Evie Summers
Sleeping pills are prescription medications that contain tranquilizers to treat insomnia, restless sleep, or difficulty falling asleep. They are stronger than over-the-counter sleep aids and carry a higher risk of side effects, misuse, and dependency. Due to these risks, they are typically prescribed for short-term use, often in conjunction with other treatments such as cognitive behavioral therapy or sleep hygiene instructions. Doctors may prescribe various medications, including antidepressants, benzodiazepines, melatonin, and Z-drugs like zolpidem, depending on the patient's specific needs and sleep issues. It's important for patients to consult a doctor before starting any sleep medication to ensure safe and effective use.
| Characteristics | Values |
|---|---|
| Prescription | Sleeping pills are prescription medications containing tranquilizers to treat insomnia, restless sleep, or difficulty falling asleep. |
| Dosage | Doctors may prescribe a 5 to 20mg dose of suvorexant (Belsomra). Trazodone (Desyrel) is typically prescribed at a starting dose of 150 mg daily, divided into two doses, with a maximum daily dose of 400 mg. Zolpidem is available in a once-daily 12.5 mg extended-release form, with a maximum of 10 mg per day. Triazolam (Halcion) is available in 0.25 mg and 0.5 mg doses, with a maximum daily dose of 0.5 mg. Ramelteon (Rozerem) comes in an 8 mg dose, not to be exceeded once daily. |
| Duration | Sleeping pills are typically prescribed for short-term use, ranging from 7 to 10 days up to 3 months. |
| Side Effects | Sleeping pills can cause drowsiness, lack of alertness, anaphylactic reactions, CNS depression, worsening depression, withdrawal effects, dependency, drug tolerance, poor memory, brain degeneration, respiratory depression, and potential weight gain. |
| Precautions | Sleeping pills should not be used continuously over an extended period to avoid long-term side effects. They should not be mixed with other sedatives or alcohol due to the risk of overdose. They are not recommended during pregnancy or for children due to safety concerns. |
| Alternatives | Non-drug treatments such as cognitive behavioral therapy, sleep diaries, changing sleep environments, and nondrug sleep aids are recommended before resorting to sleeping pills. |
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What You'll Learn
Understanding the different types of sleeping pills
Sleeping pills are prescription medications that contain tranquilizers to treat insomnia, restless sleep, or difficulty falling asleep. There are many different types of sleeping pills available, each with a unique chemical structure and pharmacological effect. It's important to note that sleeping pills are typically prescribed for short-term use due to the risk of side effects and dependency.
One common type of sleeping pill is benzodiazepines (often referred to as "benzos"). These include drugs such as alprazolam (Xanax), clonazepam (Klonopin), diazepam (Diastat, Valium), estazolam (Prosom), orazepam (Ativan), and temazepam (Restoril). Benzodiazepines can be addictive, so they are typically prescribed for short-term use only.
Another type of sleeping pill is Z-drugs, such as zolpidem (Ambien) and eszopiclone (Lunesta). These drugs work by silencing the area of the brain that keeps you alert. Like benzodiazepines, Z-drugs carry a risk of dependency and may cause complex sleep behaviours, such as sleepwalking or driving while unaware.
Antidepressants and antianxiety medications are also sometimes prescribed as sleeping pills due to drowsiness being one of their main side effects. Examples include mirtazepine (Remeron), trazodone, and quetiapine (Seroquel). However, these drugs can also have other side effects, such as weight gain, dry mouth, and decreased sexual drive.
Additionally, melatonin receptor agonists, such as ramelteon (Rozerem), are sometimes prescribed as sleeping pills. Melatonin is a naturally occurring substance in the body that helps stimulate sleep onset and regulate the sleep cycle. Due to its low risk of side effects, melatonin is often preferred for those struggling with insomnia, shift workers, or seniors.
In some cases, doctors may prescribe off-label drugs to help with sleep. For example, suvorexant (Belsomra) is typically used to treat major depressive disorder, but it can also help with sleep and is prescribed off-label for this purpose.
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Short-term use only
Sleeping pills are typically recommended for short-term use only. While they can be effective in relieving insomnia and improving sleep in the short term, they are not a cure for insomnia and come with risks of side effects, misuse, and dependency.
Prescription sleeping pills are stronger than over-the-counter options and often carry a risk of addiction and substance use disorders. Benzodiazepines, for instance, are commonly prescribed as sleeping pills but can be addictive, leading to long-term use and adverse health consequences. Similarly, Z-drugs like zolpidem (Ambien) can cause dependency, with patients experiencing withdrawal effects if they stop taking the medication.
Healthcare providers usually recommend trying alternative methods to improve sleep before resorting to sleeping pills. These can include non-drug treatments such as cognitive behavioural therapy, changing sleep environments, and keeping a sleep diary to track sleep patterns.
Even when prescribed, sleeping pills should be used with caution. Patients should avoid mixing them with other sedatives or alcohol due to the risk of overdose. Additionally, some prescription sleep medicines can induce parasomnia, a disruptive sleep disorder where individuals may engage in dangerous behaviours while appearing awake but with their brain still in an inactive state.
In summary, sleeping pills are intended for short-term relief from insomnia and sleep disturbances. They should not be relied upon as a long-term solution due to the associated risks and potential for addiction. It is always advisable to consult with a healthcare provider to determine the most suitable treatment plan for addressing sleep issues.
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Side effects and risks
Sleeping pills can cause a range of side effects, from constipation to muscle weakness. About 8 out of 10 people experience a hangover effect the day after taking sleep medicine. They may feel drowsy, have muddled thinking, and experience dizziness or balance problems. These daytime effects can negatively impact your ability to drive, work, study, and complete daily tasks.
Sleeping pills can also cause parasomnia, a disruptive sleep disorder where individuals engage in dangerous behaviors while still mostly asleep. People who take sleeping pills may sleepwalk, eat, talk, or even drive without being fully awake. Most people do not remember doing these things after they wake up. Sedatives can also worsen snoring and sleep apnea, a potentially life-threatening condition.
Sleeping pills have a risk of misuse and can be habit-forming, leading to dependence and addiction. They should not be used long-term as they are not a cure for insomnia. Benzodiazepines, a common type of sleeping pill, are potentially addictive and can cause problems with memory and attention. Additionally, sleeping pills may interact with other substances, including medications, alcohol, and vitamin supplements, increasing the risk of adverse effects. Even a small amount of alcohol can enhance the sedation caused by sleeping pills, and combining the two can lead to depressed breathing and even death.
Pregnant or breastfeeding individuals should be cautious when considering sleeping pills as any medication taken can pass to the fetus or baby. Older adults should also be cautious as sleeping pills have special risks for this population. It is recommended that individuals over 65 try non-drug treatments first, as there may be safer ways to improve sleep.
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Non-medical alternatives
Another non-medical alternative is cognitive behavioural therapy (CBT), which may be better at improving sleep than sleeping pills. Sleep Reset, for example, is a science-backed technique based on CBT-I, which provides a personalized sleep plan and a dedicated sleep coach.
Additionally, it is important to address the underlying causes of insomnia or sleep difficulties. This may involve identifying and treating any underlying medical or mental health disorders, such as depression or anxiety, which can impact sleep. Understanding the root cause of sleep issues can help inform the most effective treatment approach.
For older adults, non-drug treatments and behavioural changes are often recommended first due to the potential risks and side effects of sleeping pills in this population. Similarly, for children, changing sleep behaviours is often the preferred approach to improving sleep, rather than relying on over-the-counter medications, which may pose risks of overdose or side effects.
Overall, while non-medical alternatives to sleeping pills exist, it is always advisable to consult with a healthcare professional to determine the most suitable approach based on individual needs and circumstances.
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Withdrawal and stopping safely
When it comes to withdrawing from sleeping pills and stopping their use safely, there are several important considerations and steps to follow. Firstly, it is crucial to recognise that sleeping pills, including benzodiazepines and Z-drugs, can lead to dependence and addiction. This means that stopping their use can result in withdrawal symptoms, which can be challenging and, in some cases, severe.
Withdrawal symptoms can vary in terms of timeline and severity among individuals. They can begin within a few hours or even weeks after discontinuing the medication and may persist for several weeks. These symptoms can include trouble sleeping, restlessness, anxiety, shivering, dizziness, and feeling faint. In more severe cases, withdrawal from benzodiazepines may cause hallucinations, rapid heartbeat, sweating, high blood pressure, tremors, and agitated behaviour.
To safely stop taking sleeping pills, it is generally recommended to gradually reduce the dose over several weeks or even months. This tapering strategy helps to minimise withdrawal symptoms and reduce the risk of severe reactions. It is important to seek guidance from a healthcare provider during this process, as they can provide specific advice and medical interventions if needed. Psychological or therapeutic support, such as cognitive behavioural therapy, can also be beneficial during this time.
Additionally, it is advised to maintain a consistent sleep schedule, avoid stimulants before bedtime, and incorporate physical exercise. These habits can help stabilise mood and improve sleep quality during the withdrawal process. It is crucial to avoid self-medicating with other drugs and to seek professional help if severe withdrawal symptoms occur, as a medically supervised detox may be recommended to ensure safety and comfort.
Overall, safely stopping the use of sleeping pills requires a gradual reduction in dosage under medical supervision and incorporating supportive interventions to manage withdrawal symptoms effectively.
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Frequently asked questions
Sleeping pills are prescription medications containing tranquilizers to treat insomnia, restless sleep, or difficulty falling asleep.
Sleeping pills can have several side effects, including dependency, drug tolerance, poor memory, brain degeneration, and respiratory depression during sleep, which may lead to death. Other side effects may include constipation, difficulty urinating, a dry mouth or throat, decreased sexual drive, and possible weight gain.
Sleeping pills are not recommended for children or adolescents due to the risk of severe side effects. Pregnant individuals should also avoid taking sleeping pills, as the medication can pass to the fetus. Older adults should also try non-drug treatments first, as there may be safer ways to improve sleep.
Before prescribing sleeping pills, healthcare providers may recommend trying alternative methods such as keeping a sleep diary, changing your sleep environment, or cognitive behavioral therapy.
To get a prescription for sleeping pills, you will need to consult a doctor or healthcare provider. They will assess your particular sleep problems and may prescribe the appropriate medication. Sleeping pills are typically prescribed for short-term use, and it is important to follow the prescribed dosage to avoid potential side effects and dependency.
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