Considering Sleeping Pills? [Insomnia Medication Review]
Not being able to sleep is frustrating. It can be even more exasperating if you can’t sleep on a regular or chronic basis.
As we get more tired, we start to get clumsy, make mistakes at work, and may present a danger while driving or operating machinery.
If you can’t sleep, you’re not alone. More than eight million American adults use prescription sleep aids, according to the National Health and Nutrition Examination Survey. And at least 40 million Americans suffer from chronic, long-term sleep disorders.
If you’re experiencing regular insomnia, the first step is to make an appointment with your primary care doctor or other health care professional. In many cases, an underlying cause such as a medical condition or a sleep disorder can be identified and treated. In some cases, a doctor may order a specialized test called a “sleep study,” during which medical staff will monitor your vital signs and behavior during attempted sleep under controlled conditions. This test can reveal important findings, like sleep apnea, as well as providing a more comprehensive picture of your personal sleep disorder.
While treating the primary cause of your sleep issues is most important, some sleep specialists see sleep medication, or sleeping pills, as a bridge to treating or managing the underlying cause of the sleep issue.
If you’re considering using sleeping pills to help you sleep at night, first read through this guide for a better indication as to whether sleeping pills are right for you.
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The Most Common Prescription Medications (and How They Work)
Most sleep medications fall into one of two general categories.
First, there are the pills to help you fall asleep. Secondly, there are pills to help you stay asleep, if you wake up in the middle of the night and can’t get back to sleep. Of course, there are also a few that do both.
While insomniacs may think of sleeping pills as a miracle cure—or on the flip side, something to be avoided—the science behind how they work is sound. Most sleeping pills fall under the umbrella of drugs known as “sedative-hypnotics,” and work by dealing with neurotransmitters in the brain.
Neurotransmitters are natural chemicals found in brain that are made and released by nerves. These neurotransmitters attach to receptors on other nerves and serve as a means of communication between nerves. These neurotransmitters can be disrupted by things like anxiety, depression or other conditions, which prevents them from working properly. Most common sleeping pills increase the activity of “gamma-aminobutyric acid,” or GABA, a specific neurotransmitter that produces drowsiness and facilitates and maintains sleep.
Sleeping pills are marketed under a variety of names, but there are only about a dozen that are commonly prescribed. These include:
- Zolpidem CR Extended Release, also marketed as Ambien, Edluar or Intermezzo, works extremely well in helping people get to sleep but may not keep them asleep, which is why it is now available in an extended release version. Ambien also stays in the body for an extended period of time, so you shouldn’t drive or undertake activities that require you to be alert when taking the drug.
- Eszopiclone, marketed widely as Lunesta, is effective at helping patients sleep seven to eight hours a night, but it can also cause drowsiness. The Federal Drug Administration recommends a conservative starting dose of one milligram.
- Zaleplon, known by the brand name Sonata, has the advantage of having the shortest duration, meaning it’s generally safe to take in the middle of the night without feeling drowsy in the morning. It’s a good option for patients who usually prefer to try to fall asleep without medications.
- Benzodiazepines include older sleeping pills like triazolam (Halcion) as well as those commonly used to treat more severe sleep problems, such as sleepwalking and night terrors. These drugs can cause moderate drowsiness and may promote dependence on the medication to sleep.
Other Sleep Medications and Sleep Aids
Not all sleeping pills fall under one of the above umbrella terms. And the cause of your sleep difficulty may call for a different solution that isn’t considered a “sleeping pill.”
- Antidepressants. Some physicians use a practice known as “off label prescribing” to help patients with sleep problems by using antidepressants for insomnia related to anxiety. These meds may include brand names like Trazodone (Desyrel), Amitriptyline (Elavil) and Doxepin (Sinequan). These are generally prescribed in lower doses to treat sleep problems than they are when prescribed for depression or generalized anxiety.
- Natural Sleep Aids. Some people who don’t want to turn to prescription medications to treat their sleep problems have found some success using natural sleep aids such as Melatonin, Valerian and Chamomile. These substances provide mild relief to sleep problems, but can present a risk when combined with other medications or certain foods. None of these natural sleep aids have been proven to improve sleep in the long term, but they may help address a hormone imbalance, inflammation, or other factors contributing to difficulty sleeping.
Over-the-Counter Antihistamines with Diphenhydramine
Another highly common approach to alternative sleep aids includes the use of over-the-counter antihistamines with a medication called Diphenhydramine, commonly found in allergy medications like Benadryl and over-the-counter sleep aids like Unisom and Tylenol PM.
Antihistamines induce sleep by antagonizing central histimine-1 (H-1) receptors in the brain, blocking certain nerve signals and making users sleepy. Some antihistamines can also cross the blood-brain barrier to get to relevant receptors, making them quite effective as sedatives.
However, antihistamines are most effective as a short-term bridge to better sleep over time. Most users build up tolerances to them over time, and insomnia can quickly return when they quit taking them. As with most substances, antihistamines can produce negative effects if taken with other medications, and you should consult with your doctor or primary care physician before combining medications or over-the-counter products.
Common Side Effects of Sleep Medication You May Need to Know About
Sleeping pills, like most other common prescription medications, can cause users to experience certain side effects, ranging from mildly annoying to quite risky. In most cases, you won’t know whether you will experience negative side effects from a medication until you take it, so it’s good to be aware of what might happen (and to always stick to recommended dosage).
Because of their sedative nature, your doctor or pharmacist may alert you to the possibility of side effects due to other medications you are currently on, or if you have a health risk such as asthma, emphysema or other chronic lung problems.
Alcohol and sleeping pills are not friends! The combination of the two magnifies the sedating effects of both alcohol and sleeping pills, which can cause users to experience slower heart rate and, in some unfortunate instances, even stop breathing.
It’s also important to note that some people are actively allergic to certain sleeping pills, either to the active ingredient or a secondary ingredient such as dyes or coatings. The risk of serious complications can increase if an allergic reaction, such as Anaphylaxis, occurs, which is why it’s so important to only use sleep medication under strict doctor supervision.
Sleeping pills such as Ambien, Xanax or Lunestra should be discontinued and a doctor notified if you experience any of the following side effects:
- Blurred or altered vision
- Difficulty swallowing or breathing
- Rapid heartbeat
- Shortness of breath
- Swelling in the face or throat
You can become dependent on sleeping pills. As with most medications, a sleeping pill may stop working (or working as well) as you build up a tolerance. You may also become physically or psychologically dependent on the medication, resulting in severe anxiety at the thought of going to sleep without it.
Sleeping pills can induce amnesia. One of the risks of sleep medication, especially if combined with alcohol or other medication, is short-term memory loss. These “blackouts” enable people under the influence to continue to interact and engage with the world, but with no lingering memory of what they did at the time. People have gotten into automobile accidents and suffered serious injuries while in a blackout, so it’s important to take your medication as directed and go straight to bed.
Use common sense when using a sleeping pill to sleep. First, follow your doctor’s instructions as to when, how, and how much to take. Never mix sleeping pills with alcohol or other sedative drugs. Only take a sleeping pill when you have enough time to get a full night’s sleep (7 to 8 hours). And you should only take a sleeping pill when it’s time to go to bed.
Naturally, you shouldn’t drive a car or operate heavy machinery after taking sleep medication. Start with the lowest recommended dose and avoid more frequent use.
Some sleeping pills need to be stopped gradually to avoid setbacks, so be sure to consult with your doctor to structure the best schedule and dosage for you.
Find Out If Sleeping Pills Are Right For You
Sleeping pills and sleep aids can be powerful tools to help you live a better life. But they aren’t cure-alls, and these medications carry certain risks you need to know about before starting treatment.
Before taking sleep medication, evaluate your own sleep hygiene. In many cases, small changes to your nighttime routine can support better rest without the use of sleeping pills.
If you take away anything from this post, know that it’s critical to consult with your doctor before starting any medication, whether it’s a prescription or over-the-counter drug.
And if you want to learn more about how to fall asleep faster and sleep better (with or without the use of medication), we invite you to visit us here for more information on sleep hygiene, natural ways to fall asleep faster, and natural gateways to a better night’s rest.
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