Colin Snow
Sleep disturbances are common, with an estimated 40 to 70 million people in the US experiencing insomnia or wakefulness conditions. While there are many different types of sleeping pills available, it's important to consider the potential side effects and risks associated with their use. Prescription sleeping pills are generally stronger than over-the-counter options, and carry a higher risk of dependency and misuse. Some common prescription medications for insomnia include doxepin (Silenor), zolpidem, triazolam (Halcion), and ramelteon (Rozerem). Over-the-counter options include melatonin, antihistamines such as diphenhydramine, and doxylamine succinate. It is always recommended to consult a healthcare professional before starting any sleep medication to ensure the best course of treatment for your individual circumstances.
| Characteristics | Values |
|---|---|
| Types of sleeping pills | Prescription, Over-the-counter |
| Prescription sleeping pills | Stronger than over-the-counter pills, Doxepin (Silenor), Zolpidem, Triazolam (Halcion), Temazepam, Ramelteon (Rozerem), Eszopiclone |
| Over-the-counter sleeping pills | Melatonin, Antihistamines, Dual orexin receptor antagonists, Melatonin receptor agonists, Sedating antihistamines (Diphenhydramine, Doxylamine succinate), Non-prescription sleep medication |
| Side effects | Memory problems, Falls, Death, Headache, Dizziness, Nausea, Next-day impairment, Complex sleep behaviors, Withdrawal symptoms, Drug dependencies, Worsening depression, Anaphylactic reactions, CNS depression, Anticholinergic properties, Dry mouth, Constipation |
| Precautions | Understand the side effects and risks, Take only as directed, Take when you can get a full night's sleep, Allow time to adjust to new medication, Discuss with your doctor |
| Other treatments | Cognitive behavioral therapy, Good sleep habits |
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What You'll Learn
Prescription vs. over-the-counter sleeping pills
Sleep disturbances are common, with an estimated 50 to 70 million people in the United States experiencing chronic sleep or wakefulness conditions. Insomnia is also prevalent, affecting up to 40% of US adults. Various medications can help people fall asleep or stay asleep, but it's important to understand the risks and side effects before starting any sleep medication.
Prescription sleeping pills are typically recommended for short-term relief of insomnia or sleep disturbances. They include benzodiazepine sedative hypnotics like Ativan (lorazepam) or Restoril (temazepam), non-benzodiazepine hypnotic sedatives like Ambien (zolpidem) or Lunesta (eszopiclone), and melatonin receptor agonists such as Rozerem (ramelteon). Prescription sleeping pills are generally stronger than over-the-counter options and carry a higher risk of side effects, misuse, and dependency. Benzodiazepines, for example, can lead to physical dependence, misuse, withdrawal, and addiction. They should be used with caution, especially over the long term.
Over-the-counter (OTC) sleep aids are also available and can be effective for some individuals. These include melatonin supplements, diphenhydramine (Benadryl), and doxylamine succinate (found in certain brand-name medications). OTC melatonin supplements are generally well-tolerated, but there are mixed opinions on their effectiveness for treating insomnia. It's important to note that even OTC sleep aids carry risks and side effects, such as next-day drowsiness, nausea, and headaches. As with prescription medications, it's recommended to take OTC sleep aids over the short term to minimize health risks.
When deciding between prescription and over-the-counter sleeping pills, it's crucial to consult a healthcare professional. A doctor or pharmacist can help determine the best treatment option based on individual needs, circumstances, and medical history. In some cases, nondrug treatments and behavioural changes may be all that's needed to improve sleep quality.
Additionally, it's worth noting that certain medications, such as doxepin (Silenor) and zolpidem, are recommended for short-term use and may have side effects like central nervous system (CNS) depression, anaphylactic reactions, and withdrawal effects. Pregnant or nursing individuals should also exercise caution and consult a doctor before taking any sleep medication.
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Doxepin (Silenor)
Sleep disturbances are common, with 50 to 70 million people in the United States experiencing chronic sleep or wakefulness conditions. Doxepin (Silenor) is a medication used to treat insomnia in people who have trouble staying asleep. It is a tricyclic antidepressant that works by slowing down brain activity to allow sleep. It is available as an immediate-release tablet in 3 and 6-milligram doses, usually taken once a day within 30 minutes of bedtime. It is important to follow the directions on the prescription label and consult a doctor or pharmacist for any queries.
It is important to note that sleep medications like Doxepin (Silenor) are generally recommended for short-term use due to potential risks and side effects. Before starting any sleep medication, individuals should consult a healthcare professional to determine the most suitable option for their specific needs.
The cost of Silenor is typically around $99 or less for the authorised generic version and $115 or less for the brand name version. However, the price may vary depending on insurance coverage.
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Zolpidem
The recommended doses of Zolpidem are not the same for men and women, and this drug is not approved for use in children. Zolpidem may also cause a severe allergic reaction. If you experience hives, difficulty breathing, or swelling of your face, lips, tongue, or throat, stop taking Zolpidem and seek emergency medical help. Zolpidem may also impair your thinking or reactions. You may still feel sleepy the morning after taking this medicine, especially if you take the extended-release tablet or if you are a woman. Wait at least 4 hours or until you are fully awake before engaging in activities that require alertness.
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Melatonin
If you are experiencing insomnia, want to overcome jet lag, or are a night owl who needs to adjust your sleep schedule, you can try taking a melatonin supplement on a short-term basis. Take 1 to 3 milligrams two hours before bedtime. Melatonin supplements may also raise blood sugar and blood pressure levels, so consult your healthcare provider if you have diabetes or high blood pressure.
It is important to note that melatonin is not regulated by the Food and Drug Administration (FDA) because it is considered a food supplement and not a medication. Manufacturers are not required to list the ingredients or how the melatonin was made. Additionally, the blue and green light from electronic devices can neutralize melatonin's effects, so it is recommended to avoid screens before bed or use filters to block these wavelengths of light.
While melatonin can be helpful for sleep, it is important to remember that sleep medications, in general, carry risks and are recommended for short-term use only. The most effective and safest way to treat insomnia is with good sleep habits and cognitive behavioral therapy.
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Side effects and risks
Sleeping pills can have side effects and risks, so they are not recommended for long-term use. People aged 65 and older should try non-drug treatments first, as there may be safer ways to improve sleep. Sleeping pills pose special risks for older adults, as they can stay in the body longer, causing side effects like confusion, memory issues, and balance problems, which can increase the risk of falls and hip fractures.
Prescription sleeping pills are stronger than over-the-counter ones, and providers typically recommend against using them long-term since they are not a cure for insomnia and carry a risk of dependence and addiction. Some prescription sleep medicines may cause parasomnia, a disruptive sleep disorder that can lead to dangerous behaviors while the person is still mostly asleep. People taking these pills may sleepwalk, eat, take medications, talk, or even drive without being fully awake, and they may not remember doing these things after they wake up. Sedatives can also worsen snoring and sleep apnea, a potentially life-threatening condition. Benzodiazepines, in particular, can be addictive and lead to substance use disorders.
Even over-the-counter sleep aids can have side effects, such as headaches, dizziness, and nausea. Antihistamines, for example, may cause dry mouth, dizziness, and constipation. It is important to consult a doctor before starting any new sleep medication, as they can interact with other substances and medications, including alcohol and vitamin supplements. Some sleep medications are also broken down by enzymes in the liver, so they may be affected by other medications that use the same enzymes. This can increase the risk of serious side effects like dizziness, breathing problems, and falls.
Withdrawal symptoms are another risk to consider when taking sleeping pills. Stopping some medications too quickly can lead to withdrawal, and it may take months to stop taking the pills safely. Additionally, rebound insomnia is a potential side effect, and certain medications carry a higher risk of this than others. It is recommended to discuss your full medical history with your healthcare provider before taking any sleep aid, as some medications are not suitable for people with specific conditions, such as liver problems.
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Frequently asked questions
There is no one-size-fits-all answer to this question. The choice of a strong sleeping pill should always be tailored to individual circumstances. It is important to consult a doctor or healthcare professional before starting any new sleep medication to understand the risks and side effects.
Some prescription sleeping pills include doxepin (Silenor), zolpidem, eszopiclone, and triazolam (Halcion). Doctors may prescribe these medications for short-term insomnia relief, usually for up to 3 months.
Yes, there are several OTC sleep aids available, such as melatonin supplements, antihistamines like diphenhydramine and doxylamine succinate, and dual orexin receptor antagonists. However, it is important to note that even OTC sleep aids can cause side effects and should not be taken for more than 2 weeks without consulting a healthcare provider.
The side effects of sleeping pills can vary depending on the specific medication. Common side effects may include dizziness, lightheadedness, memory problems, next-day drowsiness, nausea, headaches, and constipation. Some medications may also lead to more severe side effects, such as CNS depression, anaphylactic reactions, and withdrawal symptoms.
Yes, there are natural sleep aids that can be considered before turning to prescription or OTC medications. These include practicing good sleep habits, cognitive behavioral therapy, and natural supplements like melatonin. While these approaches may not work for everyone, they can be effective in improving sleep quality without the risk of side effects associated with medications.
