Gina Johnson
Sleeping pills are medications that help treat insomnia and other sleep disorders. They can be purchased over the counter or with a prescription, with prescription pills generally being stronger. Sleeping pills can have side effects and are not recommended for long-term use due to the risk of dependence and addiction. Natural remedies such as melatonin and valerian are also available, but it is important to consult a healthcare provider before taking any sleep aid to ensure safe use and avoid potential interactions with other medications.
| Characteristics | Values |
|---|---|
| Purpose | To help people with sleep disorders like insomnia fall and stay asleep |
| Availability | Over-the-counter (OTC), as natural supplements or by prescription |
| OTC ingredients | Antihistamines, melatonin, valerian |
| Prescription types | Benzodiazepines, antidepressants, antipsychotics, melatonin receptor agonists |
| Side effects | Dependence, addiction, withdrawal, drowsiness, memory problems |
| Precautions | Not recommended for long-term use, consult a healthcare provider before use |
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What You'll Learn
Over-the-counter (OTC) sleeping pills
Natural sleep aids are also available OTC and typically use ingredients like melatonin, valerian, CBD, blackberry, lavender, and herbal blends. Melatonin is a hormone that occurs naturally in the body and can help with certain sleep problems, especially for those who have difficulty falling asleep or are experiencing jet lag. Valerian is an herbal supplement that acts on receptors in the brain to slow down the nervous system, inducing drowsiness. CBD, derived from the cannabis plant, is another option that has become widely available in pharmacies. It does not contain THC, so it does not produce a "high".
OTC sleeping pills are generally recommended for short-term use, such as when dealing with jet lag or occasional sleeplessness. They are not intended for long-term chronic insomnia. If sleep issues persist beyond a week, it is advised to consult a healthcare provider to identify any underlying problems and explore other interventions, such as prescription sleep aids or cognitive behavioural therapy. Older adults, in particular, should be cautious when using OTC sleep aids due to potential side effects and interactions with other medications.
It is important to note that supplements and herbal remedies are not strictly regulated by the Food and Drug Administration in the United States. Therefore, it can be challenging to verify the accuracy of the listed ingredients on the label. Before taking any OTC sleeping pill, it is recommended to consult a healthcare professional to understand the potential side effects, drug interactions, and risks associated with their use.
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Prescription-only sleeping pills
Sleeping pills are typically a short-term solution for sleep disorders, insomnia, or difficulty falling asleep. They are usually prescribed alongside good sleep practices and behavioural treatments. While they can be effective, sleeping pills can also be addictive and carry the risk of dependency. As such, healthcare providers will usually only prescribe them for short periods.
Non-benzodiazepine or Z-drugs are another type of prescription-only sleeping pill. These include eszopiclone (Lunesta), zolpidem (Ambien), and zaleplon (Sonata). These medications are also controlled substances and interact with GABA receptors in the brain. Eszopiclone can be used for long-term insomnia treatment, while the others are approved for short-term use.
Antidepressants are another group of drugs that can be prescribed to treat insomnia. Doxepin (Silenor) is a tricyclic antidepressant that is FDA-approved for treating insomnia characterised by difficulty staying asleep. Other tricyclic antidepressants like amitriptyline and nortriptyline have been prescribed off-label for insomnia but are less common due to their many potential side effects. Antidepressants can induce sleep, reduce anxiety, and promote relaxation. However, they may also cause constipation, difficulty urinating, dry mouth or throat, decreased sexual drive, and weight gain.
Additionally, antipsychotics like quetiapine (Seroquel), olanzapine (Zyprexa), and risperidone (Risperdal) may be prescribed for insomnia, especially for patients already being treated for psychiatric disorders due to their sedating effects. These medications are not controlled substances, but they are not FDA-approved for treating insomnia.
Other prescription sleep aids include suvorexant (Belsomra), trazodone (Desyrel), and ramelteon (Rozerem). Suvorexant may lead to misuse and dependency, while trazodone is typically used to treat major depressive disorder but can be prescribed off-label to aid sleep due to its drowsiness side effect. Ramelteon is the only FDA-approved, prescription melatonin receptor agonist for treating insomnia and is not a controlled substance as it has not shown potential for misuse or addiction.
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Natural remedies
Sleep is crucial for human health and well-being, playing a vital role in cognitive function, emotional regulation, physical health, and quality of life. However, sleep disorders, especially insomnia, are becoming increasingly common. The good news is that there are many natural remedies that can help improve your sleep.
Melatonin
Melatonin is a natural hormone that is released in the brain about four hours before we start feeling sleepy. However, exposure to unnatural light after dark, such as from phones, laptops, or TVs, can prevent its release, making it difficult to fall asleep. Melatonin is available as an over-the-counter supplement, and it may be a good choice for those with naturally low levels of the hormone. It is important to note that melatonin supplements are not regulated by the FDA, so dosages and ingredients may vary. Experts recommend consistently buying the same brand and avoiding unknown sources. Some people report grogginess and depression with melatonin use, and it may not be suitable for those with certain medical conditions.
Valerian
Valerian is an herbal extract that is commonly used to manage anxiety and insomnia. While there is limited evidence of its effectiveness, some findings suggest that it may reduce the time needed to fall asleep and improve sleep quality.
Tryptophan
Tryptophan is an amino acid that is naturally present in foods like turkey, cheese, nuts, beans, eggs, and milk. It is also available as a supplement, but caution is advised as some people who took it developed eosinophilia-myalgia syndrome (EMS) and, in some cases, died. However, including tryptophan-rich foods in your diet is a safe way to potentially benefit from its sleep-promoting properties.
Chamomile
Chamomile is a popular herbal sleep remedy that has been used for centuries. German chamomile is typically consumed as a tea, while Roman chamomile, with its bitter taste, is taken as a tincture. Both varieties are believed to have a calming effect, helping people feel relaxed and prepared for sleep.
Other Remedies
Other natural sleep aids include passionflower (also known as maypop), hops, kava, lavender, magnesium, glycine, and cannabidiol (CBD). While these remedies have varying levels of scientific backing, they are generally considered safer alternatives to conventional sleep medications due to their perceived lower risk of dependence and side effects.
In addition to these natural remedies, maintaining a cool and dark bedroom environment, avoiding alcohol, and engaging in moderate aerobic exercise can also promote better sleep.
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Side effects
Sleeping pills can cause a range of side effects, and it's important to be aware of these before taking them. Firstly, it's well-known that sleeping pills can cause drowsiness, which may last into the day after taking them. This can negatively impact your ability to drive, work, or complete daily tasks. Other common side effects include constipation, diarrhoea, digestive problems (including gas, heartburn, and nausea), muscle weakness, and balance problems. Less commonly, some people experience burning or tingling sensations in their hands, arms, feet, or legs.
Sleeping pills can also cause more serious side effects, particularly in older adults. For example, they can worsen snoring and sleep apnea, a potentially life-threatening condition. They can also cause confusion, memory issues, and an increased risk of falls and hip fractures. In rare cases, a sleeping pill overdose can occur, especially if combined with alcohol or other medications, and this can be deadly.
Some prescription sleep medicines may also bring on parasomnia, a disruptive sleep disorder that can cause dangerous behaviours while the person is still mostly asleep. People taking Z-drugs, for example, may sleepwalk, eat, take medication, talk, or even drive without being fully awake or aware of their actions. Most people do not remember doing these things after they wake up.
Sleeping pills can also cause or worsen dependence on sleep medications. If you stop taking them suddenly, you may experience withdrawal symptoms and find it even harder to fall asleep. This effect is called rebound insomnia. For this reason, it's important to talk to your healthcare provider about how to stop taking sleeping pills safely, as it may take months to do so.
Finally, it's important to note that sleeping pills can interact with other medications and may not be safe for everyone. They can be particularly risky for pregnant or breastfeeding women, children, and people with certain health conditions such as asthma, emphysema, or chronic obstructive pulmonary disease (COPD). Always speak with a healthcare professional before taking any sleeping pills or supplements to ensure they are safe for you.
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Long-term use
While sleeping pills can be effective in aiding sleep, they are not recommended for long-term use. Most over-the-counter (OTC) sleeping pills contain antihistamines, which can cause drowsiness. However, your body can become accustomed to antihistamines, reducing their effectiveness over time. Additionally, they may cause side effects such as grogginess and memory problems in older adults.
Prescription sleeping pills are generally stronger than OTC options and are recommended for short-term use due to their potential for abuse, addiction, and dependence. Benzodiazepines, for example, are prescription sleep medications that work by stimulating the chemical GABA in the brain, leading to sedation, muscle relaxation, and reduced anxiety. Nonbenzodiazepine prescription sleep aids, also known as "Z drugs," include eszopiclone (Lunesta), zolpidem (Ambien), and zaleplon (Sonata). Similar to benzodiazepines, these medications are classified as Schedule IV controlled substances due to their potential for misuse. Eszopiclone is an exception, as it is approved for the long-term treatment of insomnia and has a lower risk of dependence.
For elderly patients experiencing insomnia, lower-dose medications or non-benzodiazepine options such as melatonin or newer drugs are often recommended as safer alternatives. Melatonin is a naturally occurring hormone that promotes sleep and can be taken as a supplement. Valerian is another natural supplement that has a calming effect on the nervous system, aiding sleep. These supplements are easily accessible but should be used with caution and after consulting a healthcare provider, as they can interfere with other medications or health conditions.
Chronic insomnia sufferers may benefit from newer medications like daridorexant or lemborexant, which may offer sustained benefits with a potentially lower risk of dependence compared to older drugs. It is important to note that sleeping pills should not be the first line of treatment for sleep disorders. Lifestyle changes and cognitive-behavioral therapies, in combination with medication, are often recommended as a more sustainable approach to improving sleep habits.
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Frequently asked questions
Prescription sleeping pills include Belsomra, Ambien, Dayvigo, Quviviq, Lunesta, and Restoril. Zolpidem and eszopiclone are also prescription sleeping pills. Benzodiazepines are also prescription sleeping pills but are classified as a Schedule IV controlled substance due to their risk for abuse, addiction, and dependence.
OTC sleeping pills often contain antihistamines, which can make you drowsy. Some natural remedies include melatonin and valerian supplements.
The choice of a strong sleeping pill should always be tailored to individual circumstances. For elderly patients, lower-dose medications or non-benzodiazepine options, such as melatonin, may be safer. For chronic insomnia, newer medications like daridorexant or lemborexant may offer sustained benefits with a potentially lower risk of dependence.
