When you’re exhausted and having trouble sleeping, you are likely to try anything for relief, especially if your sleep deprivation lasts longer than just one night. Although many people find relief for insomnia with natural remedies, such as melatonin or a cup of decaffeinated tea before bed, others need a little extra assistance in falling and staying asleep.
For people with chronic insomnia, sleep medication can be a viable option. According to the Centers for Disease Control and Prevention (CDC), about 4% of Americans, or 9 million people, have taken a prescription sleep aid in the last month. The prevalence of sleeping pill use increases with age, as people aged 80 or older are more likely to use a prescription drug to help them sleep than younger people.
When getting adequate sleep proves to be a struggle, sleeping pills can be a valuable tool, at least in the short term. However, as with any medication, there are both benefits and drawbacks, and anyone considering using these drugs should carefully consider all sides before asking for a prescription.
Types of Sleeping Pills
It’s important to note that not all sleeping pills are the same, and not all options work the same for everyone.
At one end of the spectrum, there are sleep aids. Usually sold over the counter, these include products like Tylenol PM, ZzzQuil, or Benadryl. Designed to cause drowsiness, these drugs usually include a sleep aid along with ingredients designed to treat other symptoms. Most contain diphenhydramine, an antihistamine. Because these medications are designed for occasional use, such as when you are sick, they aren’t typically considered habit-forming or dangerous. Whether or not they actually support healthy sleep is up for debate, as antihistamines can actually cause you to wake up feeling groggy rather than well-rested, but many people find these OTC medications helpful for occasional insomnia relief.
Prescription sleep aids, on the other hand, are often referred to as “sleep hypnotics,” a class of drugs designed to help you fall asleep and stay asleep. There are several types: benzodiazepines, barbiturates, and a newer class of sleep-inducing medications, including Ambien.
Benzodiazepines like Valium, Xanax, and Ativan are sedatives that bind to specific receptors in the brain. Occasionally prescribed for insomnia, these drugs have a high risk of dependency. Barbiturates are rarely used to treat sleep issues today, as they depress the central nervous system to cause sedation. Although they are used for anesthesia, they aren’t generally prescribed for sleep as an overdose can be fatal and they become less effective over time.
The most common prescription sleep aids are another class of hypnotics, including drugs like Ambien and Lunesta. They work similarly to benzodiazepines in that they bind to chemical receptors in the brain to induce sleep, but they are less habit-forming than other drugs. Again, not all sleep aids are effective for everyone, and some people need to try several different options before finding the most effective medication. However, that still begs the question: Are sleeping pills bad?
Pros of Sleeping Pills
As with most prescription drugs, sleeping pills cannot be classified as entirely “good” or “bad.” There are many factors that can determine whether to use a prescription sleep aid, which one is the best option, and how long to use it. That being said, there are some clear benefits to using sleeping pills.
- Effective in the short term. For people who are struggling to sleep and need help getting back on track, prescription sleep medication can be just what they need to get some rest. Often, insomnia comes and goes, with long stretches of normal sleep punctuated by bouts of sleeplessness. A prescription sleep aid can help people during those times.
- Help people fall asleep fast. Perhaps the most obvious benefit of sleeping pills is that they help people get to sleep quickly. When nothing else works, a sleeping pill will usually do the trick.
- Help people who are severely sleep-deprived. Severe sleep deprivation is dangerous and can have long-term effects on a person’s overall health. When you haven’t had a decent night’s sleep in weeks or even months, sleeping pills can bring much-needed relief. Sleeping pills are also useful for people who work second or third shifts and, therefore, have disrupted sleep cycles.
- Newer medications are often considered safer and less habit-forming than older drugs. Although some of the older types of sleep medication did have a high risk of dependence, most of the newer options are less likely to be habit-forming.
Cons of Sleeping Pills
For all of the benefits of sleeping pills, there are some drawbacks and concerns to consider before taking them.
- Addiction/tolerance development. Although most sleeping pills are developed so they aren’t habit-forming, there is still a risk that you can become addicted. Also, when sleeping pills are used for longer than a few weeks at a time, it’s possible to build up a tolerance, and therefore require larger doses to achieve the same effect. \
- Side effects. Some people do experience side effects from sleeping pills, including nausea, headaches, dizziness, daytime drowsiness, weakness, constipation, and more.
- Allergic reactions. Some people have had severe allergic reactions to sleeping medication, which may be brought on by the active ingredient in the drug or any of the additional ingredients, such as dyes or binders. These reactions can range from itching and hives to vomiting or anaphylaxis.
- Drug interactions. The active ingredients in sleep medications can have severe interactions with other drugs, causing serious health issues.
- Often deemed unsafe for pregnant or breastfeeding women. Many medications that are safe for normal adults can cause harm to a developing baby, so if you’re pregnant and having sleep troubles, talk to your doctor about alternative remedies.
- Increased cancer risk. Studies suggest that the regular use of sleeping pills may increase the chances of developing certain cancers.
- Erratic behavior. Some people have reported erratic behavior after taking sleep aids, including sleepwalking, shopping, and even driving, without remembering the incident afterward. This behavior can potentially be dangerous.
- Impaired driving. All sleep medications warn users to avoid driving after use, but some people still have traces of the drug in their system the next day, even after sleeping for several hours. This can cause daytime drowsiness and impaired driving.
How to Choose and Safely Use Sleeping Pills
If you have trouble sleeping, talk with your doctor. Because different sleep aids are intended for different purposes, your doctor can help you find the right one (one that helps you fall asleep, one that helps you remain asleep, or one that does both). Generally speaking, sleep aids are only meant for short-term use, so it’s likely that your health provider will want to perform additional testing or exams to determine the underlying cause of your sleep disturbances.
Before asking for a prescription, ask your doctor important questions about the drug, including how effective it is, the potential side effects, and the risk for dependency. When you begin taking the medication, you should:
- Be careful to avoid mixing it with alcohol or other drugs.
- Only take it when you have at least eight hours to devote to sleep. For the first dose, take the medication when you don’t have plans for the following day so you can gauge how it affects you.
- Follow the exact dosing instructions provided by your doctor.
- Contact your doctor if you have any concerns or unexpected side effects, especially if the medication spurs erratic behavior.
Keep in mind that some people shouldn’t use sleep medications at all. For instance, they aren’t generally recommended for people with sleep disorders like sleep apnea, or for those with chronic respiratory conditions.
Alternatives to Sleeping Pills
When sleep doesn’t come easily, sleeping pills aren’t your only option. In fact, your doctor is likely to recommend other remedies first, while also trying to determine the cause of your insomnia. Before reaching for sleeping pills, you may wish to explore alternatives, such as natural remedies like melatonin, or “sleep teas” that contain sleep-inducing ingredients like lavender, chamomile, or valerian root.
Improving your sleep hygiene can also help you drift off more easily. Keeping your room at a comfortable temperature, following a bedtime routine, and practicing some relaxation exercises (like meditation, simple yoga stretches, or deep breathing) before bed can all help improve sleep quality.
Finally, your doctor may also recommend cognitive behavioral therapy (CBT) as a part of your treatment plan. Through CBT, you can learn the skills and techniques needed to address issues that could be contributing to your sleeplessness, including stress, anxiety, depression, or other issues in your life.
Ultimately, it’s up to you and your doctor to determine whether sleeping pills are a viable solution to your sleep problems. When used properly, they can be beneficial to those who struggle to get enough sleep, often without any negative effects. If you are having trouble sleeping, be sure to discuss the issue with your doctor to find the healthiest, safest solution.