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Millions of people around the world rely on sleeping pills to get a good night's sleep. While these pills can be effective in the short term, they can also have serious risks and side effects.
Sleeping pills fall into multiple different categories. Melatonin is a hormone that helps to regulate sleep and wake cycles. OTC (over-the-counter) sleeping pills usually contain antihistamines, which can cause drowsiness. Prescription sleeping pills are stronger and more potent than OTC options.
If you're considering sleeping pills, it's important to understand the risks you'll be exposing yourself to.
Prescription sleeping pills work by affecting the neurotransmitters in your brain. Neurotransmitters are responsible for sending messages between nerve cells. There are two main types of prescription sleeping pills, and they both increase the amount of GABA (a calming neurotransmitter) in your brain.
Benzodiazepines act on GABA receptors to promote sleepiness and relaxation. Some common benzodiazepines include alprazolam (Xanax), diazepam (Valium), and lorazepam (Ativan). Barbiturates work similarly, though they are no longer prescribed as commonly as they once were.
Non-benzodiazepine hypnotics like zolpidem (Ambien), eszopiclone (Lunesta), and zaleplon (Sonata) are all examples of selective GABA medications. These drugs are sometimes called "Z-drugs" because they all contain the letter Z in their name. They target specific GABA receptors that are associated with sleep and cause fewer side effects than benzodiazepines.
OTC medications induce drowsiness through antihistamines, drugs that inhibit histamine receptors.
Melatonin pills work by supplementing your body's natural melatonin production. Melatonin levels typically rise when your body is preparing for sleep.
All of these different types of sleeping pills have some side effects. In fact, for some, these sleeping pill side effects are so severe they can interfere with their day-to-day lives.
One of the most common side effects is grogginess or feeling drowsy during the day. This can make it hard to concentrate and make it more likely that you'll have accidents.
Or, you may have trouble waking up when you need to. This is especially true if you're on benzodiazepines, which can cause a deep sleep from which it's hard to rouse yourself. If you have an emergency, it may be very difficult to wake up and respond appropriately.
Many people take melatonin believing that it’s safe because it’s natural. However, melatonin risks look similar to those of other sleeping pills.
If you take sleeping pills for more than a few weeks, you may start to experience some major risks.
One of the biggest risks is that these pills can be habit-forming. Your body gets used to them and needs higher and higher doses to get the same effect. If you suddenly stop taking them, you may experience withdrawal symptoms like anxiety, insomnia, tremors, sweating, and nausea.
Another long-term risk of taking sleeping pills is that you may develop new sleep concerns.
For example, you may find that your sleep is less restful than it was before you started taking medication. You might experience more vivid dreams or nightmares, or even parasomnia issues like sleepwalking and sleep paralysis. People have even reported driving while asleep under the influence of sleeping pills like Ambien.
The risks of taking sleeping pills don't just stop at night. Because these medications can cause drowsiness and impaired judgment, they can also make it hard to function during the day.
In a study published by the Journal of Hospital Medicine, sleep researchers at the Mayo Clinic found that hospital patients who took zolpidem (Ambien) were four times more likely to fall than those who did not take the drug during their hospital stay.
And, the Food and Drug Administration issued an alert about the same drug after new data revealed that "blood levels in some patients may be high enough the morning after use to impair activities that require alertness, including driving."
There are also some serious long-term health concerns associated with taking sleeping pills.
For example, a 2012 study published in BMJ Open found that people who took prescription sleep aids were four times more likely to die than those who did not take the drugs. The study's authors say that the increased risk of death is likely due to "multiple causal pathways."
Another concern is that some of the most popular sleeping pills on the market today contain benzodiazepines. Benzodiazepines are a class of drugs that have been linked to an increased risk of dementia.
One study found that people over age 65 who took benzodiazepines had a 32 percent increased risk of developing dementia. And, the longer people took the drugs, the greater their risk became.
According to Dr. Anne Fabiny, chief of geriatrics at Harvard-affiliated Cambridge Health Alliance: "Benzodiazepines are risky to use in older people because they can cause confusion and slow down mental processes."
While sleeping pill risks are hard to ignore, that doesn't mean you have to suffer from insomnia. There are many drug-free alternatives that can help you get the rest you need.
Cognitive behavioral therapy for insomnia (CBT-I) is one of the most effective non-drug treatment. Research has shown that CBT-I can be even more effective than sleeping pills.
And, unlike sleeping pills, CBT-I does not have any risks or side effects.
If you're looking for a drug-free way to get better sleep, the Sleep Reset app can help. We use CBT-I principles to help you fall asleep and stay asleep all night. Our free sleep quiz can help you identify the underlying causes of your sleep problems, so you can find the best solution for you.
The Sleep Reset app is available on iOS and Android.
Take the Sleep Quiz now.