Colin Snow
Sleeping pills are a common intervention for insomnia and other sleep disorders. While they can be effective in inducing sleep, they also come with serious risks, including overdose and death. In the United States, drug overdose deaths have been on the rise since 1999, with sleeping pills, including benzodiazepines and barbiturates, being among the leading causes. The misuse of sleeping pills, accidental ingestion, or their combination with other substances like alcohol or opioids, can lead to severe health complications and even death. It is crucial to follow prescribed dosages, avoid mixing sleeping pills with other substances, and seek professional help if struggling with misuse or addiction.
| Characteristics | Values |
|---|---|
| Number of overdose deaths involving sedatives and opioids (US) | Doubled between 2002 and 2015 |
| Number of overdose deaths (US) | 64,000 in 2016, nearly 92,000 in 2020 |
| Percentage of overdose deaths involving benzodiazepines (US) | 14% in 2020 |
| Percentage increase in benzodiazepine overdose deaths (US) between 2019 and 2020 | 22% |
| Number of Americans with sleep problems | 50-70 million |
| Percentage of Americans using medication to sleep | 4% |
| Percentage of people taking benzodiazepines for longer than six months who experience withdrawal symptoms | 60% mild, 40% moderate to severe |
| Percentage of overdose or death from sleeping pills among people with a history of substance abuse or mental health disorders | Higher |
| Percentage of overdose or death from sleeping pills among people taking them for extended periods | Higher |
| Percentage of overdose or death from sleeping pills among people combining them with CNS depressants | Higher |
| Percentage of overdose or death from sleeping pills among people with a history of witnessing overdoses, incarceration, and the use of multiple drugs | Higher |
| Percentage of overdose or death from sleeping pills among people with medical conditions impairing respiration | Higher |
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What You'll Learn
Risk factors for overdose
It is important to note that even a small increase in dosage can lead to an overdose, especially when other risk factors are present. An overdose occurs when a person takes a sleeping pill in a quantity that exceeds the prescribed or recommended dose, leading to adverse health effects.
- Prolonged use of sleeping pills: Some medications for insomnia are recommended only for short-term use.
- Combining sleeping pills with other substances: Mixing sleeping pills with other substances, such as alcohol or opioids, can amplify the sedative effects and increase the risk of overdose.
- Medical conditions: Individuals with medical conditions that impair respiration, such as heart and pulmonary problems or sleep apnea, are at a higher risk of overdose when consuming opioids, which may also apply to sleeping pills.
- Age: Older adults are at a greater risk of overdose from sleeping pills due to decreased drug metabolism rates.
- Frequency of use: The development of tolerance and dependence can lead to unintended results and increase the risk of overdose.
- Lack of understanding: Overdose can also result from a lack of understanding about the medication's potency, incorrect dosing, or the body's decreased ability to metabolize the drug effectively.
- Mental health issues: Some individuals may intentionally use sleep aids to commit suicide, especially in cases of untreated mental illness.
- Withdrawal: Dependence and withdrawal can occur even when medication is taken as prescribed. Reducing the dose or stopping the medication can result in withdrawal symptoms.
- Accidental overdose: This can occur if someone takes too much of a sedative by mistake or becomes dependent on sleeping pills but over time becomes less responsive to the drug, leading to an increased dosage.
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Treatment and prevention
Sleeping pills are central nervous system depressants that slow down brain activity to help people rest. While they are a common intervention for insomnia and other sleep disorders, they can be dangerous when misused or combined with other substances. Overdosing on sleeping pills can lead to severe health complications and even death. Therefore, it is crucial to understand the risks associated with these medications and take preventive measures to ensure safe usage.
Treatment of Sleeping Pill Overdose:
- Call for Emergency Help: If you suspect someone has overdosed on sleeping pills, call 911 or your local emergency services immediately. Keep the person awake and talking if possible until help arrives. If the person is unconscious, place them in the recovery position—on their side with one leg forward of the other—and wait for assistance.
- Medical Intervention: Once emergency services arrive, provide them with as much information as possible, including the type of sleeping pill taken, the amount ingested, and the time of ingestion. This will help medical professionals provide prompt and appropriate care.
- Supportive Care: In most cases, supportive care is provided to monitor the patient's breathing and cardiovascular system while the body naturally eliminates the drug. This involves closely observing the patient's vital signs to ensure stability.
- Specific Treatments: In some cases, specific treatments may be administered to counter the effects of the overdose. Flumazenil, for example, can be used to reverse sedation caused by benzodiazepines, but it is rarely chosen due to the risk of seizure and heart rhythm disorders. Activated charcoal, hemodialysis, whole bowel irrigation, and gastric lavage may also be used in certain situations.
- Long-Term Management: After the immediate danger has passed, long-term management focuses on relapse prevention, support networks, and possibly medication-assisted treatment. This may include rehabilitation to address the physical and psychological aspects of addiction and non-pharmacological treatments like cognitive behavioural therapy (CBT) for insomnia.
Prevention of Sleeping Pill Overdose:
- Prescribed Dosages: Always follow the prescribed dosage instructions provided by your healthcare professional. Do not take more pills than prescribed, even if you are struggling to fall asleep. Understand that even a small increase in dosage can lead to an overdose, especially when combined with other risk factors.
- Avoid Mixing Substances: Do not mix sleeping pills with other substances, such as alcohol, opioids, or other central nervous system depressants. Combining sleeping pills with these substances can amplify their sedative effects, significantly increasing the risk of overdose and severe health complications.
- Secure Storage: Store your medication securely and safely to prevent accidental ingestion by children or misuse by others.
- Patient Education: It is crucial for patients to understand the risks and benefits associated with sleeping pills. Healthcare providers should educate patients about potential side effects, addiction risks, and safe usage guidelines. Patients should also be encouraged to discuss any concerns or changes in their medication usage with their healthcare team.
- Alternative Treatments: Explore non-drug treatments and behavioural changes to improve sleep. Good sleep hygiene practices and cognitive behavioural therapy can often address the underlying causes of sleep disturbances without relying solely on medication.
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Side effects of misuse
While it is difficult to ascertain the exact number of people who have died from overdosing on sleeping pills, it is a known fact that many people die each year from sleeping pill overdoses. Sleeping pills are classified as "sedative hypnotics," a specific class of drugs used to help people fall asleep or stay asleep. They are central nervous system depressants that slow down brain activity, and when taken in excess, can slow body functions to the point of causing unconsciousness, respiratory failure, and death.
The dangerous side effects of misusing sleeping pills can manifest long before an overdose occurs. One such consequence is sleep-induced injuries, including vehicle accidents caused by impaired judgment and coordination. Additionally, crimes and self-harm have been reported due to unawareness of one's actions during sleepwalking.
Physical signs of a sleeping pill overdose include excessive lethargy, abdominal pain, breathing trouble, and clumsiness. These symptoms can indicate a more serious issue, especially if the person taking the medication can differentiate typical sleepiness from excessive, drunk-like behavior.
Sleeping pills can also cause digestive problems, such as constipation or diarrhea, muscle weakness, and digestive issues like gas, heartburn, and nausea. They can worsen snoring and sleep apnea, and when taken for extended periods, can lead to rebound insomnia, where insomnia returns worse than before.
Another potential side effect is parasomnia, a disruptive sleep disorder where people may sleepwalk, eat, take medications, talk, or even drive without being aware of their actions. This can be extremely dangerous and lead to accidental injuries or even death.
Furthermore, older adults are at a greater risk of overdose and adverse side effects from sleeping pills. The drugs can stay in their bodies longer, causing confusion, memory issues, and balance problems, increasing the risk of falls and hip fractures.
It is crucial to follow the prescribed dosage and frequency for sleeping pills and be aware of their potential side effects to prevent misuse and accidental overdose.
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Suicide attempts
While sleeping pills can be effective for treating insomnia and other sleep disorders, they can also be highly addictive. The risk of overdose increases when sleeping pills are combined with other drugs, especially opioids, or with alcohol. This is because the depressive effects of sleeping pills are enhanced by other substances, increasing the risk of respiratory failure. Older adults are at a greater risk of overdose due to decreased drug metabolism rates.
The physical signs of a sleeping pill overdose include extreme lethargy, abdominal pain, breathing trouble, and clumsiness. An overdose occurs when a person takes far more than the prescribed dose, and in the case of sleeping pills, this can be as little as 60-90 times the intended amount. If you suspect someone has overdosed on sleeping pills, it is crucial to call emergency services immediately. While waiting for help to arrive, keep the person awake and talking if possible. If the person is unconscious, place them in the recovery position—on their side with one leg forward of the other.
Treatment for a sleeping pill overdose typically involves supportive care, with doctors monitoring the patient's breathing and cardiovascular system while the drug leaves their body. In some cases, activated charcoal, hemodialysis, or whole bowel irrigation may be used to help treat the overdose. Additionally, flumazenil can be administered to reverse the effects of benzodiazepines, a common type of sleeping pill, but this carries the risk of seizure and heart rhythm disorders. If opioids are involved, naloxone may be given to reverse the opioid overdose.
While sleeping pill overdose can be dangerous and even life-threatening, it is important to note that modern formulas tend to be safer and less potent than older versions. Preventative measures, such as following prescribed dosages, avoiding mixing with other substances, and secure storage of medication, can also significantly reduce the risk of overdose.
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Mixing with other substances
Mixing sleeping pills with other substances can increase the risk of overdose and death. Sleeping pills are central nervous system depressants that slow down brain activity, and when combined with other drugs that enhance their depressive effects, the risk of overdose increases significantly. This includes opioids, alcohol, and other depressant substances.
Benzodiazepines, a common type of sleeping pill, have been identified as a leading cause of drug overdose deaths, especially when combined with opioid drugs such as OxyContin (oxymorphone) and Vicodin (hydrocodone). The rate of overdose deaths involving the combined use of sedatives and opioids has doubled between 2002 and 2015, and this trend has continued to rise. Mixing sleeping pills with opioids can lead to respiratory failure and death.
Alcohol consumption while taking sleeping pills can also lead to overdose and severe health complications. Alcohol is a depressant that amplifies the sedative effects of sleeping pills, increasing the risk of respiratory depression and other adverse outcomes. Mixing sleeping pills with alcohol can cause slowed breathing, unresponsiveness, severe drowsiness, and confusion.
Additionally, older adults are at a greater risk of overdose from sleeping pills, especially when combined with other substances. This is due to decreased drug metabolism rates, which can lead to a higher concentration of the drug in their system, increasing the likelihood of overdose.
It is important to note that even a small increase in dosage when taking sleeping pills can lead to an overdose, especially when combined with other substances. This can be unintentional, as individuals may not realize the potential dangers of mixing sleeping pills with other medications or substances. Therefore, it is crucial to follow prescribed dosages, avoid mixing sleeping pills with other drugs or alcohol, and store medication securely to prevent accidental overdose.
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Frequently asked questions
It is unclear exactly how many people have died from overdosing on sleeping pills, but it is known that many people die each year from sleeping pill overdoses. In 2016, over 64,000 drug overdose deaths were reported in the US, with sleeping pills among the main causes.
A sleeping pill overdose occurs when someone takes too much of the substance at once. This can be accidental or intentional. An accidental overdose can occur if someone takes too much of a sedative by mistake or combines sleeping pills with other drugs, such as opioids, or alcohol, which enhance the depressive effects of the sleeping pills.
The physical signs of a sleeping pill overdose include extreme lethargy, abdominal pain, breathing trouble, and clumsiness.
If you suspect someone has overdosed on sleeping pills, call emergency services immediately. Keep the person awake and talking if possible until help arrives. If the person is unconscious, place them in the recovery position and wait for help.
