A Comprehensive Guide to Sleeping Pill Side Effects

We asked Dr. Shiyan Yeo, Internal Medicine Physician, Sleep Medicine Expert about sleeping pills and its potential risks. She says: “Most sleep medications were never designed for long-term use. It’s critical to understand the risks, especially dependency and cognitive effects.” Ultimately, sleeping medications should be used, if at all, in the short-term. If you'r struggling with sleep, you deserve to know what you're really getting into with sleeping pills before you start. Understanding the downsides is the first step to finding a solution that actually lasts. Let's break down what these medications do, the risks they carry, and how you can find a better way to get the rest you need.

Understanding Sleeping Pills

At their core, sleeping pills are sedatives. They work by changing your brain chemistry to make you drowsy. Most common prescription pills, like Ambien or Lunesta, work by boosting a natural chemical in your brain called GABA. Think of GABA as a dimmer switch, it calms down brain activity, quieting the "noise" that keeps you awake. Older medications, called benzodiazepines, do this too, but they have a wider range of effects and a higher risk of dependency. Doctors usually prescribe these as a short-term tool when insomnia is severe and nothing else has worked. They are meant to be a temporary bridge, not a permanent solution.

How Do Sleeping Pills Work?

• Influence on GABA, a neurotransmitter that slows down brain activity
• Promotion of melatonin release to regulate sleep-wake cycles
• Inhibition of serotonin and norepinephrine to decrease alertness
• Activation of the brain's natural sleep systems

Common Types of Sleeping Pills

Delving into the world of sleeping pills, we primarily encounter two categories: Benzodiazepines and Non-benzodiazepines. Both function to promote sleep but differ in their effects and side effects.

• Understanding Benzodiazepines: These are older generation medications including flurazepam, temazepam, and triazolam, renowned for their sedative, anti-anxiety, anticonvulsant, and muscle relaxing properties. However, they also carry a higher risk of dependency and withdrawal.
• Getting to Know Non-Benzodiazepines: Known as 'Z-drugs', they comprise newer medications such as zolpidem, zaleplon, and eszopiclone. These have a shorter half-life and fewer side effects, making them a preferred choice for many patients and physicians.
• Unpacking Zolpidem: Often marketed as Ambien, this is a common short-term treatment prescribed for insomnia. It works by slowing brain activity, allowing for sleep, but can also cause memory loss and abnormal behavior if misused or taken in excess.
• Exploring Eszopiclone: Sold under the brand name Lunesta, this is another widely used sleeping aid, approved for long-term use. While it can effectively treat insomnia, dependency and withdrawal symptoms can occur when discontinued abruptly.

When Are Sleeping Pills Prescribed?

Primarily, sleeping pills are prescribed when lifestyle adjustments and non-medicated treatment strategies have failed to improve chronic insomnia or sleep disorders. Specifically, they are used for:

• Patients battling chronic insomnia for a lengthy period.
• Individuals who have failed to respond adequately to cognitive behavioral therapy for insomnia (CBT-I).
• Persons suffering from sleep disorders like sleep apnea.
• Patients whose daily life functioning is adversely affected due to lack of quality sleep.
• Individuals who suffer from frequent night wakings or difficulty falling asleep.

Risks Associated with Sleeping Pills

The promise of a good night's sleep is tempting, but that relief can come at a cost. Here are the most common side effects people experience:

• Alterations in mental and physical functioning
• Increments on dependence and increased risk of addiction
• Potential increase in mortality rate
• Development of tolerance leading to increased dosage
• Potential for severe withdrawal symptoms
• Increased risk of falls and accidents

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