What are sleeping pills?
“Sleeping pills” refers to a generic term used to describe both prescription and over-the-counter (OTC) medications. These medications are used to help individuals who have difficulty falling asleep or staying asleep on their own. Sleeping pills are hypnotics, meaning that they promote or extend sleep. They are also sometimes called sedatives, which while literally meaning “calming,” more often can refer to “the ability to cause drowsiness.”
The most common prescription sleeping pills, or hypnotics, are in the classes of drugs called benzodiazepines or benzodiazepine receptor agonists. Sleeping pills can have serious side effects if overused or abused.
If you feel you might need sleeping pills, you should first consult your healthcare provider.
Sleeping Pills: The Pros and Cons
Which sleeping pill is right for you? Get the pros and cons with this decision chart.
Reaching for the first sleep aid you find when insomnia hits? Not all sleeping pills are the same. Each class of sleep aid works a bit differently from the other, and side effects vary.
It’s important to ask key questions before choosing your sleep medicine.
- How long does it take for the sleeping pill to take effect?
- How long do the effects last?
- What’s the risk of becoming dependent on the sleeping pill, physically or psychologically?
All sleep medicines have the potential for causing dependence. In the large majority of cases, however, this is psychological dependence, not physical.
Talk with your doctor, and use this chart to help you decide which sleeping pill is right for you.
How It Works
Duration of Effects
|Diphenhydramine||Acts on histaminereceptors in the brainto cause drowsiness.||4-6 hours (sleepiness may last longer)||Daytime sleepiness; confusion and difficulty urinating in older people.||Low|
|Selective GABA Medicines||Binds to a specific type of GABA receptor in the brain.||6-8 hours||Usually few. Memory disturbances, hallucinations, behavior changes possible.||Medium (usually low)|
|Sleep-Wake cycle Modifiers||Stimulates melatoninreceptors in the brain area that controls the sleep-wake cycle.||4-6 hours||Headache, drowsiness, dizziness. Uncommonly, problems with sex drive. Loss of menses or problems getting pregnant.||Low|
|Benzodiazepines||Binds to general GABA receptors in the brain.||Varies (from 4 hours to more than 12)||Sedation, loss of muscle coordination, dizziness, habit-forming.||Higher|
|Tricyclic Antidepressants||Binds to multiple brain receptors including acetylcholine; sedating.||Not well studied||Low at usual doses for insomnia. Dizziness, blurry vision, difficulty urinating, cardiac arrhythmias possible. Trazodone can cause prolonged, painful erections.||Low|
Understanding the Side Effects of Sleeping Pills
Between a third and half of all Americans have insomnia and complain of poor sleep. Perhaps you’re one of them. If so, you may be considering taking a sleeping pill.
A sleeping pill may be effective at ending your sleep problems short-term. But it’s important to make sure you understand everything you need to know about sleeping pills. That includes knowing about sleeping pill side effects. When you do, you can avoid misusing these sedatives.
Drugs to Treat Insomnia
In some cases, doctors will prescribe drugs for the treatment of insomnia. All insomnia medications should be taken shortly before bed. Do not attempt to drive or perform other activities that require concentration after taking an insomnia drug because it will make you sleepy. Medications should be used in combination with good sleep practices.
Here are some medications that can be used to treat insomnia.
- Antidepressants : Some antidepressant drugs, such as trazodone (Desyrel), are very good at treating sleeplessness and anxiety.
- Benzodiazepines: These older sleeping pills — emazepam (Restoril), triazolam (Halcion), and others — may be useful when you want an insomnia medication that stays in the system longer. For instance, they have been effectively used to treat sleep problems such as sleepwalking and night terrors. But these drugs may cause you to feel sleepy during the day and can also cause dependence, meaning you may always need to be on the drug to be able to sleep.
- Doxepine ( Silenor ): This sleep drug is approved for use in people who have trouble staying asleep. Silenor may help with sleep maintenance by blocking histamine receptors. Do not take this drug unless you are able to get a full 7 or 8 hours of sleep.
- Eszopiclone ( Lunesta ): Lunesta also helps you fall asleep quickly, and studies show people sleep an average of 7 to 8 hours. Don’t take Lunesta unless you are able to get a full night’s sleep as it could cause grogginess. Because of the risk of impairment the next day, the FDA recommends the starting dose of Lunesta be no more than 1 milligram.
- Ramelteon ( Rozerem ): This sleep medication works differently than the others. It works by targeting the sleep-wake cycle, not by depressing the central nervous system. It is prescribed for people who have trouble falling asleep. Rozerem can be prescribed for long-term use, and the drug has shown no evidence of abuse or dependence.
- Suvorexant (Belsomra). It works by blocking a hormone that promotes wakefulness and causes insomnia. It is approved by the FDA to treat people that have insomnia due to an inability to fall asleep or to stay asleep. The drug may cause you to feel sleepy the following day.
- Zaleplon ( Sonata ): Of all the newer sleeping pills, Sonata stays active in the body for the shortest amount of time. That means you can try to fall asleep on your own. Then, if you’re still staring at the clock at 2 a.m., you can take it without feeling drowsy in the morning. But if you tend to wake during the night, this might not be the best choice for you.
- Zolpidem ( Ambien , Edluar, Intermezzo): These medicines work well at helping you get to sleep, but some people tend to wake up in the middle of the night. Zolpidem is now available in an extended release version, Ambien CR. This may help you go to sleep and stay asleep longer. The FDA warns that you should not drive or do anything that requires you to be alert the day after taking Ambien CR because it stays in the body a long time. You should not take zolpidem unless you are able to get a full night’s sleep — at least 7 to 8 hours. The FDA has approved a prescription oral spray called Zolpimist, which contains zolpidem, for the short-term treatment of insomnia brought on by trouble falling asleep.
- Over-the-counter sleep aids: Most of these sleeping pills are antihistamines. There is no proof that they work well for insomnia, and they can cause some drowsiness the next day. They’re safe enough to be sold without a prescription. But if you’re taking other drugs that also contain antihistamines — like cold or allergy medications — you could inadvertently take too much.
What Are the Side Effects of Sleeping Pills?
Sleeping pills have side effects like most medications. You won’t know, though, whether you will experience side effects with a particular sleeping pill until you try it.
Common side effects of prescription sleeping pills such as Lunesta, Sonata, Ambien, Rozerem, and Halcion may include:
- Burning or tingling in the hands, arms, feet, or legs
- Changes in appetite
- Difficulty keeping balance
- Daytime drowsiness
- Dry mouth or throat
- Impairment the next day
- Mental slowing or problems with attention or memory
- Stomach pain or tenderness
- Uncontrollable shaking of a part of the body
- Unusual dreams
It’s important to be aware of possible sleeping pill side effects so you can stop the drug and call your doctor immediately to avoid a more serious health problem.
Are There More Complex Sleeping Pill Side Effects?
Some sleeping pills have potentially harmful side effects, including parasomnias. Parasomnias are movements, behaviors and actions over which you have no control, like sleepwalking. During a parasomnia, you are asleep and unaware of what is happening.
Parasomnias with sleeping pills are complex sleep behaviors and may include sleep eating, making phone calls, or having sex while in a sleep state. Sleep driving, which is driving while not fully awake, is another serious sleeping pill side effect. Though rare, parasomnias are difficult to detect once the medication takes effect.
Product labels for sedative-hypnotic medicines include language about the potential risks of taking a sleeping pill. Because complex sleep behaviors are more likely to occur if you increase the dosage of a sleeping pill, take only what your doctor prescribes — no more.
When Do I Take a Sleeping Pill?
It’s usually recommended that you take the sleeping pill right before your desired bedtime. Read your doctor’s instructions on the sleeping pill prescription label. The instructions have specific information regarding your medication. In addition, always allow ample time to sleep before you take a sleeping pill.
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