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Sleeping Pills

by Mary Gallagher, RN, MSN, CCRN

Feb 4, 2016
2016

One-third to one-half of all Americans experience insomnia and complain of poor sleep. Insomnia can occur during times of stress, travel and other disruptions. If you regularly have difficulty sleeping, make an appointment with your health care provider. Treatment depends on the cause of your insomnia. Some people who have difficulty falling asleep and staying asleep need medications to help with sleep for a short period. Sometimes an underlying medical disorder or sleep disorder is discovered and treated.

Before using medications for sleep, talk with your health care provider about treating other issues such as anxiety, sadness, depression and alcohol or illegal drug use. Over-the-counter sleep aids and prescription sleep medications all carry benefits, risks and side effects. Many OTC sleeping pills contain antihistamines, which usually treat allergies. While these sleeping aids are not addictive, your body can become used to them quickly, making them less effective over time. They can also leave you feeling tired and groggy when you awaken the next day and can cause memory problems in older adults.

Prescription medications that promote sleep are called hypnotics and can help reduce the time it takes to fall asleep. The most commonly used hypnotics are Ambien, Sonata, Lunesta and Rozerem. Most of these medications are habit-forming. Only take them under the direction of a health care provider, who will likely start you with the lowest dose. Take these medications no more than three times a week. Do not stop taking them suddenly; you may experience symptoms of withdrawal and have difficulty falling asleep. Do not simultaneously take other medications that can cause drowsiness. Mixing alcohol and sleeping pills can be extremely hazardous. The combination increases the sedative effect of the sleeping pills, which can be fatal.

Side effects of prescription sleeping pills may include burning or tingling in the hands, arms, feet and legs; changes in appetite; constipation and diarrhea; difficulty maintaining balance; dizziness; daytime drowsiness; and impairment the next day. Some people also experience weakness, unusual dreams, uncontrollable shaking of a part of the body, mental slowness or problems with attention or memory, dry mouth or throat, headache, heartburn and stomach pain and tenderness.

Some sleeping medications have the potential to cause parasomnias — behaviors and actions over which you have no control. During a parasomnia, you are asleep and unaware of what is happening. Parasomnias caused by sleeping pills may include sleepwalking, eating, making phone calls, driving or having sex while in a sleep state. Although rare, parasomnias are difficult to detect once the medication takes effect.

A treatment option is to take antidepressants at lower doses at bedtime since they induce drowsiness and your body is less likely to become dependent on them. Your health care provider can prescribe these medicines and monitor you while you take them. Although widely used, the Food and Drug Administration does not approve them for treating insomnia alone. When insomnia is secondary to depression or anxiety, antidepressants may improve both conditions at the same time.

Prescription sleeping pills and some OTC sleeping medications as well as certain antidepressants may not be safe for women who are pregnant or breastfeeding or for older adults. Since sleeping pills can increase nighttime falls and injury in older adults, lower doses may reduce the risk of falls.

Some health conditions such as kidney disease, asthma, high blood pressure, stroke or a history of seizures may limit your options. Prescription drugs and OTC sleep aids may interact with other medications. Taking certain prescription sleeping pills can lead to drug abuse or drug dependence, so it is important to follow your doctor’s advice and use them safely. Get a medical evaluation before taking sleeping pills and schedule a follow-up appointment to discuss the results and medication options.

Read the medication directions; if you have any questions, ask your health care provider or pharmacist. Never take a sleeping pill until you are going to bed. Plan to take your first sleeping pill when you can get a full night’s sleep, such as a Friday night if you work weekdays. Watch for side effects and report them to your doctor. Never take sleeping pills longer than your health care provider advises. When you are ready to stop taking the medication, follow your provider’s or pharmacist’s directions.

If your best attempts to get a good night’s sleep have failed, prescription sleeping pills may be an option. In the long run, however, making changes in your lifestyle and sleep habits may be the best treatment for problems with falling asleep and staying asleep.

National Institutes of Health

The content of this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition.

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