Time-crunched by work, play, and family, Americans are getting less sleep than ever. TV commercials
promise a good night's rest that's as close as the medicine cabinet, and
millions take over-the-counter and prescription aids
to help them sleep.
Taken properly, sleeping pills give enormous benefit to people suffering
from an inability to get restful sleep. At the same time, the rise in the use
of sleep medication has been accompanied
by reports of abuse and unpleasant side effects.
How do these medicines work on the brain and in the body? What are the side
effects to look for -- and what about the risk of dependence? We talked to the
experts to get insights into sleeping pills: everything from A to (your) Z's.
If you're taking a sleep aid, or think you should, here's what you need to
All sleep medications work on the brain to promote drowsiness. Some drugs
are specially designed as sleep aids; others are medicines with sedation as a
The guide that follows includes most commonly used sleeping pills. Remember,
talk to your doctor before you use a sleep aid.
Sleeping Pills for Mild Insomnia
Diphenhydramine is an over-the-counter medicine commonly taken for
allergy symptoms. One of its
side effects is drowsiness, and for this reason diphenhydramine is often used
as a sleep aid. Many of the most popular over-the-counter sleep aids contain
Diphenhydramine helps those with mild, infrequent insomnia. For someone with persistent insomnia, however,
"it's not a very good drug," according to Milton Erman, MD, clinical professor
of psychiatry at the University of California, San Diego. "Very little data
show that it helps people get good sleep."
Diphenhydramine can also cause unwanted sleepiness in the morning, according
to Susan Esther, MD, member of the board of directors of the National Sleep
Other side effects of diphenhydramine include:
Confusion or delirium
These occur most in people over 65, who should avoid taking diphenhydramine.
Younger people shouldn't take diphenhydramine for more than two weeks, because
tolerance can develop.
Common Prescription Sleep Aids
Selective Gamma-aminobutyric acid (GABA) medications are among the
newest sleep medicines and include:
Ambien (zolpidem tartrate)
Ambien CR (zolpidem tartrate extended release)
These sleeping pills work on the GABA receptors in the brain, which help
control our level of alertness or relaxation.
The selective GABA medications target only a certain type of GABA receptor,
one believed to be more dedicated to promoting sleep.
"They're more rapid in onset, more selective in their action, and less prone
to side effects," says Arthur Spielman, PhD, professor of psychology at the
City College of the City University of New York. In most people, selective GABA
medicines are metabolized completely before morning.