Evie Summers
Sleep is an essential part of a healthy lifestyle, but for many, falling and staying asleep can be a challenge. Sleeping pills are one option to help with sleep problems, and there are many different types available. Some are available over the counter, while others require a prescription from a doctor. Sleeping pills can be habit-forming and are associated with side effects, so it is important to consult a healthcare professional before starting any sleep medication. This article will explore the different types of sleeping pills available, their effectiveness, and potential risks to help you make an informed decision about which option is best for you.
| Characteristics | Values |
|---|---|
| Brand Name | Silenor, Prosom, Lunesta, Rozerem, Belsomra, Sonata, Ambien, Intermezzo, Zolpimist, Dayvigo, Quviviq, Restoril, Unisom, ZzzQuil |
| Generic Name | Doxepin, Estazolam, Eszopiclone, Ramelteon, Suvorexant, Zaleplon, Zolpidem, Daridorexant, Lemborexant |
| Availability | Over-the-counter, Prescription |
| Dosage | 1 mg, 2 mg, 3 mg, 6 mg, 8 mg, 10 mg, 12.5 mg |
| Action Time | 15-30 minutes, 1 hour, 4-6 hours, 6-8 hours |
| Side Effects | Dizziness, Bitter taste, Grogginess, Dry mouth, Urinary retention, CNS depression, Memory loss, Hallucinations, Mood changes, Withdrawal symptoms, Rebound insomnia, Death |
| Considerations | Not suitable for pregnant or nursing women, Not for those taking MAO inhibitors, Not for those with glaucoma, Not for long-term use, Risk of misuse and dependence, Not suitable for those with a history of substance abuse, depression or mood problems |
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What You'll Learn
Prescription vs. over-the-counter
There are many different types of sleeping pills available, and they can be broadly categorized into prescription and over-the-counter (OTC) medications. Prescription sleeping pills are generally stronger than OTC pills and are recommended for short-term use only, as they carry a risk of dependence, addiction, and withdrawal. Benzodiazepines, for example, are a group of prescription sleeping pills that can be effective in the short term, but they come with a risk of serious side effects in the long term. Other prescription medications include non-benzodiazepine Z-drugs like zolpidem (Ambien) and eszopiclone (Lunesta), which can help with falling asleep and sleep maintenance. Zaleplon (Sonata) is another Z-drug that may be prescribed for short-term insomnia treatment, but it does not help maintain sleep. Estazolam (Prosom) is also a prescription medication for short-term insomnia relief, but it has a risk of misuse and dependency.
On the other hand, OTC sleep aids are more readily available and can be effective for milder sleep issues. Melatonin supplements, for instance, are widely available OTC and can help regulate the sleep-wake cycle, making them a good choice for jet lag. Diphenhydramine (Benadryl) and doxylamine succinate (Unisom SleepTabs, Robitussin Nighttime Cough DM, and Vicks Nyquil D Cold and Flu Nighttime Relief) are also effective OTC sleep aids. These medications work by blocking histamines in the body, which cause alertness. It is important to consult a healthcare provider before taking any sleep medication, as they can help determine the best treatment based on individual needs and medical history. Additionally, nondrug treatments and behavioral changes may be all that is needed to improve sleep.
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Side effects
Sleeping pills can cause a range of side effects, and it is recommended that you do not use them long-term. Approximately 8 out of 10 people experience a hangover effect the day after taking sleep medicine. They may feel drowsy, confused, or sleepy during the day, with muddled thinking and dizziness or balance problems. These daytime effects can negatively impact your ability to drive, work, go to school, and complete daily tasks.
Some sleeping pills can cause constipation, muscle weakness, edema (where the body's tissues contain too much fluid), and decreased blood pressure. Others may increase thoughts of suicide or cause allergic reactions. Some sleep medications interact with other substances, including other medications, alcohol, and vitamin supplements, so it is important to consult a doctor before starting any new sleep medication.
Sleeping pills can also cause dependency, and users may not realise they are dependent until they abruptly quit the drugs, causing withdrawal symptoms and worsening insomnia (known as rebound insomnia). Older adults are more sensitive to sedative effects and side effects, and the drugs can stay in their bodies longer, causing side effects like confusion, memory issues, and balance problems, which increase the risk of falls and hip fractures.
Natural sleep aids like melatonin, which is a hormone that promotes sleep, generally have fewer side effects. However, they may not be suitable for everyone, and it is always best to consult a healthcare provider before starting any new sleep aid.
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Dosage
Sleeping pills vary in terms of how quickly they work, how long their effects last, and what side effects they may cause. It is important to consult a healthcare provider before starting any sleep medication.
Doxepin (Silenor) is a tricyclic antidepressant that is FDA-approved for treating insomnia characterised by difficulty staying asleep. Doctors may suggest people with insomnia use Silenor for up to 3 months. It is available as an immediate-release tablet in 3 and 6-milligram (mg) doses. A person should talk with a doctor about the best dose for their needs. Doctors do not recommend Silenor for those taking monoamine oxidase inhibitors, a type of antidepressant, or people with glaucoma or urinary retention.
Zolpidem, which has the brand names Ambien, Intermezzo, Zolpimist, and Ambien CR, is a sleep medication that may help with falling asleep and sleep maintenance. Zolpidem typically acts within 15-30 minutes and lasts 6-8 hours, but may cause drowsiness or dizziness the next day. Doctors may prescribe it for short-term insomnia relief, starting with the lowest possible dose and working upward to a maximum of 10 mg per day, if necessary. Zolpidem is also available in a once-daily 12.5 mg extended-release form.
Eszopiclone (Lunesta) may help a person fall and stay asleep. Lunesta is part of a drug family known as Z-drugs, which carry a risk of misuse and dependency. A doctor may prescribe 1 mg or 2 mg tablets for insomnia treatment.
Ramelteon (Rozerem) is a melatonin antagonist that may help a person fall asleep. Due to its effects on melatonin receptors, Rozerem is prescribed for longer-term use. This medication comes in a one-size dose of 8 mg, not to be exceeded once daily. Unlike many other sleep aids, Rozerem is not a controlled substance and has a low likelihood of misuse or dependency.
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Treatment duration
The treatment duration for sleeping pills depends on the type of medication and individual circumstances. Sleeping pills are generally recommended for short-term use due to the risk of dependence and addiction.
Prescription sleeping pills, such as benzodiazepines and Z-drugs like zolpidem (Ambien) and eszopiclone (Lunesta), are typically approved for short-term relief of insomnia. These medications carry a risk of misuse and dependence, so healthcare providers usually prescribe them for a few weeks or a few months at most. It's important to note that older adults and elderly patients may be more sensitive to the sedative effects and side effects of these medications, so lower doses or non-benzodiazepine options may be recommended for this demographic.
On the other hand, some sleeping pills are considered safer for long-term use due to their lower potential for misuse and addiction. Ramelteon (Rozerem), a melatonin receptor agonist, is one such example. It is not a controlled substance and has a low risk of dependence, making it suitable for longer-term use. Similarly, eszopiclone (Lunesta) is also approved for long-term treatment, although it carries a risk of misuse and dependency.
For individuals with chronic insomnia or long-term sleep difficulties, newer medications like daridorexant or lemborexant may offer sustained benefits with a potentially lower risk of dependence compared to older drugs. These medications can be tailored to individual needs and may be safer options for long-term use.
It is important to consult a healthcare provider before starting any sleep aid, as they can provide guidance on treatment duration and potential side effects. Additionally, cognitive-behavioral therapy (CBT) and behavioral changes are recommended as effective tools for improving sleep and curing insomnia without the need for medication.
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Natural alternatives
While prescription medication for sleep issues is common, natural alternatives are also available. These are generally considered safer than prescription medication as they have fewer side effects. However, it's important to note that even natural sleep aids should not replace good sleeping habits.
Natural sleep aids include melatonin, magnesium, and valerian root. Melatonin is a natural hormone that helps you fall asleep by regulating your body's sleep cycle. It is available over the counter in most pharmacies. However, it is unregulated, so the dosage and ingredients may differ between manufacturers. Valerian root is another natural sleep aid that is available over the counter. It is a herbal remedy that has been used for centuries to promote sleep and improve sleep quality. It is considered safe and non-addictive, but it is not suitable for long-term use.
Some natural sleep aids can be found in drinks such as warm milk, chamomile tea, and tart cherry juice. While there is not much scientific evidence that these drinks improve sleep, they are worth trying as they do not have side effects or cause drug interactions.
Other natural alternatives to sleep medication include lavender, antihistamines, and adjusting your sleep environment. For example, reducing exposure to blue light and other unnatural lights from phones, laptops, and TVs can help, as these lights interfere with sleep.
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Frequently asked questions
Older adults are more sensitive to sedative effects and side effects, so lower-dose medications or non-benzodiazepine options may be safer. Melatonin or certain newer drugs may be recommended. Always consult a healthcare provider before starting any sleep aid.
Newer medications like daridorexant or lemborexant may offer sustained benefits with a potentially lower risk of dependence compared to older drugs. Doctors may also suggest people with insomnia use Silenor for up to 3 months.
People needing rapid sleep onset or short-duration effects may benefit from fast-acting medications or natural aids such as melatonin.
Zolpidem, which has the brand names Ambien, Intermezzo, and Zolpimist, is a sleep medication that may help with falling asleep and sleep maintenance. Zaleplon, or Sonata, may be useful for the short-term treatment of insomnia, but it does not help maintain sleep.
