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Sleeping Pills: Side Effects & Alternatives | Sleep Reset

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Everything You Need To Know About Sleeping Pills

Medically reviewed by: 

Dr. Areti Vassilopoulos

Yale School of Medicine

Medically reviewed by: Dr. Areti Vassilopoulos, Yale School of Medicine

Sleeping pills, as their name suggests, are medications intended to help you fall asleep, stay asleep or do both, depending on what type you consume. Some people may take sleeping pills to help reduce stress or to overcome short-term sleep issues, like recovering from jet lag

"Sleeping pills" is an umbrella term that encompasses all medications and supplements that help promote sleep, including those not delivered in a pill form.You may also hear sleeping pills called:

  • Sleep aids
  • Tranquilizers
  • Hypnotics
  • Sleep medicine
  • Sedatives

In general, sleeping pills are prescribed by a doctor or bought over-the-counter. Sleep aids typically refer to supplements or medications considered "natural," like melatonin or valerian root.

Those considering sleeping pills should educate themselves on the available medications and sleep aids, how they work, and their potential side effects. Learning about additional non-drug therapy options, like Cognitive Behavioral Therapy for Insomnia (CBT-I), is also essential.

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How Do Sleeping Pills Work?

Generally speaking, sleeping pills modify chemicals in the brain that affect a person's sleep and wake cycles. The result differs depending on which drug and which chemical is targeted, but they tend to either make a person feel sleepy or tired or reduce the ability to become alert. 

There are many different types of prescription medications marketed to improve sleep. People react to sleeping pills differently, depending on their chemical makeup and unique health factors. Speaking with a healthcare professional before taking a sleeping pill is essential, as they can make the best recommendation based on your health history.

It's important to note that anything you take to help you fall asleep or stay asleep will most likely have side effects. Some prescription medications can become habit-forming and even life threatening if taken in larger quantities than indicated.

Common Brands

The National Sleep Foundation categorizes most prescription sleeping pills available in pharmacies into three main categories:

  • Hypnotics and sedatives: tend to make people drowsy. They’re also known as benzodiazepines, Z-drugs, and barbiturates.
  • Orexin Receptor Antagonists block orexin, a substance that boosts wakefulness.
  • Melatonin Receptor Agonists mirror the sleep-inducing effects of natural melatonin in the body.

Additionally, antidepressants, anticonvulsants, and antipsychotics are classes of medications that are not approved to help treat insomnia or combat sleep issues but have, in some cases, been prescribed off-label because of their sleep-inducing side effects. 

Some well-known sleep medications and their brand names include:

  • Doxepin (Silenor)
  • Estazolam
  • Eszopiclone (Lunesta)
  • Ramelteon (Rozerem)
  • Temazepam (Restoril)
  • Triazolam (Halcion)
  • Zaleplon (Sonata)
  • Zolpidem (Ambien, Edluar, Intermezzo, Zolpimist)
  • Zolpidem extended release (Ambien CR)
  • Suvorexant (Belsomra)

The Mayo Clinic notes that some drugs approved by the Food and Drug Administration for the treatment of insomnia are used "off-label" to help combat insomnia. Some examples of these medications include:

  • Amitriptyline
  • Mirtazapine (Remeron)
  • Trazodone

Over-the-Counter vs. Prescription Sleeping Medication

Many people use over-the-counter or OTC sleep aids in place of or before contacting a medical professional about prescription sleeping pills. 

Most OTC sleep medications contain antihistamines, which prevent or reduce the symptoms of allergies but have sedating side effects.

Two common antihistamine drugs are:

  • Diphenhydramine (Benadryl and Tylenol PM)
  • Doxylamine succinate (Unisom Sleep Tabs)

These antihistamines work by blocking the natural production of histamine in the body. Histamine levels decrease at night in preparation for sleep. When antihistamine drugs cross the blood-brain barrier, they produce drowsy or sedative feelings.

In addition to antihistamine-based sleep medications, dietary supplements like melatonin, valerian root, and the amino acid called L-theanine also fall under the umbrella of OTC medications.

Although prescription and OTC medications affect everyone differently, sleeping pills prescribed by a healthcare provider tend to be more robust and effective. There is limited research and evidence to suggest that OTC and dietary supplements used to promote sleep are successful. 

OTC medications, like antihistamines, are not recommended for long-term use because of their potential to increase an individual's risk for dementia and Alzheimer's disease.

What Are the Side Effects of Sleeping Pills?

Potential side effects and health risks are associated with all sleeping pills, whether obtained by prescription or over the counter.

Prescription sleeping pills

The Cleveland Clinic notes that roughly 8 out of 10 people experience a "hangover effect" the day after taking some sleeping pills. This can include dizziness, feeling groggy, and struggle with balance and clear thinking. 

Medications that fall under the hypnotic and sedative category can also impair a person's ability to complete basic tasks and reduce reaction time. This increases the risk of car accidents or injuries while operating heavy machinery. 

Parasomnias or sleep disorders can also occur while taking sleeping medications. The FDA calls these actions "complex sleep behaviors," which "include sleepwalking, sleep-driving, and engaging in other activities while not fully awake."

OTC and dietary supplements

Over-the-counter sleep aids and dietary supplements used for sleep can also have undesirable side effects.

The Cleveland Clinic lists side effects that include: 

  • Gastrointestinal issues like constipation and diarrhea
  • Digestive problems, including heartburn, gas, and nausea
  • Headaches
  • Muscle weakness
  • Dry mouth

Can You Become Addicted to Sleeping Pills?

Certain types of sleeping pills can become habit-forming.

Benzodiazepines are a habit-forming class of drugs typically prescribed to treat anxiety, panic disorder, and seizures but have shown positive effects on sleep issues. These drugs are only prescribed for short-term use, as it is possible to become dependent on the medication if used for an extended period. 

Drugs that classify as benzodiazepines include:

  • Valium (diazepam)
  • Xanax (alprazolam)
  • Ativan (lorazepam)
  • Klonopin (clonazepam)
  • Doral (quazepam)
  • Dalmadorm/Dalmane (flurazepam)
  • Halcion (triazolam
  • ProSom (estazolam)
  • Restoril (temazepam) 

Can You Overdose on Sleeping Pills?

Drug overdoses have consistently increased across all age groups in America, according to data from the National Institute on Drug Abuse that looked at cases from 1999 to 2020. Specifically, deaths related to an overdose involving benzodiazepines increased from 1,135 in 1999 to 11,537 in 2017.

Types of sleeping pills that fall under hypnotics or sedatives can depress the central nervous system. When too much of the medication is consumed, it can reduce bodily function enough to cause unconsciousness, respiratory failure, and death. 

In some cases, an accidental overdose can occur when someone dependent on a sleeping pill stops feeling the drug's effectiveness at their current dosage and decides to take more than the recommended amount.

The Problem With Taking Pills To Fall Asleep 

Struggling to fall asleep, stay asleep, or wake up with energy each day can be draining, making it easy to understand why many choose to take sleeping pills on a periodic or regular basis.

The most potent sleeping pills must be prescribed by a healthcare professional. These pills require an appointment and should include a complete conversation about other drugs you are taking to avoid a potentially serious drug interaction. 

Most of the medications prescribed for sleep are only for use in the short term, which makes them a poor option for those looking for a sustainable sleep solution. 

Likewise, prescription, OTC, and dietary supplements marketed to improve sleep come with a range of side effects, from the severe potential for addiction and overdose to frustrating gastrointestinal issues and grogginess. 

The FDA does not regulate over-the-counter and dietary supplements. Consuming these pills and supplements increases the risk of other drug interactions or ingesting a sleep aid with incorrect ingredients or dosage information from the label.

Safer Alternatives to Sleeping Pills

It is possible to start sleeping better and continue down a path of healthy and adequate sleep without using any sleeping pills or sleep aids. After extensive consideration, the American College of Physicians released a statement in 2017 recommending using Cognitive Behavioral Therapy for Insomnia (CBT-I) as the first treatment option for those with chronic insomnia.

CBT-I is effective for combating sleep issues like the failure to fall asleep, stay asleep or wake up feeling rested. A study from the National Library of Medicine found that 70% to 80% of individuals who participated in CBT-I treatment improved their insomnia. 

One of the most significant benefits of CBT-I is that it is clinically effective – and in some cases more effective – than prescription sleep medication, and its effects can be more permanent.

CBT-I works by not only addressing the way you sleep but also considering how you think and the decisions you make that impact your sleep, both night and day. 

Typically individuals works closely with a CBT-I provider to identify the thoughts and behaviors contributing to insomnia or general sleep issues. They then make behavior and lifestyle changes to overcome those obstacles and start sleeping more deeply and with fewer sleep disturbances.

There are multiple components to CBT-I, but on a high level, it involves increased self-awareness and cognitive restructuring to be effective. The process may take up to 12 weeks and requires commitment and lifestyle changes, but it is well worth the effort for a long-term solution to overcoming poor sleep. 

Getting Help

It is possible to sleep better without sleeping pills and the accompanying groggy side effects. ​​Sleep Reset can help you sleep better and reduce anxiety around sleep. Most effective methods from top-tier sleep clinics include CBT-I-based strategies and techniques.

The entire program can be completed within a convenient mobile app, meaning no travel to a sleep clinic and exorbitant fees. You will get personalized support from a dedicated sleep coach. Sleep Reset is a life-long solution to sleep better, without pills or melatonin – which means no grogginess, side effects, or dependency. 

Sleep Reset was designed by the team behind the award-winning Simple Habit meditation app in partnership with leading experts from top sleep clinics and universities.

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Not only does Sleep Reset incorporate the most current and science-backed techniques based on CBT-I, but it is also an all-natural solution, which means no pills and supplements or the grogginess and side effects that come with them.

Ready to get your personalized sleep plan and your own dedicated sleep coach? Take our sleep assessment today to see how Sleep Reset can help you.

Disclaimer: The information provided on this page should not be taken as medical advice and should not replace the advice of your healthcare provider. Always consult your physician before taking any new medication(s) or altering your current dosage.

If you are experiencing suicidal thoughts, please contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support.

Dr. Areti Vassilopoulos

Dr. Vassilopoulos is the Clinical Content Lead for Sleep Reset and Assistant Professor at Yale School of Medicine. She has co-authored peer-reviewed research articles, provides expert consultation to national nonprofit organizations, and chairs clinical committees in pediatric health psychology for the American Psychological Association. She lives in New England with her partner and takes full advantage of the beautiful hiking trails.