Sleeping or wakefulness disorders affect 50 to 70 million adults in the United States. The Centers for Disease Control and Prevention have even called it a public health problem.1 And while some people might try and get by with less sleep and ignore the fatigue, stress, and health problems that come with insufficient or less restful sleep, sleeping pills offer respite to many others. Unfortunately, these pills are no miracle cure and come with their own set of problems. Before you try and sort out your sleeping trouble with a prescription sleeping pill, here’s what you should know.
How Do Sleeping Pills Work?
There are essentially two kinds of prescription sleeping pills. Old school benzodiazepines like lormetazepam, diazepam, temazepam, nitrazepam or loprazolam target a variety of sleep-promoting receptors in your brain. Unfortunately, they have the tendency to be addictive.2 The newer generation of sleeping pills are selective gamma-aminobutyric acid medications, nonbenzodiazepines, or melatonin-receptor agonists and target more specific receptors than benzodiazepines. They are less addictive but are not without their share of side effects.3 Over-the-counter sleeping aids are usually medicines like antihistamines whose primary purpose is usually not to help someone sleep – the drowsiness or sleepiness they cause is an incidental side effect of the medication.They too have their share of side effects.4
Data from a national survey revealed that about 4 percent of all adults aged 20 and over in the United States used a prescription sleep aid in the month prior to being surveyed. That’s not counting the countless others who use antihistamines and other over-the-counter sleeping aids.5 If you are one of them, here’s what you should look out for.
Side Effects Of Sleeping Pills
Doctors usually avoid prescribing sleeping pills unless your insomnia is really severe and has not responded to cognitive/behavioral treatment. It is also seen as a short-term solution to tide you over a spell of insomnia and is never recommended for long-term use because of its potentially risky side effects.6
Here are some of the issues people taking either of these kinds of medications might face.
1. Daytime Drowsiness
Sleeping pills are known to cause daytime drowsiness in some people. This can leave you confused. Decision making and concentration may become a challenge. Some people report feeling dizzy and drowsy the day after taking sleeping pills.7
For older adults who take sleeping pills, there is an added risk. Because your body takes longer to break down the drug, it stays in your body longer. You may wake up a little unsteady on your feet or feel confused and groggy.8
2. Hallucinations And Nightmares
Medicines like zaleplon, zopiclone, and zolpidem (also dubbed Z-drugs) are given for a short-term of two to four weeks. They can cause delusions or hallucinations in some people. Some people complain of nightmares after using the drugs.9
3. Worsening Sleep Apnea
If you already suffer from sleep apnea, sleeping pills might make the problem worse. Obstructive sleep apnea is a condition that causes your airways to be either partially or totally blocked when you’re sleeping, causing you to jolt awake as oxygen levels in the body drop. This results in a very restless night of sleep marred by constant wakings.10 Unfortunately, sleeping pills that you may think will help you sleep better could make things worse. Benzodiazepines and barbiturates are known to have this effect.11
4. Drug Dependence And Addiction
Over time, you could develop drug tolerance where the sleep aid needs to be taken in higher dosages to have the same effect as before. This increased intake makes you more susceptible to all the side effects. You may even become completely dependent and may find that you simply can’t sleep when you don’t take them. Prescription sleep pills are especially notorious for their addictive nature. Not taking them all of a sudden after having them for a long time can also cause withdrawal symptoms like sweating, nausea, or shaking.12
5. Aches And Pains
Melatonin-based sleep medication has been known to improve insomnia by regulating the sleep cycle. However, it can also cause you to have headaches or develop back or joint pain.13
6. Drug Interactions
There is concern over the interaction of certain drugs, specifically prescription painkillers, with sleeping pills. When combined with sleeping pills such as benzodiazepines, they could result in respiratory depression or even coma or death. This has led the US Food and Drug Administration to move for a change in drug labeling and patient information across this class of drugs. If this falls in place, both patients and healthcare providers will be better informed of the serious risk of combining benzodiazepines with some opioid medications like analgesics or cough medication.14
7. Increased Risk Of Dementia
Consuming benzodiazepines has been linked to elevated risk of Alzheimer’s disease type dementia. This has led researchers to suggest that long-term use of the drugs may need to be addressed as a public health concern. Excess risk is linked to consuming benzodiazepines as well as other similar drugs like anxiolytics and hypnotics for a period of greater than three months. Regulating how much you consume becomes especially critical if you are an older adult.15
8. Mortality Risk
Shocking as it may seem, some research suggests taking hypnotic drugs to help with sleeping problems could raise your mortality risk. This includes antihistamines, barbiturates, benzodiazepines, and medication like zolpidem, temazepam, zaleplon, and eszopiclone. About 6 to 10 percent of all American adults are estimated to have used hypnotic drugs to treat their poor sleep in 2010. Even having under 18 pills a year could cause a threefold rise in the risk of death. For those having over 18 but under 132 doses a year, hazards of death were four or five fold that of someone not taking any pills. In those consuming over 132 doses a year, the drug intake also raised cancer risk besides causing five to six-fold increase in death risk.16
9. Risks From Improper Use
If you plan on taking an over-the-counter sleeping aid like an antihistamine, you should avoid engaging in any major activity inside or outside the house. Ideally, just hit the sack and get a good night’s rest. The same applies to any sleeping pill, including those you have been prescribed. If you try and function normally while on a sleeping pill, you put yourself and others at risk of bodily harm. Operating machinery, driving, or even heading out after taking a sleeping pill is dangerous. If you are disoriented and groggy, you may be slow to react and may not have your wits about you. This is hazardous if you’re, for instance, behind the wheel. You may also make poor judgment calls on little things like crossing the street or operating any equipment at home.17
Sleeping Better Without Sleeping Pills
Sleeping pills may not be all they are cracked up to be. In fact, according to some sleep studies, they may help you sleep just 8 to 20 minutes quicker than if you didn’t pop the pills. Overall, they may help you just get an extra 35 minutes of sleep on nights you take them.18 So what you need to ask yourself is if the pills are really necessary. And if not, what are your other options?
Here are simple, all-natural tips to help you sleep better.19
- Decide on a set bedtime and time to get up and plan your day around it to ensure you make it happen.
- Set a bedtime routine and stick with it. A warm bath, some soothing music, or a good book and a room with dim light can all lead up to a good night’s sleep.
- Banish your gadgets and focus on relaxing your mind. A book or some soft music are better alternatives.
- Don’t eat too much close to bedtime.
- Skip caffeine, alcohol, and nicotine in the hours leading up to bedtime. Ideally, avoid any of these for at least 5–6 hours before you need to sleep.
- Cognitive behavioral therapy can help you learn habits, including calming techniques, that enable you to sleep better.20
|↑1, ↑19||Insufficient Sleep Is a Public Health Problem. Centers for Disease Control and Prevention.|
|↑2||Sleeping Pills. American Sleep Association.|
|↑3||Learn the risks of sleep aids. Harvard Health Publications.|
|↑4, ↑6, ↑7, ↑9, ↑13, ↑17||Insomnia – Treatment. National Health Service.|
|↑5||Prescription Sleep Aid Use Among Adults: United States, 2005–2010. Centers For Disease Control And Prevention.|
|↑8||Using Pills to Fall Asleep at Night? AARP.|
|↑10||Obstructive Sleep Apnea. American Sleep Association.|
|↑11||Sleeping Pills and Insomnia. University of Maryland Medical Center Midtown Campus.|
|↑12||Possible Side Effects of Sleep Medication. American Academy of Sleep Medicine.|
|↑14||FDA requires strong warnings for opioid analgesics, prescription opioid cough products, and benzodiazepine labeling related to serious risks and death from combined use. US Food And Drug Administration.|
|↑15||de Gage, Sophie Billioti, Yola Moride, Thierry Ducruet, Tobias Kurth, Hélène Verdoux, Marie Tournier, Antoine Pariente, and Bernard Bégaud. “Benzodiazepine use and risk of Alzheimer’s disease: case-control study.” Bmj 349 (2014): g5205.|
|↑16||Kripke, Daniel F., Robert D. Langer, and Lawrence E. Kline. “Hypnotics9 association with mortality or cancer: a matched cohort study.” BMJ open 2, no. 1 (2012): e000850.|
|↑18, ↑20||Sleeping pills for insomnia. Consumer Reports and American Association of Sleep Medicine.|