Colin Snow
Sleeping pills are prescription medications that contain tranquilizers to treat insomnia, restless sleep, or difficulty falling asleep. Doctors may prescribe sleeping pills for short-term insomnia relief, but they are not recommended for long-term use due to the risk of dependence and addiction. Before prescribing sleeping pills, doctors will typically consider the patient's symptoms, comorbidities, age, and medical history. It is important to consult a doctor before taking any sleep aids, as they can interfere with other medications or health conditions. Additionally, sleeping pills may have side effects, and alternative treatments such as cognitive behavioral therapy (CBT) or talk therapy may be recommended to improve sleep.
| Characteristics | Values |
|---|---|
| Purpose | Treat insomnia, restless sleep, or difficulty falling asleep |
| Side effects | Dizziness, fatigue, irritability, and long-term effects like depression |
| Risks | Dependence, addiction, overdose, and interference with other medications |
| Alternatives | Cognitive behavioral therapy (CBT), lifestyle changes, talk therapy, electroacupuncture |
| Prescription | Required for stronger sleeping pills; short-term relief is preferred |
| Types | Benzodiazepines, Z-drugs (Ambien, Lunesta), Doxepin (Silenor), Suvorexant (Belsomra), Temazepam |
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What You'll Learn
Sleeping pill side effects
Sleeping pills can cause a range of side effects, from constipation to muscle weakness. Around 8 out of 10 people experience a hangover effect the day after taking sleep medicine, with symptoms including drowsiness, dizziness, muddled thinking, and balance issues. These daytime effects can negatively impact your ability to work, drive, or operate machinery, and complete daily tasks.
Sleeping pills can also cause digestive problems, including gas, heartburn, and nausea. They can worsen snoring and sleep apnea, and may cause parasomnias, or complex sleep behaviours, such as sleepwalking, sleep eating, making phone calls, or even sleep driving. In rare cases, people may take medication, talk, or engage in other dangerous behaviours while in a sleep state.
Sleeping pills can interfere with other medications and make health conditions worse. They are not recommended for long-term use as they can cause dependence and addiction, and when you stop taking them, your insomnia may return worse than before (rebound insomnia). They are also potentially harmful to older adults, pregnant or breastfeeding people, and those with certain chronic lung problems such as asthma, emphysema, or COPD.
If you think you need a sleeping aid, it is important to speak with your doctor first to ensure that a sleeping pill is safe for you and to discuss alternative treatments such as cognitive behavioural therapy (CBT).
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Short-term prescription
Doctors may prescribe sleeping pills to patients with sleep disorders such as insomnia. Sleeping pills can help patients fall asleep and stay asleep. They are also used to treat parasomnia, a disruptive sleep disorder that can cause dangerous behaviours while the patient is still mostly asleep.
Sleeping pills are typically prescribed for short-term relief only. This is because they are not a cure for insomnia, and there is a risk of dependence and addiction. Doctors may prescribe sleeping pills for up to 3 months to help the patient get their sleep back on track. After this period, the patient may experience treatment-resistant insomnia, meaning that they still do not get enough or good-quality sleep despite taking sleeping pills.
Doctors may prescribe a variety of medications to treat insomnia, including:
- Benzodiazepines: These are a powerful class of sleeping pills that help patients fall asleep, relieve anxiety, and improve learning and memory. They are available in short- and long-acting forms. Examples include alprazolam, clonazepam, diazepam, lorazepam, and temazepam (Restoril).
- Non-benzodiazepine hypnotics: These drugs are used to treat short-term insomnia. Examples include eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien).
- Doxepin: This is a sleep aid with the brand name Silenor. It may help patients fall asleep and stay asleep. It is available as an immediate-release tablet in 3 and 6-milligram doses.
- Ramelteon (Rozerem): This medication promotes sleep and positively affects circadian rhythms. It is typically prescribed for longer-term use due to its low likelihood of misuse or dependency.
- Estazolam (Prosom): This medication is prescribed for the short-term treatment of insomnia and may help with falling and staying asleep. However, it has a risk of misuse and dependency.
In addition to prescribing sleeping pills, doctors may also recommend lifestyle changes, such as reducing caffeine intake and maintaining a consistent sleep schedule. They may also refer patients to a sleep psychologist or suggest talk therapy to address any negative thinking or behaviour that may be impacting their sleep.
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Over-the-counter alternatives
Sleeping pills are not recommended for long-term use due to associated side effects and risks, including the possibility of dependency and addiction. If you are experiencing sleep difficulties, there are various over-the-counter alternatives to prescription sleeping pills that may help you.
Firstly, it is important to note that over-the-counter sleep aids are generally not recommended for regular use and should be taken occasionally. Over-the-counter sleep aids include non-prescription sleeping pills, natural supplements, and herbal remedies. However, it is important to consult your doctor or healthcare provider before taking any over-the-counter sleep aids to understand the possible side effects, drug interactions, and risks for dependency. Additionally, supplements and herbal remedies are not regulated in some places, so it is crucial to purchase from a reputable manufacturer.
Some common over-the-counter sleep aids include antihistamines such as diphenhydramine and doxylamine succinate, which help induce sleep by reducing histamine levels in the brain. These antihistamines are found in many non-prescription sleep and allergy medications. However, they are not recommended for frequent use due to associated risks and side effects, including increased risk for dementia with long-term use. Melatonin supplements are another popular over-the-counter option, as melatonin is a naturally occurring hormone that regulates the sleep-wake cycle. Valerian products are also mentioned as an over-the-counter option.
Lifestyle adjustments and good sleep habits, also known as "sleep hygiene," can also help improve sleep quality. This includes exercising during the day, avoiding large meals, alcohol, and caffeine before bed, and maintaining a cool bedroom temperature. Forming consistent bedtime habits, such as a reliable sleep schedule, can also promote better sleep. Additionally, natural remedies such as soothing teas can be calming and sleep-inducing.
It is important to remember that while over-the-counter sleep aids and lifestyle changes may help improve sleep, they are not a cure for insomnia or other chronic sleep disorders. If you are experiencing persistent sleep difficulties, it is recommended to consult a healthcare professional for advice and explore other treatment options, including cognitive-behavioral therapy (CBT) or prescription sleep medication if necessary.
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Non-drug treatments
Doctors may prescribe sleeping pills for patients with insomnia. However, these medications are typically only recommended for short-term relief due to the risk of dependence and addiction. Sleeping pills can also cause side effects such as daytime drowsiness and confusion. For these reasons, it is often preferable to try non-drug treatments first.
Cognitive Behavioral Therapy for Insomnia (CBT-I)
CBT-I is a non-pharmacological treatment approach that targets behavioral, cognitive, and physiological factors that perpetuate insomnia. It aims to modify and alter maladaptive behaviors and distorted beliefs about sleep and insomnia. CBT-I typically involves four to eight weekly sessions led by trained therapists covering topics such as stimulus control, sleep restriction, relaxation techniques, cognitive therapy, and sleep hygiene education. CBT-I has been found effective in treating insomnia in a wide range of populations, including those with psychiatric disorders and depression.
Sleep Hygiene
Sleep hygiene refers to maintaining a healthy lifestyle that promotes good sleep. This includes keeping a regular sleep/wake schedule, reducing noise and light in the bedroom, removing electronic devices, avoiding daytime napping, and refraining from consuming alcohol, nicotine, and caffeine before sleeping. It also involves maintaining a healthy diet and exercising regularly. While sleep hygiene is important, it is usually not sufficient to treat insomnia on its own.
Other Non-Drug Therapies
Other non-drug therapies that may help improve sleep include natural sleep aids such as melatonin. However, it is important to note that even natural sleep aids can cause side effects, and they may interfere with other medications. Changing sleep behaviors is often the best way to improve sleep, especially in children and older adults.
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When sleeping pills don't work
Sleeping pills can be a short-term solution for those struggling with sleep, but they are not a cure for insomnia and come with a risk of dependence and addiction. They should be used with caution and only under the guidance of a healthcare professional. If you have tried sleeping pills and they haven't worked for you, there are several reasons why this might be the case and steps you can take to address the issue.
Firstly, it is important to understand that sleeping pills do not address the underlying causes of insomnia, which can include stress, anxiety, illness, or emotional events. They merely provide temporary relief by making you feel drowsy and relaxed. If you are experiencing insomnia due to these or other underlying factors, it is worth exploring alternative treatments that target the root cause of your sleep issues.
One reason why sleeping pills may not work is that your body has developed a tolerance for the medication. This means that over time, you need to take higher doses to achieve the same effect. Additionally, some individuals experience a "rebound effect" when trying to stop or reduce their sleeping pill intake. This can result in insomnia returning or even worsening. It is always advisable to consult with your doctor before making any changes to your medication.
Undiagnosed sleep disorders, such as restless leg syndrome or sleep apnea, can also interfere with your sleep. Sleep apnea, for example, causes temporary pauses in breathing during sleep, leading to disrupted and non-restful sleep. If you suspect you may have an undiagnosed sleep disorder, consult a healthcare professional for an examination and appropriate treatment.
Furthermore, sleeping pills may not work for everyone due to individual differences in habits, medications, or health conditions. Your doctor can help assess these factors and ensure you are taking the correct dosage of sleep medication. It is also important to manage your expectations of sleeping pills and be aware of their potential side effects, which can include memory problems, morning drowsiness, changes in appetite, headaches, and more.
If you are struggling with insomnia and sleeping pills are not providing relief, consider exploring alternative therapies such as cognitive behavioural therapy (CBT), electroacupuncture, or lifestyle changes. These approaches can help address the underlying causes of your sleep issues and promote better sleep quality without the risks associated with long-term sleeping pill use. Remember, it is important to consult with your healthcare provider to determine the best course of treatment for your specific situation.
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Frequently asked questions
Doctors may prescribe sleeping pills for short-term insomnia relief. They will consider the severity of your symptoms, comorbidities, age, and congenital disease when prescribing sleep medication.
Sleeping pills can cause dizziness, fatigue, irritability, and long-term side effects such as depression, particularly in patients with liver and kidney disease. They can also lead to an addiction or dependency, and cause withdrawal effects when you stop taking them.
Doctors might recommend lifestyle changes, such as improving your sleep hygiene, or refer you for talk therapy. Other nondrug therapies like cognitive behavioral therapy (CBT) may be better at improving your sleep.
Doctors may prescribe medications such as Doxepin (Silenor), Zolpidem (Ambien), Suvorexant (Belsomra), Trazodone (Desyrel), Ramelteon (Rozerem), or Temazepam.
If you still can't sleep with sleeping pills, your doctor may check for habits, medications, or health conditions that could be keeping you awake. They may also adjust your dosage or refer you to a sleep psychologist for talk therapy.
