Ashwin Lewis
Sleeping pills are often referred to by other names, including sleeping tablets, tranquilizers, sedatives, hypnotics, and narcotics. These terms all refer to medications or substances that aid in inducing sleep or promoting relaxation. While some of these words have slight nuances in their meanings, they are generally used interchangeably with sleeping pill to describe drugs that help individuals fall asleep or maintain restful sleep.
| Characteristics | Values |
|---|---|
| Synonyms | sleeping tablet, hypnotic, tranquilizer, depressant, opiate, narcotic, downer, calmative, sedative, knockout pill, painkiller, dope, sleep aid |
| Brand names | Zolpidem (Ambien, Intermezzo, Zolpimist), Doxepin (Silenor), Ramelteon (Rozerem), Estazolam (Prosom) |
| Dosage | Zolpidem: 12.5 mg extended-release or up to 10 mg immediate-release, Doxepin: 3 or 6 mg immediate-release, Ramelteon: 8 mg, Estazolam: 25 to 100 mg |
| Use | Short-term insomnia relief, falling asleep and sleep maintenance |
| Side effects | CNS depression, worsening depression, withdrawal, drowsiness, allergic reactions, edema, increased thoughts of suicide, misuse and dependency |
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What You'll Learn
Tranquillizers
There are several types of tranquillizers available, including barbiturates, benzodiazepines, and neuroleptics. Barbiturates were first introduced in the early 1900s and were widely used for their sedative and hypnotic effects. However, due to their narrow therapeutic index, they have a high risk of overdose and are now less commonly prescribed. Benzodiazepines, on the other hand, have a wider therapeutic index and are often used to treat anxiety and insomnia. They work by enhancing the effects of the neurotransmitter GABA, which has a calming and relaxing effect on the body.
Neuroleptics are a type of tranquillizer that is used primarily in the treatment of psychotic disorders, such as schizophrenia. They work by blocking dopamine receptors in the brain, which helps to reduce hallucinations and delusions. While neuroleptics can be effective in treating these disorders, they can also have side effects such as drowsiness, weight gain, and movement disorders.
It is important to note that tranquillizers should only be taken under medical supervision. While they can be effective in treating sleep disorders and promoting sleep, they may not be suitable for everyone and can have potential side effects. Non-medical solutions for sleep issues should also be explored, such as improving sleep hygiene and making lifestyle changes.
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Sedatives
Some common types of sedatives include benzodiazepines and barbiturates, which are also widely misused due to their recreational appeal. Sedatives have the potential for addiction and can be habit-forming, leading to physical and psychological dependence. It is important to take prescription sedatives exactly as directed by a healthcare provider.
The misuse of sedatives can lead to adverse drug events and even death. Combining sedatives with alcohol or other drugs can be particularly dangerous. As such, healthcare providers prescribe sedatives cautiously, weighing the benefits against the risks of potential substance use disorder and overdose.
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Hypnotics
There are five FDA-approved types of hypnotic drugs used to treat insomnia and other sleep problems: selective melatonin agonists, benzodiazepines, nonbenzodiazepines, orexin receptor agonists, and antidepressants. Side effects of hypnotics depend on the specific drug used. Some common side effects include severe drowsiness when combined with other sleep medications or drugs that cause drowsiness, and reduced effectiveness when combined with stimulants such as amphetamines or coffee.
Benzodiazepines, a class of hypnotics, can put people to sleep by inhibiting NREM stage 1 and 2 sleep. However, they disrupt sleep architecture by decreasing sleep time, delaying time to REM sleep, and reducing deep slow-wave sleep, which is the most restorative part of sleep. Other drawbacks of benzodiazepines include the risk of tolerance, rebound insomnia, and a withdrawal period marked by rebound insomnia, anxiety, and agitation. Due to these adverse effects, it is recommended that benzodiazepines be used intermittently and at the lowest effective dose for the shortest therapeutic time, with gradual discontinuation.
Quinazolinones are another class of drugs that function as hypnotics/sedatives, with examples including cloroqualone, diproqualone, etaqualone, and methaqualone. Synthetic melatonin capsules, pills, or tablets may also help people fall asleep, although they may take a few days to a few weeks to take effect. Valerian is another supplement available to treat insomnia.
It is important to note that hypnotic drugs can be habit-forming, and physicians may recommend changes in the environment before and during sleep, improved sleep hygiene, avoidance of caffeine and alcohol, or behavioural interventions such as cognitive behavioural therapy for insomnia before prescribing medication. Elderly individuals are more susceptible to potential side effects such as daytime fatigue and cognitive impairment, and the risks generally outweigh the benefits of hypnotics in this population.
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Opiates
Opioids are a type of drug that is often prescribed to help manage chronic pain. While opioids are not typically considered sleeping pills, they are associated with sleep due to their pain-relieving effects. Anecdotal evidence suggests that opioids promote sleep by relieving pain, particularly in individuals with chronic conditions such as fibromyalgia.
Several studies have examined the relationship between opioid use and sleep. One study, published in the Journal of Clinical Sleep Medicine, investigated the daily associations between sleep and opioid use in adults with comorbid insomnia and fibromyalgia. The findings suggested that opioid use did not significantly impact total wake time or sleep quality on a daily level. However, participants reported worse sleep quality and higher opioid doses on days when they experienced more pain.
Additionally, the NIH HEAL Initiative reported on a small study that found an approved insomnia drug, suvorexant, aided in opioid use disorder recovery. Suvorexant improved sleep quality and reduced painful withdrawal symptoms, drug cravings, and the desire to use opioids. This is particularly significant as sleep problems during opioid withdrawal can contribute to drug-seeking behavior and relapse.
While opioids may not have a direct sleep-inducing effect, they can indirectly impact sleep by managing pain. Therefore, the relationship between opioid use and sleep is complex and may vary depending on individual factors and underlying health conditions.
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Barbiturates
While barbiturates have advantages such as their longevity and extensive research, they have largely been replaced by benzodiazepines and non-benzodiazepines ("Z-drugs") due to the lower risk of overdose associated with these newer medications.
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Frequently asked questions
Synonyms for sleeping pills include sleeping tablets, tranquilizers, sedatives, hypnotics, and more.
Less common synonyms include "nightcap", "soporific", and "dormitive".
Some slang or informal terms for sleeping pills include "downer", "dope", and "knockout pill".
Medical synonyms for sleeping pills include "barbiturate", "benzodiazepine", "neuroleptic", and "analgesic".
Some related phrases are "sleeping medication", "sleeping draught"/draft, and "sleeping powder"/potion.
