Gina Johnson
Sleep is essential for our health and well-being, and for many people, achieving a good night's rest can be challenging. Sleeping pills and medications can be a tempting solution, but it's important to understand the potential benefits and risks before deciding whether to take them. While sleep aids can help you fall asleep faster and provide short-term relief from insomnia, they also come with side effects and the potential for dependency. Additionally, lifestyle and behavioural changes, such as improving sleep habits and addressing stress, are often the most effective long-term solutions for better sleep. So, should you take medicines to sleep? Let's explore the considerations and alternatives to help you make an informed decision.
| Characteristics | Values |
|---|---|
| Effectiveness | Sleeping pills may help you fall asleep about 8 to 20 minutes faster and may get you an additional 35 minutes of sleep. |
| Usage | Sleeping pills are generally recommended for short-term use, especially during stressful life events. |
| Side effects | Sleeping pills may cause central nervous system (CNS) depression, anaphylactic reactions, worsening depression, withdrawal effects, and parasomnia. |
| Dependency | Sleeping pills may cause dependency, and it may be difficult to stop taking them without experiencing rebound insomnia. |
| Safety | Sleeping pills are not recommended for pregnant or breastfeeding individuals, older adults, or children. |
| Alternatives | Cognitive behavioral therapy (CBT), behavioral changes, and natural supplements like melatonin may improve sleep without the risks associated with sleeping pills. |
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What You'll Learn
Side effects of sleep medications
Sleep medications can have several side effects, and they vary from person to person and by medication. Some common side effects of sleep medications include drowsiness, constipation, muscle weakness, digestive problems, and impaired focus the next day.
Approximately 8 out of 10 people experience a "hangover" effect the day after taking sleep medication. They may feel drowsy, have muddled thinking, and experience dizziness or balance problems. These daytime effects can negatively impact your ability to drive, work, or complete daily tasks. Older adults are more susceptible to these side effects, and the drugs can stay in their system longer, causing confusion, memory issues, and balance problems, which can increase the risk of falls and hip fractures.
Sleeping pills can also cause a burning or tingling sensation in the hands, arms, feet, or legs. They can be habit-forming, and long-term use can lead to dependence and tolerance, resulting in more severe side effects. Some prescription sleep medicines may also bring on parasomnia, a disruptive sleep disorder where people may sleepwalk, eat, or even drive while mostly asleep.
It's important to note that sleep medications are generally recommended for short-term use, and behavioural changes or cognitive-behavioural therapy (CBT) may be more effective in improving sleep without the risk of side effects. Always consult a healthcare professional before taking any sleep medication to ensure it is safe for you.
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Precautions and risks
Sleep is crucial to physical and mental health, and medication can be a helpful part of improving your sleep. However, it is important to exercise caution when taking sleep medication and to be aware of the potential risks and side effects.
Firstly, it is important to consult your healthcare provider before taking any sleep medication, especially if you are pregnant, breastfeeding, or taking other medications. Sleep medication can interact with other substances, such as alcohol, and may have dangerous side effects when mixed. Additionally, medication should not be the only solution to address insomnia. It works best when paired with behavioural changes, such as maintaining a consistent sleep schedule, avoiding large meals and alcohol before bed, cutting back on caffeine, and quitting smoking.
Secondly, sleep medication can have side effects and may not be suitable for long-term use. Some common side effects include feeling tired or groggy the next day, memory problems, central nervous system (CNS) depression, and allergic reactions. There is also a risk of dependency, especially with certain medications like zolpidem-containing drugs, which can lead to withdrawal effects when discontinued. Additionally, some sleep medications may cause complex sleep behaviours, such as sleepwalking or driving while unaware, known as parasomnia.
Furthermore, sleep medication may not be effective for everyone. Studies show that sleeping pills may only provide a small additional amount of sleep, and their effectiveness may decrease over time as the body becomes accustomed to them. In some cases, behavioural changes and cognitive-behavioural therapy (CBT) may be more effective in improving sleep without the need for medication.
Lastly, sleep medication may not be recommended for certain individuals, such as children and older adults. For children, behavioural changes are often the preferred method for improving sleep, and over-the-counter antihistamines given to children to aid sleep can pose a risk of overdose. Older adults are also advised to explore non-drug treatments first, as there may be safer alternatives to sleep medication.
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Alternative treatments
There are several alternative treatments for improving sleep without medication. These include:
Lifestyle Changes
Beyond sleep hygiene, lifestyle changes can help treat insomnia. Relieving stress may help resolve short-term insomnia symptoms. Additionally, if insomnia is caused by another health problem or medication, addressing that issue may improve sleep. Cognitive behavioural therapy for insomnia (CBT-i) is a therapy-based treatment for insomnia that does not involve sleeping pills. It is usually performed with the help of a therapist or counsellor, although there are some app-based programs available.
Herbal Remedies
There are several herbal remedies that may help with sleep. These include valerian root, which may help people fall asleep or stay asleep, although it can interfere with some medications and is not safe for children or pregnant women. Chamomile is another herb that is commonly used to treat insomnia and is considered safe by the FDA, although it can interact with certain medications. Magnolia bark may also improve sleep by preventing the body from releasing the stress hormone adrenaline, although it can cause heartburn. California poppy has been used as a sedative in traditional medicine, although there is little research on its effectiveness. Kava is another herbal remedy for insomnia, but it has been linked to a risk of serious liver damage.
Supplements
Melatonin is a natural hormone that helps regulate the sleep-wake cycle and is available as an over-the-counter supplement. It may be helpful for people with naturally low levels of melatonin or those exposed to a lot of unnatural light after dark. However, melatonin supplements are not regulated by the FDA, so it is important to stick to one brand and consult a doctor before taking them. Other supplements that may be beneficial for sleep include 5-hydroxytryptophan (5-HTP) and magnesium.
Cannabinoids
Some studies suggest that THC and CBD, alone or in combination, may help people fall asleep, stay asleep, and improve sleep quality. However, marijuana and products containing THC can create dependence, and withdrawal from them can aggravate sleep problems. CBD is also not recommended for pregnant or nursing people and is classified as a controlled substance in some states.
Other Techniques
Other techniques that may help improve sleep include meditation, progressive muscle relaxation, biofeedback, and regular exercise. Yoga, tai chi, and acupuncture have also been found to enhance sleep quality.
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Short-term use
Sleep is crucial for physical and mental health, and medication can be a helpful part of improving your sleep. However, sleep medication should generally be used for short-term relief only. This is because your body can become dependent on sleep medication, and when you stop taking it, your insomnia may return worse than before—a phenomenon known as rebound insomnia. Sleep medication may also cause parasomnia, a disruptive sleep disorder that can cause dangerous behaviours while you are still mostly asleep.
Sleep medication may be most helpful if a stressful life event, such as a divorce or death in the family, is keeping you awake. Doctors may prescribe medication for short-term insomnia relief, such as triazolam (Halcion), typically for 7 to 10 days. Doxepin, a sleep aid with the brand name Silenor, may be prescribed for up to 3 months. Zolpidem is another short-term sleep medication, available in a once-daily 12.5 mg extended-release form. Doctors will often start with the lowest possible dose and increase it if necessary.
Over-the-counter (OTC) sleeping pills typically contain antihistamines, which are commonly used to treat allergies. While these sleep aids are not addictive, your body becomes used to them quickly, and they are less likely to help you fall asleep over time. These medicines can also leave you feeling tired or groggy the next day and may cause memory problems in older adults. Melatonin is another over-the-counter option, a naturally occurring hormone that controls the sleep-wake cycle. It can speed up the time it takes you to fall asleep, but it is recommended to start with a low dose (between 1 and 5 milligrams) and take it 30 minutes before bedtime.
It is important to note that medication should be just one part of a larger strategy to address insomnia. Behavioural changes often improve sleep without the need for medication. For example, maintaining a consistent sleep schedule, avoiding large meals and alcohol before bed, cutting back on caffeine, quitting smoking, and relaxing with soothing music, a good book, or meditation can all help improve your sleep.
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Dependency and misuse
Sleeping pills are not recommended for long-term use due to their potential for dependence and misuse. While they can be helpful in the short term for those experiencing insomnia due to stressful life events, they should not be relied upon as a long-term solution.
Sleeping pills are powerful sedatives that can change how the brain functions, helping individuals fall asleep and stay asleep. However, with prolonged use, the brain can become dependent on these medications, leading to tolerance and, in some cases, addiction. Tolerance develops when an individual needs to increase their medication dosage to achieve the same effects, and dependence occurs when the brain becomes convinced that it needs the medication to fall asleep. According to the Institute for Quality and Efficiency in Healthcare, this dependency can develop within a few weeks of starting the medication.
Withdrawal symptoms can be physically and mentally challenging, and may include trouble sleeping, restlessness, anxiety, shivering, and dizziness. To avoid a cycle of dependence and withdrawal, it is essential to gradually reduce the dosage over time with medical supervision. Additionally, psychological or therapeutic support can be beneficial during this process.
Misuse of sleeping pills involves taking them in a manner other than prescribed, such as taking a higher dose than recommended, using them without a prescription, or combining them with other substances. Addiction to sleeping pills is characterized by a lack of control over their use, continued use despite negative consequences, and an inability to fulfil duties due to their influence. It's important to note that not everyone who develops a dependence on sleeping pills becomes addicted, but it is a significant risk factor.
To avoid the potential for dependence and misuse, it is generally recommended to explore non-drug treatments first. Cognitive-behavioural therapy (CBT), behavioural changes, and lifestyle modifications can often improve sleep without the need for medication.
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Frequently asked questions
Some over-the-counter sleep medications include antihistamines like diphenhydramine and doxylamine succinate. Melatonin supplements can also be purchased over the counter and can help promote sleep.
Doctors may prescribe sleep medications such as doxepin (Silenor), zolpidem, and triazolam (Halcion) for short-term insomnia relief. Rozerem is another option that can be prescribed for longer-term use and has a low likelihood of misuse or dependency.
Sleep medications can have various side effects, including dizziness, lightheadedness, central nervous system (CNS) depression, and daytime sleepiness. They may also cause complex sleep behaviours, such as sleepwalking or driving while unaware. Additionally, there is a risk of dependency with some sleep medications, and they should be used cautiously and under medical supervision.
Yes, cognitive behavioural therapy (CBT) is an effective tool for improving sleep and addressing insomnia. Lifestyle changes, such as avoiding large meals and alcohol before bed, reducing caffeine intake, quitting smoking, and incorporating relaxing activities, can also significantly improve sleep quality.
Sleep medications should be used with caution in certain populations. Pregnant or breastfeeding individuals should consult their healthcare provider before taking any sleep medications, as the medication can pass to the fetus or infant. Older adults may experience memory problems with certain sleep aids. Additionally, individuals taking monoamine oxidase inhibitors or specific types of antidepressants should be cautious about using certain sleep aids.
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