Ashwin Lewis
Sleep is essential for our health and well-being, but many people experience challenges falling asleep or staying asleep. Sleeping pills are one option to help with sleep issues, and they can be obtained in the UK either by prescription or over the counter. Over-the-counter sleep aids typically contain antihistamines, which cause drowsiness as a side effect, and are intended for short-term use. Stronger sleeping pills, such as benzodiazepines, Z-drugs, and antidepressants, require a prescription and are recommended for severe insomnia. Natural sleep supplements that combine botanical extracts, amino acids, and minerals are also available for those seeking an alternative to traditional medication.
| Characteristics | Values |
|---|---|
| Availability | Prescription or over the counter |
| Prescription sleeping pills | Zopiclone, Zolpidem, Temazepam |
| Over-the-counter sleeping pills | Drowsy antihistamines, herbal sleeping tablets |
| Drowsy antihistamines | Diphenhydramine, Promethazine |
| OTC brand names | Nytol, Benadryl, Avomine, Sominex |
| Herbal sleeping tablets | Valerian root, Chamomile, Lavender, Magnesium, Vitamin B12 |
| Side effects | Sleep-walking, dependence, withdrawal, hangover effect |
| Precautions | Not for long-term use, not suitable for pregnant or breastfeeding women |
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What You'll Learn
Prescription sleeping pills
In the UK, prescription sleeping pills are available for those with severe insomnia. These include benzodiazepines, Z-drugs, and antidepressants. Z-drugs, such as zolpidem and zopiclone, are non-benzodiazepine hypnotics that act in a similar way to benzodiazepines, including similar problems with dependence and withdrawal. They are short-acting drugs with a lower likelihood of a 'hangover' effect than other sleep medications. Doctors should only prescribe Z-drugs for severe insomnia and only after other non-medication treatments have been attempted.
Pregnant, breastfeeding, or soon-to-be pregnant individuals can consult their doctors about the risks and benefits of taking Z-drugs. It is important to note that Z-drugs are intended to be taken when one is ready for sleep and not before. They are typically taken for a maximum of three weeks, and ideally for no more than one week. Gradual withdrawal from Z-drugs is recommended to avoid negative withdrawal effects. If one Z-drug is found to be ineffective, another should not be prescribed. All Z-drugs carry a risk of sleepwalking, where individuals may get up and perform actions while not fully awake.
Benzodiazepines are a class of drugs that can be prescribed as sleeping pills. They are typically used for the short-term treatment of severe insomnia. These medications are generally well-tolerated and act as central nervous system depressants, inducing sleep and relaxation. However, they may cause side effects such as drowsiness, dizziness, and impaired coordination. It is important to use them exactly as prescribed and not to stop taking them abruptly, as this can lead to withdrawal symptoms.
Antidepressants are another type of prescription medication that can be used off-label to treat insomnia. These medications are typically prescribed for depression but can also help with sleep issues. They work by increasing the availability of certain neurotransmitters in the brain, such as serotonin, which can promote relaxation and improve sleep. However, they may have side effects, and it is important to discuss the risks and benefits with a doctor before taking them.
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Over-the-counter pills
Over-the-counter sleeping pills are typically designed for short-term sleep problems. They are available in the UK as drowsy antihistamines, herbal sleeping tablets, and melatonin medication.
Antihistamines are the strongest over-the-counter sleeping pills available in the UK. They work by blocking the effects of histamine, a chemical produced by the nervous system that causes allergy symptoms like a runny nose or sneezing. This process often causes drowsiness, making antihistamines useful as sleep aids. Popular brands of OTC sleeping aid tablets that contain antihistamines include Nytol, Benadryl (containing diphenhydramine), Avomine, and Sominex (containing promethazine). It is important to note that some antihistamines are designed to be "non-drowsy," so those seeking a sleep aid should avoid these. Additionally, antihistamines may not be suitable for those who are pregnant or breastfeeding, and older individuals may experience more side effects.
Herbal or natural sleeping aids are also available over the counter and often include ingredients like valerian root, chamomile, lavender, magnesium, vitamin B12, and melatonin. Valerian root is a grassland plant that some studies have shown can reduce the time it takes to fall asleep. Chamomile and lavender are traditional remedies for poor sleep and are commonly found in calming herbal teas and other nighttime products. Magnesium is believed to reduce stress and muscle tension, and while it should be obtained from a balanced diet, oral supplements have been found to improve sleep. Vitamin B12 plays a role in producing melatonin, which helps regulate sleep. Melatonin is typically offered as a short-term medication for people aged 55 and over, and it is not generally recommended for those under 18.
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Natural sleep supplements
There are various natural sleep supplements available on the market, catering to different preferences. They can be found in the form of capsules, powders, or teas. Capsules often contain a blend of nutrients and botanicals, such as magnesium, vitamin D3, B12, L-tryptophan, lemon balm, and chamomile. They are typically flavourless and need to be taken 30 minutes to an hour before bedtime.
For those who prefer not to take tablets, there are alternative options like passion fruit-flavoured gummies that contain herbal extracts from chamomile, lavender, and lemon balm. These gummies, however, tend to be higher in sweeteners and may have a distinctive smell. Another option is a powder formulation that can be mixed into water, smoothies, or drinks before sleep, although it may not dissolve easily and leave a residue.
It is important to note that while natural sleep supplements offer a milder approach, they should still be used with caution. Consulting a doctor before starting any new supplement is essential, as natural does not always equate to safe for everyone. Additionally, creating a bedtime routine, maintaining a dark and quiet bedroom environment, and engaging in gentle activities like yoga before bed can also contribute to better sleep.
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Non-benzodiazepine medications
Z drugs have a short duration of action and are less likely to cause a "hangover" effect compared to other sleep medications. However, they can cause dependence and withdrawal issues. Doctors should only prescribe Z drugs for severe insomnia after other non-medication treatments have been attempted. It is recommended that they are taken for no more than three weeks and ideally for no more than one week. Z drugs can cause sleepwalking and may make individuals feel unsteady or clumsy if they need to get up during the night. It is important to gradually withdraw from Z drugs to avoid negative withdrawal effects.
Over-the-counter sleep aids are also available and are typically recommended for short-term use. Antihistamines are the strongest over-the-counter sleeping pills in the UK and are available under brand names such as Nytol, Benadryl, Avomine, and Sominex. These antihistamines cause drowsiness by blocking the effects of histamine, the chemical that causes allergy symptoms. However, some antihistamines are designed to be non-drowsy, so it is important to avoid those if the goal is to aid sleep.
In addition to antihistamines, over-the-counter sleep aids may contain herbal ingredients such as valerian root, which has traditionally been used to relieve anxiety and improve sleep quality. Other herbal ingredients include chamomile, lavender, magnesium, and vitamin B12, which plays a role in melatonin production. These herbal and nutritional supplements aim to promote relaxation and support natural sleep by combining botanical extracts, amino acids, and minerals.
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'Z drugs'
Z-drugs are non-benzodiazepine hypnotics that work by slowing down brain activity. They are commonly prescribed to treat insomnia and include zolpidem, zopiclone, eszopiclone, and zaleplon. Zolpidem is available in oral tablets, oral spray, and sublingual formulations, as well as an extended-release version for middle insomnia. Eszopiclone is used for sleep maintenance and initiation due to its long half-life. Zaleplon is the shortest-acting Z-drug and is indicated for sleep initiation following middle-of-the-night awakenings.
Z-drugs are generally considered to be safer than benzodiazepines, with less impact on daytime wakefulness and a lower risk of addiction and abuse. However, they can still cause a range of side effects, including nausea, dizziness, hallucinations, and next-day somnolence. They may also lead to undesirable sleep-related behaviours, such as sleepwalking, sleep eating, and sleep driving, which can be dangerous. Z-drugs are not recommended for long-term use, typically prescribed for no more than seven to ten consecutive nights.
If you are considering taking Z-drugs, it is important to consult with a healthcare professional to discuss the risks and benefits. They are available by prescription only, and a doctor will be able to advise if they are suitable for your specific circumstances.
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Frequently asked questions
Sleeping pills are typically prescribed by a doctor and are meant to be taken occasionally or over a short period. The strongest sleeping pills are usually only available on prescription, but there are some over-the-counter options as well. Sleeping pills can be divided into two categories: benzodiazepines and non-benzodiazepines. Non-benzodiazepines include Z drugs, which are commonly used to treat severe insomnia. Z drugs include zolpidem and zopiclone, which is sometimes sold under the brand name Zimovane. Melatonin is another commonly prescribed sleep aid, often for older adults, but it can be effective for younger people as well.
Over-the-counter antihistamines such as promethazine can be used to help with insomnia. Natural sleeping pills with vitamins and herbal extracts can also help improve sleep, sometimes in conjunction with medical treatment. Key ingredients to look for include tart cherry (a natural source of melatonin), chamomile, and Vitamin B6.
Sleeping pills work by increasing the effects of a chemical called gamma aminobutyric acid (GABA) in the brain and body. GABA is responsible for lessening activity in parts of the brain that control emotions, memory, reasoning, and essential functions like breathing. Benzodiazepines boost natural GABA, making you feel relaxed and sleepy.
Sleeping pills can cause sleepwalking and dependence or withdrawal if used for a long time. They may also cause sleep inertia, which is the feeling of grogginess, drowsiness, or disorientation immediately after waking up.
Sleeping pills are typically taken for one to four weeks, but they should not be taken for more than three weeks. Ideally, they should be taken for no more than one week.
