Gina Johnson
Sleep is an essential part of our lives, and insomnia, which affects up to 40% of U.S. adults, can significantly impact our health and well-being. While there are several causes of insomnia, including medications, pain, and mental health conditions, it is important to understand the risks associated with sleep medications before considering them as a treatment option. Sleep medications are typically intended for short-term use and come with significant risks and side effects, including memory problems, falls, and even death. Additionally, there is no convincing evidence that they improve long-term health. However, for those seeking short-term relief from insomnia, prescription medications such as zaleplon (Sonata), eszopiclone (Lunesta), zolpidem (Ambien), and doxepin (Silenor) are a few of the options available. It is always recommended to consult with a healthcare professional to determine the most suitable treatment option and to ensure safe usage.
| Characteristics | Values |
|---|---|
| Purpose | To help fall asleep or to help stay asleep |
| Usage | Occasional or long-term |
| Types | Prescription or over-the-counter (OTC) |
| Prescription sleep medication examples | Zaleplon (Sonata), Zolpidem, Eszopiclone (Lunesta), Estazolam (Prosom), Ramelteon (Rozerem), Doxepin (Silenor), Temazepam, Triazolam (Halcion), Clonazepam (Klonopin) |
| OTC sleep medication examples | Diphenhydramine (Benadryl), Melatonin, Valerian |
| Side effects | Memory problems, dizziness, lightheadedness, falls, slowed breathing, unresponsiveness, nausea, headaches, daytime sleepiness, sleepwalking, complex sleep behaviours, dependence, misuse, memory loss, hallucinations, mood changes |
| Risks | Drug interactions (e.g. with alcohol or opioids), dependence, misuse, long-term health impact |
| Precautions | Understand side effects and risks, only take as directed, do not mix with alcohol or opioids, consult a doctor before starting or stopping |
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What You'll Learn
Prescription vs. over-the-counter (OTC) sleeping pills
Sleeping pills can help you fall asleep or stay asleep, but they are intended for short-term use as they carry significant risks and side effects. Prescription sleeping pills are stronger than over-the-counter (OTC) 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.
Prescription sleep medications for insomnia include benzodiazepines, Z-drugs, antidepressants, and barbiturates. Benzodiazepines, such as triazolam (Halcion), are FDA-approved to treat insomnia, while those approved for anxiety, such as clonazepam (Klonopin), may be prescribed if anxiety and insomnia are both present. However, benzodiazepines can be addictive and lead to substance use disorders, so they are typically prescribed for short-term use only. Z-drugs, such as zolpidem (Ambien) and eszopiclone (Lunesta), carry a risk of misuse and dependence and may cause complex sleep behaviours, such as sleepwalking or driving while asleep. Eszopiclone may also cause diminishing effects or increased tolerance over time. Other prescription sleep medications include estazolam (Prosom), which is prescribed for short-term insomnia relief, and doxepin (Silenor), which may be suggested by doctors for up to three months of use. Ramelteon (Rozerem) is another prescription option that affects melatonin receptors to promote sleep and positively impact circadian rhythms. Due to its low likelihood of misuse or dependency, it may be prescribed for longer-term use.
Over-the-counter (OTC) sleep aids are widely available, but they are not recommended for treating chronic insomnia. They can be useful for short-term sleep difficulties, such as overcoming jet lag or a brief bout of sleeplessness. Most OTC sleep aids contain antihistamines, such as diphenhydramine, which is found in Benadryl and other sleep aids under different brand names. Antihistamines work by blocking histamines, the substances in the body that cause alertness. However, they can cause side effects such as daytime drowsiness, blurred vision, constipation, and trouble urinating. Diphenhydramine is not recommended for those over 65 due to an increased risk of serious side effects, including falls. Other OTC sleep aids include melatonin, which is a synthetic version of the natural hormone that regulates the sleep-wake cycle, and CBD (cannabidiol), which is being studied as a treatment for insomnia due to its anxiety-relieving properties. However, it is important to note that supplements like melatonin, valerian, and CBD are not as strictly regulated by the Food and Drug Administration, so there is no guarantee of the accuracy of the label information.
While prescription sleeping pills are stronger and may be more effective for treating insomnia, they come with higher risks of dependence and addiction. OTC sleep aids are more easily accessible and may be useful for short-term sleep issues but are not recommended for chronic insomnia. It is always advisable to consult a healthcare professional before taking any sleep medication to ensure safe and appropriate use.
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Short-term use only
Sleeping pills are intended for short-term use and are not a long-term solution for insomnia. They can be habit-forming and come with significant risks, including memory problems, falls, and even death. It's important to consult a healthcare professional before starting any sleep medication to understand the potential side effects and risks.
Some prescription sleep medications commonly used for short-term relief from insomnia include:
- Zaleplon (Sonata): Helps with falling asleep but does not maintain sleep. It has a risk of dependency and misuse.
- Zolpidem (Ambien, Intermezzo, Zolpimist): Assists with falling asleep and staying asleep. It may cause complex sleep behaviours, such as sleepwalking or driving while asleep.
- Eszopiclone (Lunesta): Aids in falling and staying asleep but has a risk of misuse and dependency.
- Estazolam (Prosom): Prescribed for short-term insomnia, aiding in falling and staying asleep, but carries a risk of misuse and dependency.
- Benzodiazepines: Medications like triazolam (Halcion) are FDA-approved to treat insomnia, while others, like clonazepam (Klonopin), may be prescribed if anxiety is also a concern. Benzodiazepines have a higher risk of misuse than Z-drugs.
Over-the-counter (OTC) sleep aids are also available, but they are not recommended for treating chronic insomnia. Diphenhydramine, an antihistamine found in OTC sleep aids, can cause drowsiness but is not advised for long-term use due to potential memory issues and increased side effects in older adults.
Additionally, Ramelteon (Rozerem) is a melatonin-based medication that may be prescribed for longer-term use due to its low likelihood of misuse or dependency. It promotes sleep by affecting melatonin receptors and positively influencing circadian rhythms.
While short-term use of sleeping pills can provide temporary relief from insomnia, it's important to prioritize developing good sleep habits and exploring other sleep remedies before relying on medication.
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Potential side effects
Sleeping pills are not without their side effects, and they are not recommended for long-term use. They are intended for short-term relief from insomnia. The potential side effects of sleeping pills include:
- Daytime sleepiness and confusion.
- Parasomnia, which includes sleepwalking and sleep eating.
- Memory problems.
- Risk of falls, which can be more harmful to older adults.
- Dependence and addiction, especially with prescription sleeping pills.
- Rebound insomnia when trying to stop taking the medication.
- Withdrawal symptoms.
- Increased sensitivity to sedative effects in older adults.
- Tolerance, which means that over time, a higher dose is required to achieve the same effects.
Additionally, some sleeping pills may interact with other medications, especially those that affect liver enzymes. Mixing sleeping pills with other medications such as opioids or muscle relaxers, or with alcohol, can be dangerous and even fatal. It is important to consult a healthcare professional before taking any sleep medication to understand the potential risks and side effects.
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Natural sleep aids
While prescription sleep medications are available for insomnia, they often carry significant risks and are recommended for short-term use only. Natural sleep aids, on the other hand, offer a safer alternative with fewer side effects and drug interactions. Here are some effective natural remedies to help you fall asleep more easily:
Melatonin Supplements: Melatonin is a hormone that is naturally produced by the brain a few hours before we feel sleepy. However, exposure to artificial light from electronic devices can interfere with its release, disrupting our sleep. Melatonin supplements, available over the counter, can help promote sleep and regulate circadian rhythms. It is important to consistently purchase the same brand of melatonin supplements as dosages and ingredients may vary between manufacturers.
L-Theanine: L-Theanine is a natural sleep aid that does not cause daytime sleepiness. Consuming up to 200 mg per day is considered safe, and it can help improve sleep and behaviour in children with ADHD.
Glycine: Glycine is an amino acid and neurotransmitter that plays a role in various bodily functions, including sleep. Taking a small dose of glycine supplement before bed may improve sleep quality and reduce daytime sleepiness in people with insomnia.
Valerian: Valerian is a natural sedative that can be helpful for menopausal women experiencing hot flashes and insomnia. However, it may cause morning drowsiness and other side effects, including irregular heartbeat and dizziness. It should not be combined with alcohol or sedative medications.
Dietary Changes: Magnesium is a mineral that influences sleep quality and quantity. Consuming magnesium-rich foods such as whole grains, avocados, bananas, nuts, seeds, beans, and dairy can help improve sleep. Older adults with insomnia may benefit from magnesium supplements.
Beverages: Warm milk, chamomile tea, and tart cherry juice are recommended for improving sleep. Chamomile tea is believed to contain flavonoids that interact with benzodiazepine receptors in the brain, promoting sleep. Tart cherry juice may also support melatonin production and enhance sleep cycles.
Exercise: Physical activity, particularly moderate aerobic exercise, can boost the amount of deep sleep you get. However, it is important to time your workouts correctly, as aerobic exercise releases endorphins that can keep you energized and awake.
Temperature and Light Control: Maintaining a cool temperature between 65 and 72 degrees Fahrenheit in your bedroom can promote better sleep. Additionally, minimizing light exposure, especially from electronic devices, is crucial as light interferes with sleep. If you need to get up at night, use a flashlight instead of turning on bright lights.
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Alternatives to sleeping pills
While sleeping pills can be effective in treating insomnia, they are intended for short-term use and carry significant risks, including memory problems, falls, and even death in rare cases. As such, it is important to explore alternative treatments for insomnia that do not involve medication.
One alternative to sleeping pills is cognitive behavioural therapy (CBT). CBT is a type of psychotherapy that can help individuals with insomnia identify and change negative thoughts and behaviours that may be impacting their sleep. This may include techniques such as relaxation training, sleep restriction, and stimulus control therapy.
Another option is to improve sleep hygiene habits. This involves establishing a consistent sleep schedule, creating a comfortable and relaxing sleep environment, and avoiding stimulants such as caffeine and nicotine close to bedtime. Reducing exposure to blue light from electronic devices before bed and engaging in relaxing activities such as reading or meditation can also promote better sleep.
Additionally, certain lifestyle changes can improve insomnia. Regular physical activity during the day can improve sleep quality, while avoiding excessive napping can help maintain a healthy sleep-wake cycle. Maintaining a balanced diet and managing stress through techniques like yoga or deep breathing can also positively impact sleep.
For those with insomnia related to mental health conditions such as anxiety or depression, treating the underlying condition may improve sleep. Antidepressants or anti-anxiety medications can be prescribed, as drowsiness is often a side effect. However, it is important to note that these medications may not be suitable for everyone and should be used under the guidance of a healthcare professional.
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Frequently asked questions
Sleeping pills are medication that can help with falling and staying asleep. They are intended for short-term use and come with significant risks, including memory problems, falls, and in rare cases, death.
Some prescription sleeping pills include:
- Zaleplon (Sonata)
- Zolpidem (Ambien, Intermezzo, Zolpimist)
- Estazolam (Prosom)
- Eszopiclone (Lunesta)
- Ramelteon (Rozerem)
- Doxepin (Silenor)
- Triazolam (Halcion)
Melatonin supplements are available over the counter and can help promote sleep by regulating the body's sleep-wake cycle. Antihistamines can also cause drowsiness and help with sleep, but they can cause grogginess.
Sleeping pills should only be taken when you can get a full night's sleep. They should not be mixed with alcohol or opioids, as this can lead to dangerously slowed breathing or unresponsiveness. It is important to understand the side effects and risks of any medication before taking it and only take it as directed by a healthcare professional.
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