Ashwin Lewis
Sleeping pills are medications that can help people fall asleep, relieve stress and anxiety, and stay asleep. They are often used to treat insomnia and other sleep disorders. While sleeping pills can be effective in aiding sleep, they come with a range of side effects and risks, such as dependency, addiction, and withdrawal symptoms. Prescription sleeping pills, such as benzodiazepines and Z-drugs, are stronger than over-the-counter options and are typically recommended for short-term use due to their potential for abuse and side effects like dizziness and drowsiness. Over-the-counter sleep aids, including antihistamines and melatonin, are also available but may not be recommended for long-term use without consulting a healthcare provider. As sleep issues can be caused by various factors, it is essential to address the underlying causes and practice good sleep hygiene before resorting to sleeping pills.
| Characteristics | Values |
|---|---|
| Purpose | Help people fall asleep, relieve stress and anxiety, and treat insomnia |
| Types | Prescription, Over-the-counter, Antidepressants, Benzodiazepines (Benzo), Non-Benzodiazepine (Non-BZD) or Z-drugs, Melatonin, Valerian |
| Effectiveness | Vary in how quickly they work, how long their effects last, and what side effects they may cause |
| Side Effects | Dizziness, Fatigue, Irritability, Confusion, Memory Issues, Balance Problems, Dependence, Addiction, Withdrawal Symptoms, Worsening of Snoring and Sleep Apnea |
| Risks | Overdose, Parasomnia, Interference with Other Medications, Worsening of Health Conditions, Not Suitable for Children |
| Alternatives | Cognitive-Behavioral Therapies, Relaxing Activities, Sleep Hygiene (consistent sleep schedule, controlled noise and temperature) |
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What You'll Learn
Sleeping pill side effects
Sleeping pills can cause a range of side effects, from constipation to muscle weakness. Some common side effects include daytime drowsiness, dizziness, and confusion. For older adults, confusion and memory issues can result in falls, broken hips, and car accidents. Other over-the-counter sleep medications can cause a dry mouth, constipation, and difficulty urinating.
Sleeping pills can also cause digestive problems, including gas, heartburn, and nausea. They can worsen snoring and sleep apnea, a potentially life-threatening condition. They may also interfere with normal breathing and be dangerous for people with certain chronic lung problems, such as asthma, emphysema, or chronic obstructive pulmonary disease (COPD).
Some sleeping pills can lead to dependence and addiction, especially with long-term use. When you stop taking them, your insomnia may return worse than before, a phenomenon known as rebound insomnia. Additionally, certain prescription sleep medicines may induce parasomnia, a disruptive sleep disorder characterised by dangerous behaviours while still mostly asleep. People taking these pills may sleepwalk, eat, talk, or even drive without being fully awake or aware of their actions.
It is important to consult a healthcare provider before taking any sleep aids, including over-the-counter supplements, as they can interfere with other medications or aggravate existing health conditions.
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Prescription vs. over-the-counter
There are a variety of sleep aids available, from natural remedies to over-the-counter choices and prescription medications. Over-the-counter sleep aids are easily accessible and may be the best option for jet lag or regulating your sleep-wake cycle. However, it is recommended that you consult a healthcare provider before taking them as they can interfere with other medications or aggravate health conditions.
Over-the-counter sleep aids include melatonin supplements, which are widely available, as well as diphenhydramine (Benadryl), and doxylamine succinate (Unisom SleepTabs, Robitussin Nighttime Cough DM, and Vicks Nyquil D Cold and Flu Nighttime Relief). Most over-the-counter sleeping pills contain antihistamines, which work by blocking histamines in the body that cause alertness.
Prescription sleeping pills, on the other hand, are stronger than over-the-counter ones and require a prescription from a healthcare provider. These are typically only recommended for short-term relief as they are not a cure for insomnia and carry a risk of dependence and addiction. Examples of prescription sleep aids include benzodiazepine sedative hypnotics like Ativan (lorazepam) or Restoril (temazepam), and non-benzodiazepine hypnotic sedatives like Ambien (zolpidem) or Lunesta (eszopiclone).
It is important to note that sleeping pills, whether over-the-counter or prescription, can have side effects. These can include constipation, muscle weakness, dizziness, and drowsiness the next day. Additionally, mixing sleep aids with other sedatives or alcohol can lead to an overdose, and certain prescription sleep medicines may bring on parasomnia, causing people to engage in dangerous behaviours while mostly asleep. Therefore, it is crucial to use caution when taking any sleep medication and to consult a healthcare provider to determine the best treatment option based on individual needs and circumstances.
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Natural sleep aids
While over-the-counter and prescription sleeping pills are available, they can have side effects and safety concerns. Natural sleep aids, on the other hand, offer a safer alternative to improve your sleep. Here are some natural remedies and lifestyle adjustments that can help you get a good night's rest:
Melatonin Supplements
Melatonin is a hormone naturally produced by your body that signals to your brain that it's time to sleep. Melatonin supplements have become a popular sleep aid, especially for older adults and those experiencing jet lag. They are available over the counter and can help reduce the time it takes to fall asleep. However, it's important to consistently buy the same brand of melatonin supplements due to the lack of FDA regulation.
Magnesium and Valerian Root
Magnesium is a mineral that plays a crucial role in various bodily functions, including sleep regulation. Valerian root is an herb that has been traditionally used to promote relaxation and sleep. Both of these natural remedies have been associated with improving sleep quality.
CBD Products
CBD has been found to relieve anxiety and act as a natural sleep aid, especially when used in conjunction with THC. However, it's important to note that more research is needed to establish its long-term safety, and CBD is not recommended for pregnant or nursing individuals. Additionally, the legality of CBD varies depending on your location.
Lifestyle Adjustments
Making certain lifestyle changes can also improve your sleep:
- Avoid working out within two hours of bedtime to prevent raising your core body temperature, which can interfere with sleep.
- Minimize exposure to unnatural light before bed, especially from smartphones, laptops, and TVs, as it can disrupt your body's melatonin production.
- If you need to get up during the night, use a flashlight instead of turning on bright lights, as it causes less visual disruption.
- Sleep in layers to easily adjust your bedtime temperature.
- Avoid alcohol, which can interfere with sleep, and instead opt for warm milk, chamomile tea, or tart cherry juice, which are believed to have sleep-promoting properties.
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Addiction and withdrawal
Sleeping pills can be addictive, and users may experience withdrawal symptoms when they try to stop taking them. This is especially true of older types of sleeping pills, such as benzodiazepines, which include Valium and Xanax. Newer pills, like Ambien and Sonata, are less likely to cause physical addiction, but psychological addiction is still possible. Addiction to sleeping pills can be challenging to overcome because the user's body becomes reliant on the drugs to function.
Dependence on sleeping pills can develop quickly, sometimes after just a few weeks. People can become dependent on sleeping pills after taking them for several months or even years. Women, especially older women, are more likely to use these medications. Healthcare providers usually prescribe sleeping pills only for short-term relief because of the risk of dependence and addiction.
Withdrawal symptoms can occur when someone stops taking sleeping pills suddenly. These symptoms can start within a few hours or weeks after stopping the medication and typically include trouble sleeping, restlessness, anxiety, shivering, and feeling dizzy and faint. These symptoms are similar to those that the sleeping pills were originally meant to treat, which can create a vicious cycle where people start taking the pills again to relieve the symptoms. To avoid this, it is generally recommended to gradually reduce the dose over several weeks before stopping the medication completely.
Medical detox is the safest way to withdraw from sleeping pills, as doctors can monitor the patient and address any potential health concerns. Doctors may administer intravenous (IV) fluids to balance electrolytes and replenish the body. Withdrawal symptoms can be moderate to severe and may even be life-threatening in some cases. People with multiple addictions or co-occurring mental health problems may experience a more complicated withdrawal process and may require a longer stay in medical detox.
To taper off sleeping pills safely, it is important to seek guidance from a healthcare provider. Certain types of therapy can also help people learn to sleep without medication. Keeping a regular sleep schedule, exercising, limiting screen time, and avoiding caffeine can all contribute to improving sleep without the use of drugs.
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Sleep hygiene
Sleep Schedule
- Go to sleep and wake up at the same time every day, including weekends.
- If you've had a week with insufficient sleep, consider catching up on sleep during the weekend.
Bedroom Environment
- Minimize noise by using heavy curtains and rugs to absorb sound, or use a sleep machine that provides white noise or soothing sounds.
- Minimize light with light-blocking curtains or shades if outside lights shine into your bedroom.
- Maintain a slightly cool temperature in your bedroom, as most people sleep better in a cool room.
- Replace your mattress and pillows if they're worn or uncomfortable.
Bedtime Routine and Daily Habits
- Reduce or avoid consuming substances that may interfere with sleep, such as alcohol or certain medications.
- Avoid screens before bed, as the blue light from electronic devices can disrupt sleep.
- Engage in relaxing activities before bed, such as reading, meditation, or listening to soothing music.
- Avoid stimulating activities or intense exercise close to bedtime.
- Limit caffeine intake, especially in the afternoon and evening.
- Establish a pre-sleep routine that prepares your mind and body for sleep, such as taking a warm bath or doing some light stretching.
Remember, sleep hygiene alone may not cure severe sleep problems. If you have persistent sleep difficulties or daytime sleepiness, consult a doctor for personalized advice and treatment options.
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Frequently asked questions
Some over-the-counter sleep aids include antihistamines (e.g. diphenhydramine, doxylamine), melatonin, L-tryptophan, and valerian.
Prescription sleeping pills include benzodiazepines (temazepam), alprazolam, clonazepam, diazepam, lorazepam, zolpidem, zopiclone, suvorexant, and lemborexant.
Sleeping pills can have various side effects, including drowsiness, dizziness, dry mouth, urinary retention, constipation, difficulty urinating, decreased sexual drive, weight gain, and addiction. They can also cause confusion, memory issues, and balance problems, especially in older adults.
Yes, there are several alternatives to sleeping pills. Improving sleep hygiene by creating a good sleep environment, maintaining a consistent sleep schedule, and limiting caffeine and alcohol intake can help. Cognitive-behavioral therapy (CBT) is also an effective way to improve sleep without medication.
