Gina Johnson
Sleep is an essential part of our lives, and for those who struggle with it, there are prescription medications that can help. Sleeping pills are typically prescribed for short-term use and are often used in conjunction with good sleep practices and behavioural treatments. There are many different types of prescription sleeping pills, including benzodiazepines, antidepressants, and antihistamines. Some common prescription sleeping pills include Temazepam (Restoril), Zolpidem (Ambien, Intermezzo, Zolpimist), and Zaleplon (Sonata). It is important to note that while these medications can be effective, they also carry risks of side effects, misuse, and dependency, so it is important to consult a doctor before starting any new sleep medication.
| Characteristics | Values |
|---|---|
| Prescription sleep pills | Belsomra, Ambien, Dayvigo, Quviviq, Lunesta, Restoril, Rozerem, Silenor, Sonata, Zolpidem, Zaleplon, Eszopiclone, Alprazolam (Xanax), Clonazepam (Klonopin), Diazepam (Diastat, Valium), Estazolam (Prosom), Lorazepam (Ativan), Temazepam (Restoril), Gabapentin Enacarbil (Horizant), Pramipexole (Mirapex), Ropinirole (Requip), Rotigotine (Neupro), Methylphenidate (Ritalin), Modafinil (Provigil), Pitolisant (Wakix), Sodium Oxybate (Xyrem, Xywav), Mirtazepine (Remeron), Trazodone, Quetiapine (Seroquel) |
| Over-the-counter sleep pills | Unisom, ZzzQuil |
| Risk factors | Side effects, misuse, dependency, allergic reactions, CNS impairments, complex sleep behaviours, hallucinations, mood changes, memory loss, addiction |
| Usage | Short-term, long-term |
| Dosage | 8 mg, 12.5 mg extended-release, 10 mg per day |
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What You'll Learn
Prescription sleep aids for insomnia
Sleep is an essential part of a healthy life, and for those who struggle to fall asleep or stay asleep, prescription sleep aids can provide relief. However, it is important to note that these medications often come with risks of side effects, misuse, and dependency, and should be used with caution and under medical supervision. Here is a list of prescription sleep aids that are commonly used to treat insomnia:
Belsomra (Suvorexant)
Belsomra is a controlled substance that can help a person fall asleep and maintain sleep. It is associated with a risk of misuse and can lead to CNS impairments, affecting activities like driving.
Rozerem
Rozerem is a medication that can be prescribed for longer-term use, unlike many sleep aids that are intended for short-term treatment. It comes in an 8 mg dose, with a recommendation of no more than one dose per day. Rozerem is not a controlled substance and has a low likelihood of misuse or dependency. However, it can cause side effects, including allergic reactions.
Zolpidem (Ambien, Intermezzo, Zolpimist)
Zolpidem is a Z-drug that can help with falling asleep and staying asleep. It is typically prescribed for short-term insomnia relief and is available in an extended-release form. Doctors usually start with the lowest possible dose and gradually increase it if needed.
Zaleplon (Sonata)
Zaleplon is another Z-drug that may be prescribed for the short-term treatment of insomnia. While it can aid in falling asleep, it does not help maintain sleep. It carries a risk of dependency and has a high likelihood of misuse. Less common side effects include hallucinations, mood changes, and memory loss.
Temazepam (Restoril)
Temazepam is a benzodiazepine that can be prescribed for the short-term treatment of insomnia. While it can be effective, it may also lead to dependency and addiction if misused.
Doxepin (Silenor)
Doxepin is a sleep aid that doctors may recommend for up to 3 months for people with insomnia.
It is important to consult a doctor before starting any sleep medication to ensure safe and effective use, as they can interact with other substances and medications. Additionally, combining prescription sleep aids with good sleep practices and behavioural treatments can lead to better outcomes.
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Sleeping pills for shift workers
Working outside the typical 9-to-5 workday can be challenging, especially when it comes to getting a good night's rest. This is a common issue, with an estimated 10% to 38% of shift workers suffering from shift work disorder, a condition marked by excessive sleepiness when one should be awake or an inability to sleep when needed. This disorder is a result of a mismatch between one's "internal body clock" and the external environment, which affects the timing and duration of sleep.
There are several strategies that shift workers can use to mitigate the effects of shift work disorder and improve their sleep. One approach is to make changes to your work and sleep routines, such as decreasing the number of consecutive night shifts worked and limiting each shift to eight hours or less. Additionally, bright light therapy can be beneficial, as light is a powerful driver of the circadian rhythm, and exposure to light at targeted times may help shift your sleep cycle.
In terms of prescription sleeping pills, benzodiazepines are one option that can be used to facilitate sleep for shift workers. It is important to be cautious when taking sleep medications, as they may raise the risk of accidents if drowsiness persists at the start of your shift. They can also be habit-forming and may worsen existing sleep disorders. Therefore, it is crucial to consult with a physician about the appropriate dosage and timing of sleep-promoting medications based on your specific work schedule.
Another option for promoting sleep as a shift worker is to take melatonin supplements. Melatonin is a sleep-promoting hormone that the body typically produces in the evening. Taking melatonin supplements at different times of the day can help prepare your body for sleep at unusual hours. However, while melatonin supplements can aid night shift workers in sleeping during the day, they may not necessarily improve alertness during the work shift.
In addition to medication, there are lifestyle modifications that can help shift workers manage their sleep. Keeping a sleep journal for at least two weeks can aid in diagnosing shift work sleep disorder and understanding your sleep patterns. Additionally, catching up on sleep during days off and taking short naps during shifts or on days off can help reduce sleep debt. Lastly, if possible, minimising disturbances such as noise and light when sleeping during the day can create a more restful environment.
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Sleeping pills for narcolepsy
While there is no specific cure for narcolepsy, its symptoms can be managed and minimised. Some simple changes to your sleeping habits can help, such as taking frequent, brief naps throughout the day, sticking to a strict bedtime routine, relaxing before bed, and ensuring a good sleeping environment. If your symptoms are more severe, medication can be prescribed to help manage them.
Modafinil
Modafinil is a medication that can help with sudden loss of muscle control and daytime sleepiness. However, it can interfere with the effectiveness of contraceptive pills, so it is advised to use alternative contraception while taking this medication and for at least two months after stopping it.
Sodium Oxybate (Xyrem, Xywav)
Sodium oxybate is a powerful medication that can improve sudden loss of muscle control, help you sleep at night, and reduce daytime sleepiness. It is taken in two doses, with the second dose administered 2.5 to 4 hours after the first. It is important to note that this medication can be habit-forming and may cause side effects such as dizziness, upset stomach, sleepwalking, and bedwetting. It may not be suitable for individuals with high blood pressure, kidney problems, or certain heart conditions.
Pitolisant (Wakix)
Pitolisant is prescribed for daytime sleepiness and may also prevent episodes of cataplexy in people with narcolepsy. It is not likely to be addictive and can be a good option for those with liver or kidney problems, as it does not affect these organs. However, possible side effects include headache, nausea, anxiety, trouble sleeping, and irregular heartbeat.
Solriamfetol (Sunosi)
Approved in 2019, solriamfetol helps the body release more histamine, which encourages wakefulness. It is effective in treating excessive daytime sleepiness but may cause side effects such as headache, nausea, decreased appetite, insomnia, and anxiety. It may not be suitable for individuals with high blood pressure, certain heart conditions, or mental illnesses.
It is important to consult with a healthcare professional to determine the most appropriate treatment plan for narcolepsy, as the right medication and dosage can vary from person to person.
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Sleeping pills for anxiety
Sleep and anxiety are closely linked. Worrying about insomnia may do more harm than poor sleep, and sleep deprivation can make anxiety worse. Doctors have long recognized sleep problems to be a symptom of anxiety disorders, and insomnia is also an independent risk factor for the development of anxiety.
There are several types of prescription medication that doctors may prescribe for anxiety and insomnia. These include sleep aids (non-benzodiazepines), which are widely used by individuals with insomnia. Non-benzodiazepines, also called “Z” drugs, have fewer reports of dependency, abuse potential, rebound insomnia, and interactions with other medications. Examples include zolpidem (Ambien), eszopiclone (Lunesta), and zaleplon (Sonata).
Benzodiazepines are another type of prescription medication used to treat insomnia or anxiety that is disabling, severe, and causing extreme distress. Examples include diazepam (Valium), alprazolam (Xanax), and triazolam (Halcion). Long-acting benzodiazepines like diazepam may be better for individuals experiencing early wakefulness or those who need help with anxiety throughout the day.
It is important to note that sleeping pills should ideally be taken for no longer than one week, and for no longer than three weeks. Anti-anxiety drugs should be taken for no longer than four weeks, including the withdrawal period. These are guidelines for doctors to follow, and you should discuss what is best for you with your doctor.
In addition to prescription medication, cognitive-behavioral therapy for insomnia (CBT-I) is an effective therapy for treating insomnia.
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Sleeping pills for elderly people
Sleep is essential for our health and well-being, but many older adults experience challenges with sleep due to age-related alterations in sleep physiology. Insomnia is a common issue in older adults, and while both clinicians and patients often prefer the simplicity of medication, it is important to consider the risks associated with certain hypnotics in this age group.
When it comes to sleeping pills for elderly individuals, it is crucial to proceed with caution and explore non-drug treatments first. Cognitive Behavioral Therapy for Insomnia (CBT-I) is the gold standard for treating insomnia in all age groups, including older adults. CBT-I addresses dysfunctional beliefs and behaviours related to sleep, such as worrying about falling asleep or the effects of poor sleep. While it is time-intensive and does not offer immediate results, it is highly effective in improving sleep quality.
If sleep problems persist and significantly impact an individual's quality of life, prescription sleeping pills may be considered. However, it is essential to consult a healthcare provider to carefully monitor the treatment and ensure the medication is helping without causing adverse side effects. Additionally, medication should be used at the lowest effective dose and for a limited duration. Some pharmacologic options for older adults include low-dose doxepin, melatonin, ramelteon, and dual orexin receptor antagonists.
It is worth noting that certain sleeping pills, such as the "Z" drugs (Zolpidem and Zopiclone), carry risks, especially for older adults. These drugs may have a higher risk profile than older sleep medications and could be as addictive as other sedatives. Therefore, it is crucial to thoroughly evaluate other solutions before resorting to prescription sleeping pills.
To improve sleep quality in older adults, it is recommended to maintain a consistent sleep schedule, regular physical activity (while avoiding vigorous exercise close to bedtime), and a peaceful bedroom environment. Additionally, limiting caffeine intake after 3 pm (or earlier, depending on sensitivity) and moderating alcohol consumption can promote better sleep. Addressing psychosocial factors, such as social isolation, can also help improve sleep habits and enhance overall sleep quality in elderly individuals.
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Frequently asked questions
Temazepam, also known as Restoril, is a benzodiazepine that can be prescribed to treat insomnia. Other prescription sleeping pills include Belsomra, Ambien, Dayvigo, Quviviq, Lunesta, and Silenor (Doxepin).
Temazepam is a benzodiazepine that helps induce and maintain sleep. While it can be effective for treating insomnia, it also carries a risk of dependency and addiction if misused.
Belsomra, or Suvorexant, is a controlled substance that can help a person fall asleep and maintain sleep. It is only available as a brand-name medication and carries a risk of misuse and dependency.
Yes, Rozerem is a sleeping pill that is not a controlled substance and has a low likelihood of misuse or dependency. However, it can still cause side effects, including allergic reactions in some individuals.
Yes, there are alternative treatments for insomnia that do not involve prescription medications. Antinarcoleptics such as methylphenidate (Ritalin) and modafinil (Provigil) can help improve daytime wakefulness for shift workers or those with narcolepsy or sleep apnea. Additionally, antidepressants or anti-anxiety medications like mirtazepine (Remeron), trazodone, and quetiapine (Seroquel) can be used to aid sleep due to their drowsiness side effects.
