Colin Snow
Sleeping pills are medications that can help treat insomnia, restless sleep, or difficulty falling asleep. They are available over the counter (OTC) or by prescription and typically come in doses ranging from 10 to 50 milligrams. While short-term use of sleeping pills can be acceptable, they are not recommended for continuous long-term use due to potential side effects and the risk of dependency. It is important to use caution when taking sleeping pills and to consult a healthcare provider, especially when considering discontinuation, as stopping certain medications too quickly can lead to withdrawal symptoms and rebound insomnia.
| Characteristics | Values |
|---|---|
| Availability | Over the counter (OTC), as natural supplements or by prescription |
| Age restriction | Anyone age 18 and older can buy OTC sleep medications |
| Side effects | Dizziness, fatigue, irritability, and long-term side effects such as depression, particularly in patients with liver and kidney disease |
| Dosage | 10 to 25 or 50 milligrams, available in various forms, including tablets and liquids |
| Withdrawal | Stopping medication too quickly can lead to withdrawal symptoms |
| Dependency | Sleeping pills can cause dependency, and rebound insomnia |
| Tolerance | The body can develop a tolerance to sleeping pills |
| Caution | Should not be used long-term |
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What You'll Learn
Prescription vs. over-the-counter sleep pills
Sleeping pills can help you fall asleep and relieve stress and anxiety. They are available over the counter (OTC), as natural supplements, or by prescription. Prescription sleeping pills are stronger than over-the-counter ones, and you need a prescription from a healthcare provider to obtain them. Providers generally do not recommend using prescription sleeping pills long-term because they are not a cure for insomnia and carry a risk of dependence and addiction.
Over-the-counter sleep aids often contain an antihistamine, which treats allergies but can also cause drowsiness. Some people take natural remedies like melatonin or valerian supplements to help them sleep. Melatonin is a hormone naturally produced by the body that promotes sleep. Valerian is an herb that purportedly aids relaxation and sleep. Although OTC sleep aids and supplements are easily accessible, you should consult your healthcare provider before taking them as they can interfere with other medications or aggravate health conditions.
Prescription sleep medications work in different ways. Benzodiazepines, for example, stimulate a brain chemical called GABA, leading to sedation, muscle relaxation, and reduced anxiety. They can be addictive and lead to substance use disorder. To reduce this risk, healthcare providers only prescribe these sleeping pills for short-term use. Z-drugs, such as zolpidem (Ambien) and eszopiclone (Lunesta), work by slowing down brain activity. They are fast-acting, taking effect within 30 minutes and lasting up to eight hours.
Sleeping pills can cause various side effects, including constipation, muscle weakness, digestive problems, and worsened snoring and sleep apnea. Approximately 8 out of 10 people experience a hangover effect the day after taking sleep medicine, feeling drowsy and dizzy. These daytime effects can impair your ability to drive or perform daily tasks, so caution is essential when taking sleep medicine. Additionally, long-term use of sleeping pills can lead to dependency, and abruptly stopping them can cause rebound insomnia, where insomnia returns worse than before. If you have used sleep aids for an extended period, consult your healthcare provider about safely discontinuing them.
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Side effects of sleep pills
Sleeping pills can cause a range of side effects, from mild to severe. While some people may not experience any side effects at all, it's important to be aware of the potential risks before taking these medications.
One of the most common side effects of sleeping pills is the "hangover" effect, which can cause drowsiness, muddled thinking, dizziness, and balance problems the day after taking the medication. This can negatively impact activities that require alertness, such as driving or operating machinery. Older adults are more susceptible to these side effects, which can increase their risk of falls, broken hips, and car accidents.
Sleeping pills can also cause digestive issues such as constipation, diarrhoea, gas, heartburn, and nausea. They may worsen snoring and sleep apnea, and long-term use can lead to dependency and rebound insomnia when trying to stop the medication. Additionally, mixing sleeping pills with alcohol or other sedatives can increase the risk of overdose, which can be deadly.
Some prescription sleep medications can cause parasomnia, a disruptive sleep disorder where individuals may sleepwalk, eat, talk, or even drive while unaware of their actions. Other potential side effects include burning or tingling sensations in the extremities, memory issues, confusion, and impaired focus.
In rare cases, serious allergic reactions to sleeping pills can occur, including anaphylaxis, which requires immediate medical attention. It is important to consult a doctor if any concerning side effects develop and to follow their recommendations for safe use.
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Natural sleep remedies
Sleep is incredibly important for your health and well-being. Disturbed sleep can negatively affect your memory, concentration, and mood, and it can increase your risk of depression, obesity, type 2 diabetes, heart disease, and high blood pressure.
Melatonin Supplements
Melatonin is a naturally occurring hormone that regulates the body's sleep-wake cycles. It is triggered by the body's response to reduced light exposure, which should naturally occur at night. However, exposure to unnatural light from sources such as phones, laptops, or TVs can prevent melatonin release, making it difficult to fall asleep. Melatonin supplements are available over the counter and can help with sleep issues like jet lag and trouble falling or staying asleep. It is recommended to take 1-3 milligrams two hours before bed. However, melatonin is unregulated, and some people experience side effects like grogginess, depression, and nausea. It is also unclear how safe it is for breastfeeding mothers.
Magnesium
Magnesium is a naturally occurring mineral that helps muscles relax and relieves stress, promoting healthy sleep patterns. Studies show that magnesium supplements may improve sleep in older people and those with restless leg syndrome. It is recommended that women take 310-320 milligrams per day, while men take 400-420 milligrams. However, too much magnesium can lead to negative side effects, so consult your doctor before taking supplements. You can also increase your magnesium intake through foods like nuts and leafy greens.
Herbal Teas and Remedies
Herbal teas and tinctures may help induce sleepiness and improve sleep quality. Some popular herbal sleep aids include:
- Chamomile: German chamomile tea and Roman chamomile tinctures may have a calming effect, helping people feel relaxed and more prepared for sleep.
- Passionflower: This climbing vine, traditionally used by Native Americans, contains GABA, a brain chemical that affects mood and sleep. Studies have shown that drinking passionflower tea before bed can improve sleep quality.
- Valerian: Valerian is an herbal extract used to manage anxiety and insomnia. Some findings suggest it may reduce the time needed to fall asleep and improve sleep quality, but more research is needed to confirm its effectiveness.
Other Tips for Better Sleep
In addition to natural sleep aids, developing good sleep habits and making adjustments to your bedtime routine can improve your sleep:
- Avoid working out within two hours of bedtime, as it can raise your core body temperature and signal to your body that it's time to be awake.
- Go dark: The light from smartphones and other electronic devices interferes with sleep. If you need to get up at night, use a flashlight instead of turning on the lights.
- Sleep in layers so you can adjust your bedtime temperature as needed.
- Avoid alcohol before bed, as it can interfere with sleep. Instead, try warm milk, chamomile tea, or tart cherry juice, which is a natural source of melatonin.
- Practice meditation: Mindfulness meditation involves slow, steady breathing while sitting quietly and observing your breath, body, thoughts, and feelings. It has been shown to reduce stress, improve concentration, and promote better sleep.
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Dosage and duration
The dosage and duration of sleep pills vary depending on the type of medication and individual circumstances. Sleeping pills are typically available over the counter (OTC) or by prescription, and can come in various forms, including tablets and liquids. The dosage generally ranges from 10 to 25 or 50 milligrams.
For example, zolpidem is a prescription sleep medication that is typically prescribed at a starting dose of 12.5 mg extended-release or a maximum of 10 mg per day for immediate-release. On the other hand, doxepin (Silenor), another prescription sleep aid, is available in 3 and 6 mg doses, and doctors may recommend its use for up to 3 months.
It is important to note that sleeping pills are generally not recommended for long-term use due to potential side effects and the risk of dependency. Short-term use, typically ranging from a few days to a few months, is generally considered acceptable. For instance, triazolam (Halcion) is usually prescribed for the short-term treatment of insomnia, typically for 7 to 10 days.
When taking sleeping pills, it is essential to follow the instructions provided by a healthcare professional. If you are taking OTC sleep aids, it is recommended to consult a healthcare provider if you plan to take them for more than 2 weeks. Additionally, if you have been taking high doses of sleep medication for a prolonged period, it is important to consult a doctor before stopping abruptly to avoid potential withdrawal symptoms. Tapering down the dose gradually under medical supervision is often recommended to ensure a safe discontinuation process.
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Withdrawal and rebound insomnia
Rebound insomnia occurs due to changes in brain chemistry. When you take sleeping pills regularly, your body adapts to the drug's effects, and when you stop taking them, your body needs to adjust to functioning without them. The duration of rebound insomnia varies depending on personal factors, the specific sleep aid, and how long it takes for the drug to leave your body. Generally, doctors expect withdrawal symptoms for benzodiazepines to last no more than four weeks.
To prevent rebound insomnia, it is crucial to gradually reduce the dosage of sleeping pills under the supervision of a healthcare provider. This allows the body to adapt and reduces the risk of withdrawal symptoms. Additionally, creating healthy sleep habits, such as maintaining a consistent sleep schedule and practising relaxation techniques, can help improve sleep quality and prevent insomnia.
If you are experiencing rebound insomnia, relaxation training and natural strategies can help you cope. Psychoeducation, which involves learning about insomnia and its management, may also be beneficial. It is important to avoid caffeine and alcohol, as they can exacerbate insomnia. Seeking medical advice is crucial, especially when dealing with sleeping pill addiction, as withdrawal symptoms can be intense and may lead to anxiety, panic attacks, and, in rare cases, deep clinical depression.
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Frequently asked questions
Sleeping pills can cause a hangover effect, with drowsiness, muddled thinking, dizziness, and balance problems. Other side effects include constipation or diarrhea, muscle weakness, digestive problems, and worsened snoring and sleep apnea. Sleeping pills can also cause long-term side effects such as rebound insomnia, dependency, and changes in brain function.
There are many different types of sleeping pills available, both over the counter and by prescription. Doxepin (Silenor) is a tricyclic antidepressant that is FDA-approved for treating insomnia and is available by prescription. Other prescription sleeping pills include zolpidem, temazepam, suvorexant, and lemborexant. Benzodiazepines (BZD) are a powerful class of sleeping pills that include alprazolam, clonazepam, diazepam, and lorazepam.
It is important to gradually reduce the dosage of sleeping pills to allow the body to adjust and avoid withdrawal symptoms. It is recommended to combine medication with cognitive-behavioral therapies and create healthy sleep habits, such as maintaining a consistent sleep schedule and limiting distractions in the bedroom.
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