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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Mental and Behavioural Disorders Sleeping pills

Sleeping pills

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Sleeping medications are effective if they are used sparingly for short term situations. Various medications are available to induce sleep.

 

Over the counter sleeping aids

The main over the counter sleeping pills are antihistamines. The commonly used are diphenhydramine and Doxylamine. OTC sleeping aids are sued for short term insomnia. Long term use can cause tolerance and higher doses are needs to induce sleep.

 

Side effects of OTC sleeping aids:

Common side effects of sleeping pills

  • Dizziness
  • Facial swelling
  • Headache
  • Prolonged drowsiness, though less so than with drugs that help you stay asleep
  • Sleep behaviors such as sleep-driving and sleep-eating

Prescription sleeping medications.

These include sedative hypnotics.

Benzodiazepine sedative hypnotics: These are the most commonly sued for insomnia. The commonly used drugs are:

  • Estazolam
  • Flunitrazepam
  • Lormetazepam
  • Midazolam
  • Nitrazepam
  • Quazepam
  • Temazepam
  • Triazolam

Non-Benzodiazepine sedative hypnotics

Zolpidem, Eszoiclone and Zalepon are the most commonly used.

Melatonin receptor agonist

This medication resemble the sleep regulation hormone melatonin. It has less risk of physical dependence. The commonly used is Rameleton.

The common problems with sleeping pills

Drug dependence. You may come to rely on the medication to sleep, and will be unable to sleep or have even worse sleep without it.

Drug tolerance. You may have to take more and more of the sleep aid for it to work, which can lead to more side effects.

Withdrawal symptoms. If you  stop the medication abruptly, you may have withdrawal symptoms, such as nausea, sweating and shaking

Side effects. There are several side effects to sleep medications, such as drowsiness the next day, confusion, forgetfulness and dry mouth. These side effects can be severe.

Drug interactions. If you are taking other medications, sleeping medications can interact with them. This can worsen side effects and be dangerous with medications like prescription painkillers and other sedatives. 

Rebound insomnia. If you need to stop the medication, sometimes the insomnia can become even worse than before.  

Masking an underlying problem. There may be an underlying medical or mental disorder, or even a sleep disorder, that if treated would provide more relief from insomnia.