcome. Therefore, it is crucial to follow the directions of a healthcare provider when taking sleeping pills and avoid mixing them with other substances.
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Intentional suicide
Sleeping pills are depressant medications that act upon the central nervous system to slow down the body's functions. They are classified as "sedative hypnotics" and are prescribed to ease anxiety or enable sleep. While they can be effective solutions for managing sleep disorders, caution must be exercised when using them. Adhering to the recommended dosage provided by a healthcare professional is crucial to mitigate potential risks.
Sleeping pills can be intentionally used to commit suicide. Some refer to sedatives as "suicide pills" due to their use in intentional overdoses, especially in cases of untreated mental illness. The tranquilizing effect of a hypnotic overdose may lead individuals to choose sleeping pills as a means of suicide, expecting a painless death. Diphenhydramine, commonly found in hypnotics, has been associated with an increased number of suicides. In 1997, 200 diphenhydramine-related suicides were reported in England and Wales.
It is important to note that not all suicide attempts succeed. Vomiting is common when an excessive amount of the drug is ingested, which may lead to survival but with potential brain damage due to oxygen deprivation. Additionally, the likelihood of fatal overdoses has decreased as barbiturates have been replaced by safer alternatives. Modern sleeping agents are less likely to cause death compared to their predecessors, but dangerous ranges of misuse can still lead to life-threatening consequences.
The safe dosage of sleeping pills depends on the specific medication, age, and overall health status of the individual. Typically, the recommended dose ranges from 5 mg to 50 mg, taken 30 minutes before bedtime. However, taking a much higher quantity, such as 2000 mg (equivalent to 200 tablets), can be lethal. Overdosing on sleeping pills can occur when an individual takes 60 to 90 times the intended dose. For example, Lunesta, a strong sleeping pill, can lead to an overdose at approximately 90 times the prescribed dose, while Ambien, typically taken at 10 mg, can cause serious damage at 600 mg and death at doses higher than 2000 mg.
If you or someone you know is experiencing suicidal thoughts or tendencies, it is imperative to seek help immediately. Contact your local emergency number or the National Suicide Prevention Lifeline at 988 in the United States to speak with a trained counselor.
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Side effects and long-term use
While sleeping pills can help with short-term sleep problems, they are not intended for long-term use. Long-term use can lead to dependence, with your body becoming reliant on the pills to fall asleep. This can result in rebound insomnia, where your insomnia returns worse than before when you stop taking the medication. In some cases, taking sleeping pills can even worsen insomnia in the long term.
Additionally, long-term use of sleeping pills can increase your risk of developing a tolerance, leading some people to increase their dosage or abuse the medication. This can result in more severe side effects, including:
- Parasomnias: complex sleep behaviours such as sleepwalking, where individuals perform actions without awareness and may drive, take medication, or eat while still asleep.
- Allergic reactions: severe side effects such as allergic reactions require immediate medical attention.
- Dizziness and nausea: while considered mild side effects, these can negatively impact daily tasks such as driving and working.
- Memory issues and confusion: particularly in older adults, these side effects can increase the risk of falls and accidents.
- Digestive problems: these can include constipation or diarrhoea, gas, heartburn, and nausea.
- Worsening of snoring and sleep apnea.
- Long-term fatigue.
- Interference with normal breathing: sleeping pills can be dangerous for individuals with chronic lung problems such as asthma, emphysema, or COPD.
It is important to note that the side effects of sleeping pills can vary depending on the specific medication and the individual's health. Therefore, it is crucial to consult a healthcare provider before taking any sleep medication and to follow the prescribed dosage.
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Treatment and recovery
People who overdose on sleeping pills are admitted to the hospital and closely monitored, usually in the intensive care unit. Treatment may include activated charcoal to absorb the overdose, as well as fluids or medications to help revive the patient and keep their heartbeat and breathing at a safe level. Flumazenil may be used to reverse the sedation caused by hypnotics if the person does not develop seizure symptoms.
People can generally recover from a sleeping pill overdose if treatment is started early. The overdose effects tend to only last as long as the drug is in the person's system, provided there hasn't been extended oxygen deprivation. However, even if a person survives an overdose, they may experience brain injury due to a lack of oxygen.
Sleeping pill addiction can be difficult to overcome, but with treatment and support, recovery is possible. Treatment for substance addiction often focuses on psychotherapy, but medications may also be prescribed to help manage symptoms. Types of therapy that a doctor or therapist might recommend include cognitive behavioural therapy (CBT), motivational enhancement therapy (MET), and group therapy. Support groups and 12-step programs can also be important sources of encouragement and information about recovery. It is important to address both the physical and psychological aspects of addiction during treatment and recovery.
Inpatient detox is often the first step in treating sleeping pill addiction, as it allows for constant monitoring by medical professionals during the withdrawal process. Outpatient treatment is a less intensive option that allows the patient to live at home and attend regular therapy sessions. Standard outpatient programs typically require patients to attend rehab for a couple of hours a day, once or twice a week.
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Prevention
While sleeping pills can be effective in treating insomnia and other sleep disorders, they are not without risks. Sleeping pills can be highly addictive, and misuse can lead to overdose and even death. Therefore, it is essential to take precautions to prevent adverse outcomes. Here are some preventive measures to ensure the safe use of sleeping pills:
Consult a Healthcare Professional:
Before taking any sleeping pills, it is crucial to consult a healthcare professional. A doctor can evaluate your condition, conduct necessary tests, and determine if sleeping pills are an appropriate treatment option for you. They will provide a prescription and instructions tailored to your specific needs. Ensure you understand the potential risks and side effects associated with the medication.
Follow Prescribed Dosages:
Always adhere to the dosage instructions provided by your doctor or pharmacist. Do not exceed the recommended dosage or take the medication more frequently than directed. Taking higher doses or increasing your dosage without medical supervision can increase the risk of overdose and adverse side effects.
Avoid Mixing Substances:
Sleeping pills should not be combined with other substances, especially central nervous system (CNS) depressants like alcohol, benzodiazepines, or opioids. Mixing sleeping pills with these substances can amplify their effects, leading to respiratory depression, hypoxia, and even death. Alcohol, in particular, increases the sedative effects of sleeping pills, making overdose more likely.
Securely Store Medication:
Keep your sleeping pills in a secure location, out of the reach of children and others who might misuse them. Properly storing your medication helps prevent accidental ingestion or misuse by others.
Monitor for Side Effects:
When taking sleeping pills, be vigilant about monitoring yourself for side effects. Common side effects may include next-day drowsiness, dependence, and withdrawal symptoms. If you experience any unusual or concerning symptoms, consult your healthcare provider immediately.
Explore Alternative Treatments:
Sleeping pills should not be the sole intervention for sleep disorders. Insomnia and sleep disturbances can often be addressed through lifestyle modifications, good sleep hygiene practices, and behavioural therapies. Explore these alternatives with your healthcare provider to find a treatment plan that suits your needs without relying solely on medication.
Seek Help for Substance Abuse:
If you have a history of substance abuse or mental health disorders, be cautious about taking sleeping pills. These individuals are at a higher risk for overdose and misuse. Seek professional help to address any underlying issues and ensure you have the necessary support during treatment.
Remember, while sleeping pills can be beneficial for some, they require careful use and monitoring. Always follow the advice of your healthcare provider, and do not hesitate to reach out for help if you experience any adverse effects or concerns.
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Frequently asked questions
The amount of sleeping pills required to cause an overdose varies depending on the type of medication and the individual's physiology. For example, it takes upwards of 270 mg of Sonata to overdose. However, it's important to note that any amount of sleeping pills can be dangerous when mixed with depressants like alcohol or benzodiazepines.
Yes, sleeping pills can kill you, especially when taken in high doses or combined with other substances like alcohol or opioids. They work by depressing the central nervous system, slowing down brain activity and respiratory functions, which can lead to respiratory arrest and death.
If you suspect someone has overdosed on sleeping pills, call emergency services immediately. Do not leave the affected individual alone and provide support until professional help arrives. If the person is conscious, monitor their breathing and cardiovascular system. In a hospital setting, treatments may include activated charcoal, medications, fluids, hemodialysis, or whole bowel irrigation to reverse the effects of the overdose.
