Insomnia affects an estimated third of the adult population, according to studies. Many people never seek treatment for the issue, leaving the issue undiagnosed and untreated for a significant number. In fact, research indicates that 50 to 70 million Americans have chronic problems sleeping that are so significant that they impact their ability to function on a daily basis and can adversely affect their long-term health.
Those who seek help from health care professionals may be prescribed some form of prescription sleeping aid or a sleeping pill.
According to the Centers for Disease Control and Prevention, the number of adults ages 20 and older using prescription sleep aids in an average month is about 4%. They also found that one in six adults with a diagnosed sleep disorder and one in eight adults with trouble sleeping reported using sleep aids. Many people may wonder, then, if sleeping pills are effective and safe or if they can become habit-forming and addictive.
Why Do People Take Sleeping Pills?
Sleeping pills are most often prescribed for individuals who are suffering from diagnosed insomnia. The American Academy of Sleep Medicine (AASM) defines insomnia as “persistent difficulty with sleep initiation, duration, consolidation or quality.”
If someone has problems with sleep that happens at least three times a week and continues for at least three months, they may have chronic insomnia. Short-term insomnia refers to sleep issues that occur for three months or less.
There are also different ways that people can experience insomnia. Some people can fall asleep but then struggle to stay asleep, which is known as sleep maintenance insomnia. If someone has an issue falling asleep, they may have sleep-onset insomnia. It is possible for someone to have issues with both types of insomnia.
The main cause of insomnia is hyperarousal, which can be caused by mental or physical challenges or a combination of both. People with hyperarousal may find it difficult to quiet their mind, calm themselves down, or lower their heart rate and breathing enough to fall asleep.
In addition to hyperarousal, various factors can impact someone’s sleep, including environmental, physiological and psychological issues.
What Are Sleeping Pills?
A wide range of prescription sleeping pills can help people with sleep issues. Some medications assist a person in falling asleep more easily or staying asleep longer, while others provide both remedies. However, all prescription offerings have potential side effects as well as benefits.
There are numerous medications available to help someone dealing with insomnia. They include:
- Antidepressants
- Benzodiazepines
- Doxepine (Silenor)
- Eszopiclone (Lunesta)
- Lemborexant (Dayvigo)
- Ramelteon (Rozerem)
- Suvorexant (Belsomra)
- Zaleplon (Sonata)
- Zolpidem (Ambien, Edluar, Intermezzo)
- Over-the-counter sleep aids
Newer sleeping pill options like eszopiclone, zaleplon and zolpidem are thought to be somewhat less likely to cause side effects. This is because they target only specific GABA receptors in the brain. The GABA receptors control a person’s level of alertness and relaxation. These drugs target a particular receptor that is mostly focused on promoting sleep.
Some natural options, such as melatonin and valerian, offer help for some people to encourage better sleep. A hormone that the body produces naturally to promote sleep, melatonin may help the body enter a state that promotes sleep. Valerian is an herb that has been shown to reduce the length of time it takes someone to fall asleep, as well as help them sleep more soundly.
Evidence has shown that sleeping pills don’t typically provide that much assistance for people dealing with insomnia. What’s more, they should only be taken for a brief period. As a result, they can be easily misused, resulting in individuals becoming dependent on them or even addicted.
The Side Effects of Sleeping Pills
Most prescription sleeping pills fall into the category of sedative hypnotics. This class of drug includes benzodiazepines, barbiturates and various other hypnotics.
While benzodiazepines can help people fall asleep in the short term, they are potentially addictive with long-term use. Additionally, they can cause problems with memory and attention.
Barbiturates are also problematic because they can lead to potentially fatal overdoses. A type of hypnotic, barbiturates are most often used for anesthesia.
People with asthma or other breathing conditions like emphysema or forms of chronic obstructive pulmonary disease (COPD) may not be able to take sleeping pills because of the way the medications interfere with normal breathing. Other side effects of sleeping pills to be aware of include:
- Burning or tingling in the hands, arms, feet or legs
- Changes in appetite
- Constipation
- Diarrhea
- Balance problems
- Dizziness
- Daytime drowsiness
- Dry mouth or throat
- Gas
- Headache
- Heartburn
- 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
- Weakness
Sleeping pills can also cause a condition known as parasomnia. This is a sleep disorder that can be disruptive and even dangerous, causing people to sleepwalk or sleep eat without being aware of what they are doing. The individual may also take other medications, talk or even drive when under the influence of certain prescription sleep medications. While the person appears awake, their brain is not fully alert. Most individuals who experience these behaviors have no recollection of anything they have done when they wake up.
Signs of Sleeping Pill Addiction
It is rare that an individual becomes physically addicted to sleeping pills, but it can be quite common for someone to develop a psychological addiction to these drugs. This means that the person thinks they can’t fall asleep or stay asleep without the medication.
Common signs that someone has a problem with sleeping pills are:
- Steadily increasing the dosage
- Taking sleeping pills every night for years
- Trying to quit but being unable to
- Looking around for new doctors to write a prescription (“doctor shopping”)
- Avoiding social and professional obligations where they cannot take the drug
A person can experience withdrawal symptoms if they take sleeping pills for long enough or at a high enough dosage. This can happen with any form of a sleeping pill but especially benzodiazepines. The withdrawal symptoms are often like those experienced by someone with an alcohol addiction, including increased blood pressure and heart rate, muscle shakes and anxiety.
How to Get Off Sleeping Pills
The length of time someone can take sleeping pills without developing a dependence or an addiction will vary from person to person. Dealing with a dependence or addiction to sleeping pills can be challenging, but several treatment methods can help.
Tapering off the use of sleeping pills can help an individual avoid any potential withdrawal symptoms or relapses. The most common way of doing this is to reduce the dosage over several weeks gradually. This may take as long as three to four months. It’s important to involve a doctor in any plan to taper off a habit-forming medication.
In more severe cases, a doctor may recommend individuals seek out care at a professional addiction treatment program. This often involves a detox period, where the drug leaves the person’s system, followed by behavioral therapy and peer support. Psychological support has been shown to be particularly helpful, with cognitive behavioral therapy (CBT) proving to be the most effective psychotherapeutic option.
The best way to avoid a problem with sleeping pills is to always comply with a doctor’s recommended dosage. Do not take sleep-related medication daily, never increase the dose beyond what the doctor recommends and do not combine different types of sleep medication. Additionally, never use sleeping pills with alcohol due to the potential for fatal overdose.
Withdrawal from Sleeping Pills
The withdrawal symptoms associated with sleeping pills are typically not life-threatening, but they can be very uncomfortable. The intensity will vary depending on the individual, the dosage they are taking and the length of time they have been using sleeping pills.
It is possible for someone undergoing detox from sleeping pills to have a dangerous reaction. For this reason, most experts recommend a medically supervised detox under the care of healthcare professionals. This allows a medical team to monitor vital signs and assist with any complications that may arise. Many of the typical sleeping pill withdrawal symptoms can be treated with intravenous (IV) fluids that aid in balancing electrolytes and replenishing the body.
Typical sleeping pill withdrawal symptoms may include:
- Difficulty sleeping
- Restlessness
- Shivering
- Circulation problems
- Body spasms
- Seizures
- Insomnia
- Delirium
- Anxiety
- Drug cravings
- Irritability
- Depression
- Confusion
- Hallucinations
- Sweating
- Increased heart rate
- Hand tremors
- Nausea
- Vomiting
Alternative Treatments for Insomnia
A wide number of alternative treatment options can help someone experiencing insomnia. Possibilities include:
- Diet and exercise
- Mental conditioning
- Lifestyle changes
- Acupuncture
- Guided imagery
- Yoga
- Hypnosis
- Biofeedback
- Aromatherapy
- Relaxation
- Massage
Acupuncture has been shown in a limited number of studies to offer relief from insomnia, but more research needs to be done.
The use of relaxation techniques and meditation has been shown to be effective in treating insomnia. These techniques range from relaxing the muscles through progressive muscle relaxation and biofeedback to the use of meditation to quiet the mind. However, people must learn these techniques. The learning process can take several weeks before individuals have mastered these steps to the point that they can ease a person’s insomnia.
Regular exercise appears to improve sleep in people of all ages. What’s more, the type of exercise does not have to be strenuous. Even moderate yoga or tai chi can prove helpful. Incorporating more physical activity is always recommended, as long as exercise occurs at least three to four hours before bedtime.
Sleep hypnosis provides some individuals with relief from insomnia. Done under the care of a licensed professional, sleep hypnosis puts the person into a trance-like state where they will receive suggestions on sleep-related changes that can address issues with insomnia.
Cautions About Alternative Insomnia Therapies
Avoiding sleeping pills to address insomnia is not a bad idea, but many alternative approaches need to be approached with caution as well. It is important to discuss any alternative strategies with a healthcare provider to ensure there will be no negative interactions with other medications or existing health conditions.
Additional Tips for Preventing Insomnia
Someone dealing with insomnia may also want to make lifestyle or sleep hygiene changes to help them control or stop their sleep issues.
For instance, they could:
- Limit or eliminate any naps, especially late in the day
- Restrict the use of alcohol, caffeine and tobacco products in the evening
- Avoid late-night meals
- Limit screen time prior to bedtime
- Follow a regular sleep schedule every day with consistent bedtimes and wake-up times
- Use the bedroom only for sleep and sex. That means no working, playing video games or other stimulating activities in bed
Ensuring that the bedroom is conducive to sleep can also help. This can include adjusting the temperature, lighting and noise to help a person fall asleep and stay asleep. Pets may interrupt sleep, so it may be helpful to have them sleep elsewhere if they have been sleeping on the bed.
Finally, if a person finds themselves lying in bed worrying, they should consider establishing a time before bed, to review their day and plan for the next. This may help them avoid thinking about these things when trying to fall asleep. Making a list of tasks for the next day or simply putting worries or anxiety down in a journal may also offer a way to eliminate any concerns that can interrupt sleep.
Being unable to fall or stay asleep can cause major difficulties in everyday activities. Unfortunately, misusing prescription sleep medication can lead to addiction. If you’re concerned that your use of sleep-related medication is causing harm to yourself or others, you should explore your options for addiction treatment. Your doctor can help you determine the appropriate next steps for your recovery from habit-forming sleep medication.
Remember, we’re not doctors and this isn’t medical advice. If you’re concerned about your use of sleeping pills or aids, talk to your healthcare provider immediately.
Aftermath Addiction Treatment Center was founded by people in recovery. We utilize proven clinical and medical approaches to assist in recovery. Our treatment plans begin and end with the most crucial ingredients: love, empathy and direction.
