Miya Pearson
Sleeping pills are drugs used to treat insomnia, restless sleep, or difficulty falling asleep. They are available over the counter (OTC) or by prescription. OTC sleeping pills often contain antihistamines, which can cause drowsiness, while prescription pills include antidepressants, barbiturates, and benzodiazepines. Prescription sleeping pills are generally stronger and carry a higher risk of side effects, misuse, and dependency. These side effects can include constipation, muscle weakness, and complex sleep behaviours such as sleepwalking or driving while asleep. Due to these risks, healthcare providers typically recommend short-term use of sleeping pills, combined with cognitive-behavioural therapies and lifestyle changes.
| Characteristics | Values |
|---|---|
| Availability | Over the counter (OTC), as natural supplements or by prescription |
| OTC Examples | Diphenhydramine, Melatonin, Doxylamine, Valerian |
| Prescription Examples | Zolpidem (Ambien), Eszopiclone (Lunesta), Zaleplon (Sonata), Estazolam (Prosom) |
| Side Effects | Constipation, Diarrhea, Muscle Weakness, Dizziness, Dry Mouth, Urinary Retention, Memory Loss, Mood Changes, Hallucinations, Dependency, Drug Tolerance, Poor Memory, Brain Degeneration, Alzheimer's Disease, Risk of Accidental Falls, Respiratory Depression, Death |
| Usage | Short-term use is acceptable, long-term use is not recommended |
| Alternative Treatments | Cognitive-behavioral therapies, lifestyle changes, stimulus control, sleep hygiene instruction |
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What You'll Learn
Prescription vs. over-the-counter sleeping pills
Sleeping pills are categorised as either prescription or over-the-counter (OTC) drugs. Prescription sleeping pills are generally stronger than OTC ones, and they require a prescription from a healthcare provider. They are typically recommended for short-term relief and not meant for long-term use due to the risk of dependence and addiction.
Prescription sleeping pills include benzodiazepine sedative hypnotics like Ativan (lorazepam) and Restoril (temazepam), non-benzodiazepine hypnotic sedatives like Ambien (zolpidem) and Lunesta (eszopiclone), and melatonin receptor agonists such as Rozerem (ramelteon). Benzodiazepines, for example, stimulate the GABA chemical in the brain, leading to sedation, muscle relaxation, and reduced anxiety. However, they are associated with a risk of abuse, addiction, and dependence, and long-term use is generally not advised.
Over-the-counter sleeping pills, on the other hand, are easily accessible without a prescription. They often contain antihistamines, which can cause drowsiness as a side effect. Common ingredients in OTC antihistamines include diphenhydramine, found in Benadryl, and doxylamine, found in Unisom SleepTabs and other products. Melatonin, a natural hormone that promotes sleep, and valerian, an herb that aids relaxation, are also available as OTC supplements. While these options are more accessible, it's important to consult a healthcare provider before taking them, as they can interfere with other medications or aggravate certain health conditions.
While prescription sleeping pills are typically stronger and more effective for severe or chronic insomnia, they also carry a higher risk of side effects and dependence. OTC sleeping pills are more readily available and suitable for milder sleep difficulties, but they may not provide the same level of relief as prescription options. It's important to consult a healthcare professional to determine the most appropriate treatment based on individual needs and circumstances.
In addition to prescription and OTC sleeping pills, natural sleep aids and cognitive-behavioural therapies can also be explored as alternatives or complementary approaches to improving sleep quality.
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Natural sleep aids
Sleeping pills are available over the counter (OTC) or by prescription. While prescription pills are stronger, they are generally recommended for short-term use due to the risk of dependence and addiction. OTC pills often contain antihistamines, which can cause drowsiness.
Some natural sleep aids do not involve supplements. For example, drinking warm milk, chamomile tea, or tart cherry juice before bed is believed to promote sleep, although there is limited scientific proof. It is also recommended to avoid exposure to light from smartphones or other devices before bed, as this can interfere with sleep. Additionally, maintaining a comfortable bedtime temperature and avoiding exercise within two hours of bedtime can improve sleep quality.
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Side effects
Sleeping pills can cause a range of side effects, from constipation to muscle weakness. Some people experience a hangover effect the day after taking sleep medicine, feeling drowsy, confused, and dizzy. These daytime effects can negatively impact your ability to drive, work, or complete daily tasks.
Sleeping pills can cause digestive problems, including gas, heartburn, and nausea. They can also worsen snoring and sleep apnea. When taken over a long period, the body may become dependent on sleeping pills, and insomnia may return worse than before when the medication is stopped. This effect is called rebound insomnia. Mixing sleep aids with other sedatives or alcohol can lead to an overdose.
Some sleeping pills can cause parasomnias, which are complex sleep behaviours where individuals may sleepwalk, eat, talk, or drive while unaware of their actions. While rare, parasomnias are difficult to detect once the medication takes effect. Older adults are more susceptible to the side effects of sleeping pills, which can result in falls, broken hips, and car accidents.
Sleeping pills can interfere with normal breathing and are dangerous for individuals with certain chronic lung problems such as asthma, emphysema, or chronic obstructive pulmonary disease (COPD). They may also cause burning or tingling sensations in the hands, arms, feet, or legs. It is important to consult a doctor before taking sleeping pills to ensure they are safe for your specific circumstances.
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Dependency and addiction
Sleeping pills can be purchased over the counter (OTC) or with a prescription. They are typically used to treat insomnia and other sleep disorders. While they can be effective in the short term, they can also lead to dependency and addiction if used for too long or at too high a dose.
Dependency
Sleeping pills can cause dependency, especially if used regularly and over a long period. Dependency can develop quickly, sometimes within a few weeks. The risk of dependency is higher with certain types of sleeping pills, such as benzodiazepines and Z-drugs (zolpidem and zopiclone). When you stop taking sleeping pills, your insomnia may return or even worsen. This is known as the rebound effect, and it can lead to a vicious cycle of pill dependency.
Addiction
Sleeping pills can also lead to addiction, which is characterised by a person's inability to quit taking them despite negative consequences. Addiction to sleeping pills can be physical or psychological. Physical addiction is more common with older types of sleeping pills, such as benzodiazepines, which include Valium and Xanax. Newer sleeping pills, like Ambien and Sonata (known as Z-drugs), may be less physically addictive but can still lead to psychological addiction. Signs of addiction include steadily increasing the dosage, experiencing withdrawal symptoms, and neglecting social and professional obligations.
Withdrawal
Stopping the use of sleeping pills can be physically and mentally challenging due to withdrawal symptoms. These symptoms can include trouble sleeping, restlessness, anxiety, shivering, dizziness, and increased heart rate and blood pressure. To minimise withdrawal symptoms, it is recommended to gradually reduce the dosage over time with the guidance of a doctor. Therapeutic support and behavioural therapy can also help during this process.
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Short-term relief
Sleeping pills are available over the counter (OTC) or by prescription. Over-the-counter sleep aids often contain antihistamines, which treat allergies but can also cause drowsiness. Natural remedies, such as melatonin and valerian root supplements, are also available without a prescription.
Prescription sleeping pills are stronger than over-the-counter ones and are typically recommended for short-term relief only. This is because they carry a risk of dependence and addiction, and insomnia may return worse than before if the medication is stopped. Doctors may prescribe sleeping pills in combination with cognitive-behavioural therapies.
Benzodiazepines, such as alprazolam (Xanax), clonazepam (Klonopin), diazepam (Diastat, Valium), estazolam (Prosom), orazeparm (Ativan), and temazepam (Restoril), are included in a class of drugs called hypnotics. They work by stimulating a chemical in the brain called GABA, which leads to sedation, muscle relaxation, and reduced anxiety. However, they are generally recommended for short-term use only (a few weeks) due to their risk for abuse and addiction.
Other prescription drugs used for short-term relief from insomnia include zaleplon (Sonata), eszopiclone (Lunesta), and zolpidem (Ambien, Intermezzo, Zolpimist). These are part of a group of drugs known as Z-drugs, which work by slowing brain activity. While they can help with falling asleep and staying asleep, they carry a risk of dependency and misuse. Doxepin (Silenor, Doxepin), a tricyclic antidepressant, is another prescription drug used to treat insomnia characterised by difficulty staying asleep. It is typically prescribed for up to three months and can cause side effects such as central nervous system depression.
In summary, while prescription sleeping pills can provide short-term relief from insomnia, they should be used with caution due to their potential side effects and risk of dependence. It is always advisable to consult a healthcare provider before taking any sleep medication.
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Frequently asked questions
Sleeping pills are usually classified as either over-the-counter (OTC) or prescription medications. Prescription sleeping pills tend to be stronger and include benzodiazepines, antidepressants, and antipsychotics. Non-benzodiazepine or Z-drug sleeping pills are also fast-acting prescription medications.
Some commonly prescribed sleeping pills include zolpidem (Ambien), eszopiclone (Lunesta), alprazolam (Xanax), clonazepam (Klonopin), and diazepam (Valium).
Yes, melatonin and valerian are natural supplements that can aid sleep and are available over the counter. Some OTC sleeping pills contain antihistamines, which can cause drowsiness.
Sleeping pills can cause various side effects, including constipation, muscle weakness, digestive issues, and dizziness. They may also lead to dependence and addiction, especially with long-term use.
If you have been taking sleeping pills for a long time or at a high dose, consult your healthcare provider before stopping. They may advise tapering down the dose gradually to ensure a safe discontinuation.
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