Between a third and half of Americans have insomnia and complain of poor sleep. Perhaps you're one of them. If so, you may be considering taking a sleeping pill.
A sleeping pill can help your sleep problems for the short term. But it's important to understand everything you need to know about sleeping pills. That includes knowing about sleeping pill side effects. When you do, you can avoid misusing these sedatives.
What Are Sleeping Pills?
Most sleeping pills are classified as "sedative hypnotics." That's a specific class of drugs used to go to sleep or stay asleep. Sedative hypnotics include benzodiazepines, barbiturates, and various hypnotics.
Benzodiazepines such as Ativan, Librium, Valium, and Xanax are anti-anxiety medications. They also increase drowsiness and help people sleep. Halcion is an older benzodiazepine sedative-hypnotic medicine that has largely been replaced by newer medicines. While these drugs may be useful for the short term, all benzodiazepines are potentially addictive and can cause problems with memory and attention. They are usually not recommended for long-term treatment of sleeping problems.
Barbiturates, another group of drugs in this sedative-hypnotic class, depress the central nervous system and can cause sedation. Short- or long-acting barbiturates are prescribed as sedatives or sleeping pills. But more commonly, these hypnotic drugs are limited to use as anesthesia. They can be fatal in overdose.
Newer medications help you fall asleep faster. Some of these sleep-inducing drugs, which bind to the same receptors in the brain as do benzodiazepines, include Ambien, Lunesta, and Sonata. They are somewhat less likely than benzodiazepines to be habit-forming, but over time can still sometimes cause physical dependence. They can work quickly to increase drowsiness and sleep. Another sleep aid, called Rozerem, acts differently from other sleep medicines. It affects a brain hormone called melatonin, and it's not addictive. Belsomra is another unique sleep aid that affects a brain chemical called orexin and is not addictive. Another sleep medicine that is not addictive, Silenor, is a low-dose form of the tricyclic antidepressant doxepin.
What Are the Side Effects of Sleeping Pills?
Like most medications, sleeping pills have side effects. You won't know, though, whether you will have side effects with a particular sleeping pill until you try it.
Your doctor may be able to tell you about some side effects if you have asthma or other health conditions. Sleeping pills can interfere with normal breathing and can be dangerous in people who have certain chronic lung problems such as asthma , emphysema, or forms of chronic obstructive pulmonary disease (COPD).
Common side effects of prescription sleeping pills such as Ambien, Halcion, Lunesta, Rozerem, and Sonata include:
- Burning or tingling in the hands, arms, feet, or legs
- Changes in appetite
- Balance problems
- Daytime drowsiness
- Dry mouth or throat
- Impairment the next day
- Mental slowing or problems with attention or memory
- Stomach pain or tenderness
- Uncontrollable shaking of a part of the body
- Unusual dreams
It's important to be aware of possible sleeping pill side effects so you can stop the drug and call your doctor immediately to avoid a more serious health problem.
Sleeping Pills and Older Adults
If you’re 65 or older, experts suggest that you avoid all sleep aids. This includes over-the-counter drugs and the newer “Z” drugs like eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien).
Compared to younger people, older adults have a greater chance of health problems on sleep meds. When you’re older, sleeping pills tend to stay in your system longer. Drowsiness can last into the day after you’ve taken them. Confusion and memory problems are also a known side effect. For older adults, this could result in falls, broken hips, and car accidents.
Other symptoms of some over-the-counter sleep medications can be especially hard for older adults to handle. Your mouth may be dry. You may also be constipated and find it hard to pee.
Before you decide to take sleeping pills, talk to your doctor. They may recommend a medical exam to help you figure out the cause of your sleep problems, like depression, anxiety, or a sleep disorder. Your doctor will also suggest ways to treat sleeplessness without drugs.
Are There More Complex Sleeping Pill Side Effects?
Some sleeping pills have potentially harmful side effects, including parasomnias. Parasomnias are movements, behaviors, and actions over which you have no control, like sleepwalking. During a parasomnia, you are asleep and unaware of what is happening.
Parasomnias with sleeping pills are complex sleep behaviors and may include sleep eating, making phone calls, or having sex while in a sleep state. Sleep driving, which is driving while not fully awake, is another serious sleeping pill side effect. Though rare, parasomnias are difficult to detect once the medication takes effect.
Product labels for sedative-hypnotic medicines include language about the potential risks of taking a sleeping pill. Because complex sleep behaviors are more likely to occur if you increase the dosage of a sleeping pill, take only what your doctor prescribes -- no more.
Can I Be Allergic to Sleeping Pills?
Yes. People can have an allergic reaction to any medicine, which could be related to either the active ingredient of the medicine itself or to any of its inactive ingredients (such as dyes, binders or coatings). People who have an allergic reaction to a specific sleeping pill should avoid it. It's important to talk to your doctor at the first sign of these serious side effects, including:
- Blurred vision or any other problems with your sight
- Chest pain
- Difficulty breathing or swallowing
- Feeling that the throat is closing
- Pounding heartbeat
- Shortness of breath
- Swelling of the eyes, face, lips, tongue, or throat
In addition, a serious -- even deadly -- side effect of any medicine someone is allergic to is anaphylaxis. Anaphylaxis is an acute allergic reaction. Another possible effect is angioedema, which is severe facial swelling. Again, discuss these possibilities with your doctor if you are at risk of allergic reactions.
When Do I Take a Sleeping Pill?
It's usually recommended that you take the sleeping pill right before your desired bedtime. Read your doctor's instructions on the sleeping pill prescription label. The instructions have specific information regarding your medication. In addition, always allow ample time to sleep before you take a sleeping pill.
Is It Dangerous to Combine Sleeping Pills and Alcohol?
Yes. Mixing alcohol and sleeping pills can have additive sedating effects from both drugs, and the combination can cause someone to stop breathing, which could cause death. Sleeping pill labels warn against using alcohol while taking the drug.
Also, you should not eat grapefruit or drink grapefruit juice while taking some sleeping pills. Grapefruit increases the amount of the drug absorbed into your bloodstream and how long it stays in the body. That can cause over-sedation.
Can I Become Dependent on Sleeping Pills?
For short-term insomnia, your doctor may prescribe sleeping pills for several weeks. Yet after regular use for a longer period, some sleeping pills such as benzodiazepines or benzodiazepine agonists such as zolpidem or eszopiclone may stop working as you build a tolerance to the medication. (However, tolerance has not been shown with non-habit-forming sleeping pills like Belsomra, Rozerem, or Silenor.) You may also become psychologically dependent on the medicine. Then the idea of going to sleep without it will make you anxious.
Without the sleeping pill, you might find it difficult to sleep. If that happens, it could be a sign of a physical or emotional dependence or both. Some studies show that long-term use of sleeping pills actually interferes with sleep. The best way to avoid developing a physical or emotional dependence on sleeping pills is to follow your doctor's instructions and stop taking the drug when recommended.