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Sleeping Pills: What You Need to Know

From dependency risks to a.m. drowsiness, not all sleep aids work alike. Which is right for you?

Older Sleep Aids

Benzodiazepines are older medicines that effectively help people get to sleep, and were previously the most commonly used sleep medicines. Drugs in the benzodiazepine class include:

  • Ativan (lorazepam)
  • Halcion (triazolam)
  • Restoril (temazepam)
  • Valium (diazepam)
  • Xanax (alprazolam)

Benzodiazepines activate GABA receptors in the brain, causing sedation and relaxation and promoting sleep. Because they act on various types of GABA receptors throughout the brain, though, benzodiazepines have other effects:

  • Reduced anxiety
  • Muscle relaxation
  • Poor memory of some events while taking the drug
  • Euphoria

Benzodiazepines are only available by prescription. While they are sometimes the right medicine, benzodiazepines should be used with caution:

  • People who take benzodiazepines regularly may develop tolerance, or even a physical dependence on the drug (addiction).
  • Benzodiazepines have a relatively high potential for abuse.
  • They are not appropriate for long-term use.

"You wouldn't want to use them more than a few days," or longer in rare cases, according to Esther.

These days, physicians prescribe benzodiazepines infrequently, because newer medicines generally work as well without as much potential for abuse or dependence.

Tricyclic Antidepressants as Sleep Aids

Physicians usually prescribe tricyclic antidepressants, called TCAs, for depression or chronic pain. TCAs include:

  • Adapin (doxepin)
  • Aventyl (nortriptyline)
  • Elavil (amitriptyline)
  • Pamelor (nortriptyline)
  • Sinequan (doxepin)
  • Trazodone (desyrel)

For people with depression or chronic pain who also suffer from insomnia, TCAs may play a role in treatment. But because they act throughout the brain, tricyclic antidepressants can have pronounced side effects:

  • Blurry vision
  • Dry mouth
  • Difficulty urinating
  • Dizziness

The lower doses used for treatment of insomnia tend to reduce these effects. These medicines can be useful for "someone who has failed better agents or is anxious about the other medicines," says Erman.

Good Sleep Habits: Part of the Sleep Solution

Experts agree that while sleeping pills can be an important and necessary part of a successful sleep program, they can't be the only answer.

"Medicines can be helpful, but they shouldn't be a quick fix," says Esther. "They need to be part of a balanced plan of habits and common sense."

According to the National Sleep Foundation and others, good sleep habits should include:

  • No caffeine later in the day
  • Avoid nicotine or alcohol two to three hours before bedtime.
  • Use your bedroom only for sleeping and sex.
  • Maintain a regular sleep-wake schedule on all days, including weekends.
  • Exercise regularly but complete it several hours before bedtime.
  • Finish eating at least 2-3 hours before bedtime
  • Create a restful sleep environment by reducing noise, light, and temperature extremes with ear plugs, window blinds, an electric blanket, or air conditioner.

Sleeping Pills: The Risk of Dependence

All sleep medicines have the potential to cause dependence, according to sleep experts. Dependence means not being able to stop taking the drug without problems. Nearly always, this is a psychological dependence.

According to Erman, "If you're used to taking the drug to sleep, going without it will make you anxious, and in fact, unable to sleep"-- even though you're not physically dependent on the medicine.

If you feel you're dependent on a sleep medicine, see your doctor. He or she will address the problem with you. Your doctor may refer you to a sleep specialist.

Taking benzodiazepines regularly can lead to a physical tolerance and dependence, or addiction. If you've been taking these medicines for a prolonged period, do not stop abruptly. See your doctor and work out a schedule to stop taking them safely.

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You say you are able to function well with fewer than seven hours of sleep. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

Since you usually get too little sleep, please talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have insomnia or other conditions affecting your sleep.

Sleep deprivation can have both short- and long-term consequences. Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's not surprising you feel that you're not functioning at your best today. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

Since you usually get too little sleep, please talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have difficulty sleeping, have insomnia, or have other sleep disorders.

Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's not surprising you feel that you're not functioning at your best today. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

It's good that you usually do get more sleep, since sleep deprivation can have both short- and long-term consequences. Learn more about the health consequences of sleep loss. And if you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

You say you are able to function well with fewer than seven hours of sleep. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

It's good that you usually do get more sleep because sleep deprivation can have both short- and long-term consequences. Learn more about the health consequences of sleep loss. And if you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's not surprising you feel that you're not functioning at your best today. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

Since you usually get less sleep, please talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have difficulty sleeping or have insomnia or other sleep disorders.

Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's wonderful that you got a good night's sleep last night. Many people struggle to do so. Having a good sleep routine often is the key to getting the quality sleep night after night that your body needs for optimal health. Whether your sleep routine involves taking a warm bath, reading a book, or meditating, it's important to keep your bedtime and routine consistent every night and wake up around the same time every morning.

Click here to read more about the importance of sleep. If you're concerned about having trouble falling asleep, staying asleep, or sleeping too much, assess your risk for a sleep disorder.

It's unfortunate you're not functioning at your best today. You say you had a good quantity of sleep last night, but maybe the quality of your sleep is not as good as it could be? Having a good sleep routine — including a consistent bedtime and wake time — often is the key to getting the quality sleep night after night that your body needs for optimal health. Since you usually sleep this amount, if you often aren't feeling your best, you should consider talking to your doctor. Could you have an underlying condition? Are you feeling anxious or depressed? Have you taken medication that disrupted your sleep? Do you or could you have sleep apnea? Or do you naturally require a little bit more sleep?

Although sleep is crucial for optimal health, some research suggests that sleeping too much can also have negative consequences. Learn more about sleep. If you're concerned about having trouble falling asleep, staying asleep, or sleeping too much, assess your risk for a sleep disorder.

It's unfortunate you're not functioning at your best today. You say you had a good quantity of sleep last night, but maybe the quality of your sleep is not as good as it could be? Having a good sleep routine — including a consistent bedtime and wake time — often is the key to getting the quality sleep night after night that your body needs for optimal health. Since you usually sleep longer, if you often aren't feeling your best, you should consider talking to your doctor. Could you have an underlying condition? Are you feeling anxious or depressed? Have you taken medication that disrupted your sleep? Do you or could you have sleep apnea? Or do you naturally require a little bit more sleep?

Although sleep is crucial for optimal health, some research suggests that sleeping too much can also have negative consequences. Learn more about sleep. If you're concerned about having trouble falling asleep, staying asleep, or sleeping too much, assess your risk for a sleep disorder.

It's wonderful that you got a good night's sleep last night. Many people struggle to do so. Having a good sleep routine often is the key to getting the quality sleep night after night that your body needs for optimal health. Whether your sleep routine involves taking a warm bath, reading a book, or meditating, it's also important to keep bedtime consistent and wake up around the same time every morning.

Although sleep is crucial for optimal health, some research suggests that sleeping too much can have negative consequences. Learn more about sleep. If you're concerned about having trouble falling asleep, staying asleep, or sleeping too much, assess your risk for a sleep disorder.

It's unfortunate you're not functioning at your best today. You say you had a good quantity of sleep last night, but maybe the quality of your sleep is not as good as it could be? Having a good sleep routine — including a consistent bedtime and waking up at the same time — often is the key to getting the quality sleep night after night that your body needs for optimal health.

Since you usually get less sleep, please talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have insomnia, another sleep disorder, or conditions affecting your sleep.

Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's wonderful that you got a good night's sleep last night. Many people struggle to do so. Having a good sleep routine often is the key to getting the quality sleep night after night that your body needs for optimal health.

Since you usually get less sleep, talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have insomnia or another sleep disorder or conditions affecting your sleep.

Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

SOURCES:

Centers for Disease Control and Prevention (CDC). Effect of short sleep duration on daily activities--United States, 2005-2008. MMWR Morb Mortal Wkly Rep 2011; 60:239.

Carskadon, MA, Dement, WC. Normal Human Sleep: An Overview. In: Principles and Practices of Sleep Medicine, Fifth, Kryger, MH, Roth, et al. (Eds), Elsevier Saunders, St. Louis, MO 2011. p.16.

Harvard University: "Sleep, Performance, and Public Safety."

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