Colin Snow
Sleeping pills are medications that treat insomnia and other sleep disorders by making the user feel drowsy and relaxed. They are available over the counter, as natural supplements, or by prescription. Sleeping pills can have side effects and are not recommended for long-term use due to the risk of dependence and addiction. Some common types of sleeping pills include benzodiazepines, Z-drugs (zolpidem and zopiclone), and antidepressants in lower doses. While they can be helpful for short-term relief, healthcare providers often suggest non-drug therapies, such as cognitive-behavioral therapy (CBT), as a better solution for improving sleep quality.
| Characteristics | Values |
|---|---|
| Purpose | To help people with sleep disorders like insomnia fall and stay asleep |
| Availability | Over-the-counter (OTC) or by prescription |
| Types | OTC sleep aids, natural supplements, prescription sleep medications |
| OTC Ingredients | Antihistamines (e.g. diphenhydramine, doxylamine), melatonin, valerian |
| Prescription Types | Benzodiazepines, nonbenzodiazepines or "Z drugs" |
| Prescription Ingredients | Benzodiazepines: triazolam (Halcion), temazepam, estazolam (Prosom); Nonbenzodiazepines: eszopiclone (Lunesta), zolpidem (Ambien), zaleplon (Sonata), ramelteon (Rozerem) |
| Side Effects | Drowsiness, allergic reactions, edema, increased thoughts of suicide, hallucinations, mood changes, memory loss, complex sleep behaviors |
| Risks | Misuse, dependency, addiction, interference with other medications |
| Recommendations | Short-term use, combine with cognitive-behavioral therapies, consult a healthcare provider |
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What You'll Learn
Sleeping pills are addictive and have side effects
Sleeping pills are often viewed as a quick fix for insomnia and other sleep disorders, but it's important to understand that they come with risks and side effects. While they can be effective in the short term, they are not a long-term solution and can lead to dependence and addiction.
One of the main concerns with sleeping pill use is the potential for addiction and dependence. These medications can be habit-forming, especially if taken for prolonged periods or in higher doses than prescribed. Prolonged use can lead to physical dependence, where the body adapts to the presence of the drug, and stopping it results in withdrawal symptoms. Withdrawal from sleeping pills can be uncomfortable and may include symptoms such as rebound insomnia, anxiety, and irritability.
Sleeping pills also carry a range of side effects. Drowsiness and dizziness are common and can increase the risk of falls and accidents. More severe side effects may include confusion, memory problems, and strange behavior, such as sleepwalking or even sleep-driving. Sleeping pills can also interact with other medications and substances, such as alcohol, which can be dangerous and lead to respiratory depression and other health complications.
In addition, sleeping pills can have paradoxical effects, where they induce strange and unwanted behaviors. Some people may experience hallucinations, agitation, or even aggressive behavior. These pills can also impair judgment and coordination, leading to accidents and injuries. It's important to note that sleeping pills do not treat the underlying causes of sleep disorders and may even mask underlying issues, preventing proper diagnosis and treatment.
It is crucial to weigh the risks and benefits before taking sleeping pills and to use them only as directed by a healthcare professional. Exploring non-pharmacological treatments, such as cognitive-behavioral therapy for insomnia, improving sleep hygiene, and making lifestyle changes, can often be more effective and safer in the long term. Sleeping pill use should be carefully monitored, and if side effects or dependence develops, it is important to seek medical advice.
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Melatonin as a sleeping aid
Melatonin is a naturally occurring brain hormone that controls how and when we sleep. Our brains start producing melatonin a few hours before our natural sleep time as it starts to get dark outside. As the levels of melatonin rise, the levels of cortisol (the stress hormone) fall, our respiration slows, and we start to feel sleepy.
Melatonin is sometimes called the "hormone of darkness" or the "'vampire hormone'" because it comes out at night. While melatonin is not a sleeping pill, it can be used as a sleep aid for people with insomnia or other sleep problems. It is available as a synthetic hormone in the form of standard tablets, slow-release tablets, capsules, and liquid. It is meant to be taken for short periods and can help you fall asleep faster and reduce the chances of you waking up during the night. It may also help with jet lag symptoms.
In the United States, melatonin is available over the counter as a dietary supplement, whereas, in most other countries, it is available only via prescription. Experts recommend consulting a doctor or a sleep specialist before taking melatonin as it does not address the underlying health problems that may be disrupting sleep. For example, sleep issues may be caused by anxiety, sleep apnea, restless leg syndrome, or mood disorders like depression, which may require medical treatment.
It is important to note that melatonin is not regulated by the Food and Drug Administration (FDA) because it is considered a food supplement and not a medication. Manufacturers are not required by law to list the ingredients or how the melatonin was made. Additionally, blue light from electronic devices can affect melatonin levels more than any other type of light, so it is recommended to avoid screens at least one hour before bedtime.
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Prescription vs. over-the-counter sleeping pills
Sleeping pills are medicines used to help people fall asleep and stay asleep. They are typically recommended for short-term use only, as they can cause dependence and addiction. Sleeping pills can be obtained either through a prescription or over-the-counter (OTC) at a pharmacy.
Prescription Sleeping Pills
Prescription sleeping pills are stronger than over-the-counter ones and are recommended by healthcare providers for short-term relief only. They are typically recommended for severe insomnia after other non-medication treatments have been attempted. The main types of prescription sleeping pills are benzodiazepines, non-benzodiazepines (also known as Z-drugs), and melatonin receptor agonists.
Benzodiazepines, such as temazepam (Restoril), are the most common type of prescription sleeping pill. They slow down brain and body function, making you feel relaxed and helping you fall asleep. However, they are not recommended for long-term use due to the risk of serious side effects, including dependence, misuse, withdrawal, and addiction. Z-drugs, such as zolpidem (Ambien) and zopiclone, are also commonly prescribed and have similar effects to benzodiazepines. Melatonin receptor agonists, such as ramelteon (Rozerem), are considered the first line of therapy for insomnia as they do not cause physical dependence or abuse.
Over-the-Counter Sleeping Pills
Over-the-counter sleeping pills are available without a prescription and are typically recommended for milder sleep issues. Melatonin supplements, for example, are widely available OTC and can help regulate the sleep-wake cycle, making them a good choice for jet lag. Other effective OTC sleep aids include diphenhydramine (Benadryl) and doxylamine succinate (Unisom SleepTabs). Most OTC sleeping pills contain antihistamines, which work by blocking histamines that cause alertness. However, it is important to consult a pharmacist or doctor before taking any OTC sleep medications to determine the best treatment based on your medical history.
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Natural sleep aids
Melatonin
Melatonin is a hormone that is naturally released in the brain four hours before we feel sleepy. It is triggered by the body's response to reduced light exposure, which should naturally happen at night. However, exposure to unnatural light from phones, laptops, or TVs prevents melatonin release, making it hard to fall asleep. Melatonin supplements have become a popular sleep aid, with studies showing that they improve sleep quality and reduce the time it takes to fall asleep. It is available over the counter, but it is important to note that it may have side effects and can reduce the effectiveness of some medications.
Valerian
Valerian is a perennial plant that has been used as a sleep aid for hundreds of years. It may raise GABA levels, which boosts relaxation. It is considered safe for short-term use, but may cause headaches and stomachaches in some people. It can be taken as a supplement or brewed as a tea.
Cannabidiol (CBD)
CBD is a compound found in marijuana and hemp plants that does not produce a high. It has been shown to help with anxiety and sleep, with studies indicating that it improves sleep quality and reduces anxiety. However, it may cause side effects such as nausea and tiredness, and its long-term safety is still being studied.
Magnesium
Magnesium is a mineral that has been linked to promoting better sleep.
Lavender
Lavender is a natural sleep aid that can help induce sleepiness.
Other natural sleep aids include herbal teas, such as chamomile tea, and tart cherry juice. It is important to remember that even natural sleep aids can have side effects and interact with medications, so it is always a good idea to consult a doctor before trying them.
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Sleeping pills for elderly patients
Sleep is an essential part of our lives, and when it is disrupted, it can have a huge impact on our health and quality of life. Sleep disorders are a significant concern for elderly patients, with 57% of the elderly population in the United States suffering from chronic insomnia. This can be caused by various factors such as retirement, health problems, grief, and changes in circadian rhythm.
Sleeping pills are one option to treat insomnia, but they should be approached with caution. Prescription sleeping medication can be habit-forming and can cause undesirable side effects. These side effects can include drowsiness, impaired focus and memory, difficulty with balance and movement, and a "hangover" effect the next day. More severe side effects may include parasomnias such as sleepwalking, sleep-talking, sleep-eating, and even sleep-driving, which can be extremely dangerous. Sleeping pills can also interact with other medications, particularly those that affect the central nervous system, and even a small amount of alcohol can enhance the sedation, causing depressed breathing or, in the worst cases, death.
Due to these risks, it is recommended that elderly patients avoid sleeping pills, especially those over 65. Doctors will usually suggest alternative treatments for insomnia in elderly patients, such as psychological and behavioural therapies, light therapy, or a combination of therapies.
If sleeping pills are considered necessary, it is important to consult a doctor and be aware of the potential side effects. The choice of medication should be symptom-based, and the patient's full medical history should be taken into account, including any other medications they are taking.
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Frequently asked questions
Sleeping pills can have side effects and safety concerns. They may cause constipation, diarrhoea, muscle weakness, digestive problems, worsen snoring and sleep apnea, and cause psychological dependence. They can also interfere with other medications, particularly those that affect your central nervous system, and even a small amount of alcohol can be dangerous when combined with sleeping pills.
Common side effects of prescription sleeping pills include burning or tingling in the hands, arms, feet or legs. Sleeping pills can also cause parasomnia, where people may sleepwalk, eat, take medication, talk or even drive while still mostly asleep.
Non-drug therapies like cognitive behavioural therapy (CBT) are often better at improving sleep. Natural sleep aids such as melatonin, valerian, L-tryptophan, and antihistamines like diphenhydramine (ZzzQuil) and doxylamine (Unisom) are also available over the counter.
Sleeping pills are not recommended for children, and there are no FDA-approved sleeping pills for children under 16. Experts suggest that people over 65 avoid all sleep aids, including over-the-counter drugs and "Z" drugs like eszopiclone (Lunesta), zaleplon (Sonata) and zolpidem (Ambien). Pregnant or breastfeeding people should consult a healthcare provider before taking any sleeping pills or supplements.
