It's midnight, and you're staring at the ceiling, worrying about your job, or your bills, or your children. It is tempting to turn to a sleeping pill or sleep aid for relaxation when sleep just won't come. And in an instant, you can get it. But if you're having trouble sleeping on a regular basis, that's a red flag that something is wrong. It may be anything as easy as too much caffeine or late at night watching television, your tablet, or other screens. Or it may be an indication of an underlying medical or mental issue. But whatever it is, with sleeping pills it won't be healed. Sleeping pills are, at best, a temporary band aid. Worst of all, they are an addictive crutch that can render long-term insomnia worse.
That doesn't mean that medicine can never be used, but it's important to balance the risks against the benefits. Generally, when used sparingly for short-term conditions, such as moving across time zones or recovering from a surgical procedure, sleeping pills and sleep aids are most effective. If you want to take sleeping pills for the long term, to prevent dependency and tolerance, it is better to use them only on an infrequent, "as needed" basis.
There are side effects of all prescription sleeping pills, which vary depending on the actual medication, the dose and how long the drug lasts in your system. Popular side effects include the next day's prolonged drowsiness, headache, muscle aches, constipation, dry mouth, concentration issues, dizziness, unsteadiness, and insomnia rebound.
Drug tolerance. You can build up a tolerance for sleep aids over a period of time, and you will have to take more and more for them to function, which may lead to more side effects in turn.
Dependency on drugs. You will come to rely on sleeping pills to sleep and without them you would not be able to sleep or have even worse sleep. In fact, prescription drugs can be very addictive, making it impossible to avoid taking them.
Withdrawal symptoms. You can have withdrawal symptoms, such as nausea, sweating, and trembling, if you quit the drug suddenly.
Interactions with medications. Sleeping pills are able to interfere with other drugs. This can make side effects worse and can be harmful sometimes, particularly with prescription painkillers and other sedatives.
Insomnia rebounds. Often, insomnia can get even worse than before if you need to stop taking sleeping pills.
To cover an underlying problem. Your insomnia can be caused by an underlying medical or mental condition, or even a sleep disorder that can't be cured with sleeping pills.
To encourage drowsiness, regular over-the-counter sleeping pills rely on antihistamines as their primary active ingredient.
Popular drugs for over-the-counter sleep include:
Diphenhydramina (found in brand names like Nytol, Sominex, Sleepinal, Compoz)
Doxylamine (brand names such as Unisom, Nighttime Sleep Aid)
Some other OTC sleep aids combine antihistamines with acetaminophenophen, a pain reliever (found in brand names like Tylenol PM). Others mix antihistamines with alcohol, including NyQuil.
The problem with antihistamines is that they often last long into the next day with their sedating properties, resulting in a hangover effect for the next day. They can also induce oblivion and headaches when used for a long time. Sleep experts warn against their routine use because of these problems.
There are some different kinds of sleeping pills for prescription, known as sedative hypnotics. These drugs usually act to slow down the nervous system by acting on receptors in the brain. Some drugs, while others are used to stay unconscious, are used mostly to induce sleep. Some last longer in your system (a longer half-life) than others, and some have a higher chance of developing habits.
Benzodiazepine sedative hypnotic sleeping pills
The oldest form of sleep medicine still widely used is benzodiazepines. As a category, benzodiazepines are known to have a greater risk of dependency than other sedative hypnotics for insomnia and are categorized as regulated drugs. Estazolam (brand name ProSom), flurazepam (Dalmane), quazepam (Doral), temazepam (Restoril), and triazolam are benzodiazepines mainly used to treat anxiety disorders and have been approved for the treatment of insomnia (Halcion).
Non-benzodiazepine sedative hypnotic sleeping pills
Some newer drugs do not have the same chemical structure as benzodiazepines, but they function in the brain in the same place. It is assumed that they have less side effects and less chance of dependence, but they are still considered controlled drugs. These include zalepon (Sonata), zolpidem (Ambien), and eszopiclone (Lunesta), which have been checked for up to six months of long-term use.
Melatonin receptor agonist hypnotic sleeping pills
Ramelteon (Rozerem) is the newest form of drug for sleep and works by mimicking the hormone melatonin for sleep control. It has little chance of physical dependence, but side effects are still present. It is used for problems with sleep onset and is not effective for issues related to staying asleep.
The most common side effect Ramelteon has is dizziness. It can also exacerbate symptoms of depression, and people with serious liver damage should not use it.
Antidepressants used as sleeping pills
Antidepressants have not been approved by the FDA for the treatment of insomnia, nor has their use been proven successful in the treatment of sleeplessness. However, owing to their sedating effects, some antidepressants are administered off-label. There is a small but significant risk of suicidal thoughts or a worsening of depression, particularly in children and adolescents, as with all depression medication.
Go to the drugstore and you will see hundreds of sleep supplements labeled "natural". For safety, consistency, efficacy, or even truth in labeling, the FDA does not control dietary supplements, so it is up to you to do your due diligence. The following supplements have the most studies supporting them as insomnia therapies, although the evidence is mixed:
Valerian. Valerian is a herb that has been used in sedation since the second century A.D. To relieve anxiety and insomnia. By - brain levels of the relaxing chemical GABA, it is believed to function. Although the use of valerian for insomnia has not been thoroughly studied, the study shows promise and is usually considered safe and non-habit development. It works well for two or more weeks if taken on a regular basis.
Melatonin. Melatonin is a hormone that exists naturally and rises at night. Darkness activates it and its levels remain elevated throughout the night until the light of morning suppresses it. Although melatonin does not appear to be especially effective in the treatment of most sleep disorders, sleep problems caused by jet lag and shift work can help. However, simple exposure to light at the correct time may be just as successful. If you take melatonin, be mindful that some drugs for blood pressure and diabetes will interfere with it. To prevent side effects and next-day sleepiness, it is safe to stick with low doses, one to three milligrams for most individuals.
Chamomile. Thanks to its gentle sedative properties, many people drink chamomile tea, although it may cause allergic reactions in people with allergies to plants or pollen. Bring water to a boil to get the full sleep-promoting advantage, then add two to three tea bags (or the loose-leaf tea equivalent), cover with a lid, and brew for ten minutes.
Tryptophan. Tryptophan is a simple amino acid that is used to produce the chemical messenger serotonin, a brain material that helps tell the body to sleep. L-tryptophan is a natural tryptophan byproduct that can be converted into serotonin by the body. Some research has shown that L-tryptophan can help individuals fall asleep more quickly. However, the findings have been contradictory.
Kava. Kava has been shown to enhance sleep in individuals with insomnia associated with stress. Kava, however, can cause liver damage, so unless taken under close medical supervision, it is not recommended.
Lemon balm, passionflower, and lavender are other herbs that have been found to have a soothing or sedating effect. To support sleep, many natural sleep supplements use a mixture of these ingredients.
Keep the following safety instructions in mind if you plan to try sleeping pills or sleep aids.
Never mix alcohol or other sedative medications with sleeping pills. Not only does alcohol disrupt the quality of sleep, but it improves the sedative effects of sleeping pills. The mixture can be very harmful, even fatal.
Taking a sleeping pill only when you have enough time to sleep for at least seven to eight hours. Otherwise, the next day, you may feel really drowsy.
In the middle of the night, don't take a second dose. It may be risky to double your dose, because it can be hard to get up the next morning and shake off grogginess with less time for the drug to clear the system.
Begin with the lowest dose that is recommended. See how you are affected by the drug and the kinds of side effects that you encounter.
Stop being used regularly. Try saving sleeping pills for emergencies, rather than nightly use, to prevent dependency and avoid adverse effects.
Never drive a car or run machinery after a sleeping pill has been taken. When you start using a new sleep aid, this tip is extremely important, as you do not know how it will impact you.
Read the packet insert that comes with your prescription carefully. Pay attention to the possible adverse effects and medication reactions carefully. Many popular drugs can cause dangerous interactions with both prescription and over-the-counter sleeping pills, including antidepressants and antibiotics. For several sleeping pills, it is also important to avoid certain foods, such as grapefruit and grapefruit juice.