What Are The Potential Risks Or Complications Of Prescription Sleeping Pills
Some prescription sleep medicines may bring on parasomnia. This disruptive sleep disorder can cause dangerous behaviors while youre still mostly asleep. People who take Z-drugs, in particular, may sleepwalk or eat, take medications, talk or even drive, all while unaware that theyre doing these things. You may appear to be awake, but your brain is not fully alert. Most people dont remember doing these things after they wake up.
Benzodiazepines can be addictive and lead to substance abuse. To lower this risk, healthcare providers only prescribe these sleeping pills for short-term use. Youre more likely to get a prescription for Z-drugs instead.
What Medications Are Used
Rather than using the same medication in each person, I use a range of medication depending on peoples individual circumstances. Some people just have trouble getting to sleep, so will do better with a medication that has a quick onset and doesnt last for long. Other people wake after 3-4 hours and have trouble in the second half of the night. They need a medication that lasts longer, but this comes with the risk of medication not completely wearing off by the time they need to get up in the morning.
Ill also try to get an idea of the underlying mechanisms for peoples insomnia. If someone has insomnia because of a body clock problem, then melatonin may be helpful. Whereas if they have trouble switching off, drugs that block alerting neurotransmitters may be more helpful.
So, rather than have a go to drug that works for everyone, its a matter of matching the medication choice to peoples symptoms and the factors that are contributing to their insomnia.
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How To Use Doxepin Oral
Read the Medication Guide provided by your pharmacist before you start taking doxepin and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth, usually once nightly within 30 minutes before bedtime on an empty stomach, or as directed by your doctor. Do not take it within 3 hours of a meal because the effect of the medication will be delayed.
Do not take this medication unless you are able to get a full night of sleep before you must be active again.
Dosage is based on your medical condition, age, and response to therapy. Do not take more than 6 milligrams per day.
Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.
Tell your doctor if your condition lasts or gets worse after 7-10 days.
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Are Sleeping Pills Or Sleep Aids Right For You
Its the middle of the night, and youre staring at the ceiling, thinking about work, or bills, or the kids. When sleep just wont come, its tempting to turn to a sleeping pill or sleep aid for relief. And you may get it in the moment. But if you regularly have trouble sleeping, thats a red flag that somethings wrong. It could be something as simple as too much caffeine or viewing TV, your phone, or other screens late at night. Or it may be a symptom of an underlying medical or psychological problem. But whatever it is, it wont be cured with sleeping pills. At best, sleeping pills are a temporary band aid. At worst, theyre an addictive crutch that can make insomnia worse in the long run.
That doesnt mean that you should never use medication, but its important to weigh the benefits against the risks. In general, sleeping pills and sleep aids are most effective when used sparingly for short-term situations, such as traveling across time zones or recovering from a medical procedure. If you choose to take sleeping pills over the long term, it is best to use them only on an infrequent, as needed basis to avoid dependence and tolerance.
When To Consider Sleep Aids
As many as 9 million Americans use prescription sleep aids according to a National Health and Nutrition Survey conducted by the CDC. While these prescriptions can improve sleep quality and symptoms in those suffering from insomnia and other sleep disorders, in some cases they may be unnecessary.
There are many lifestyle changes people can try before turning to OTC sleep aids and prescription options. Exercising, practicing good sleep hygiene, avoiding nicotine and alcohol, and limiting caffeine can all help regulate the circadian rhythm and prevent insomnia.
In cases where lifestyle adjustments are not working or when insomnia or another sleep disorder is severe, it may be time to consider using sleep aids to improve sleep quality. It is best to avoid the use of long-term prescriptions that can cause dependency over time and may make insomnia worse. Instead, using a temporary solution can help to get things back on track so you can re-establish a normal rhythm and stop medication altogether.
If you are experiencing a short-term bout of sleeplessness as a result of jet lag, emotional upset, or illness , an OTC sleep aid or natural sleep aid may be able to help you fall asleep faster and get back to your normal patterns. In this case, you could use it temporarily for a couple of nights and then try going without.
Want to learn more? Take a look at our insomnia statistics and facts here.
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Best For Sleep Disorders: Melatonin
- Dosage: Up to 10 milligrams
- Best for: Circadian rhythm sleep disorders
- Benefits: May help people with shift work, jet lag, insomnia, and those living in places with short night hours
- Risks: Overdose and safety in pregnancy
The brain produces the hormone melatonin. Melatonin regulates the sleep-wake cycle by telling the body that it is almost time for sleep.
The brain makes less melatonin when it is light outside and more when it is dark, such as during the winter. Age also plays a role according to
Many sleeping aids contain melatonin. They tend to be most effective for people with circadian rhythm sleep disorders, which are problems with the timing of sleeping or waking up.
Melatonin can beneficial for people:
- having trouble falling asleep at night
- doing shift work
In recent years, manufacturers have marketed snacks and drinks that contain melatonin as relaxation products. However, doctors do not know if they are effective.
Melatonin supplements are available without a prescription from drug stores, supermarkets, and online shops. Melatonin is available in dosages of 110 mg, and a person should take them at bedtime. How long the effects last depend on the dosage taken.
It is possible to overdose on melatonin, so people should always follow product instructions or talk with a doctor about safe dosages.
Experts do not know if melatonin is safe to use during pregnancy.
The following are sedating antihistamines:
What Affects Circadian Rhythm
Light is the major outside factor controlling the bodys circadian rhythms. It keeps the circadian rhythm in sync with the Earths natural 24-hour cycle. In addition, other environmental cues may help synchronize the circadian rhythm, including food intake and activity level. However, many things can disrupt this process.
While circadian rhythms occur naturally, several factors may affect them across the day.
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Best Prescription Sleep Aid
Your physician will evaluate your medical history, pregnancy and nursing status, age, and any issues with drug or alcohol dependence before making a decision on what to prescribe. Your doctor will also evaluate other drugs you may be taking for drug interactions.
If your doctor prescribes Ramelteon , you will be taking the prescription sleep aid with the lowest risk of adverse side effects.
Regardless of what your physician prescribes, remember that sleeping pills are not a cure for insomnia they are only a dose-dependent way to get some sleep on a temporary basis. The risks associated with long-term use are high. There are other methods of addressing insomnia that do not require you to take dangerous prescription sleep aids.
What Should I Expect From A Medication For Insomnia
Unfortunately none of the medications that are available for sleep are perfect, so its important to understand the limitations of medications and not expect too much.
The perfect sleeping tablet would:
- Work quickly every time it was taken
- Work for 7-8 hours
- Maintain its effect in the long-term
- Have no potential for addiction or becoming dependent
However, no medications meet all or even most of these criteria. So in choosing a medication its important to determine what is important to the individual as different medications have different profiles. For example, some do work quickly, but only last 3-4 hours, whereas others can take longer to work, but last for 5-6 hours.
Research on most common medications used shows that they:
- Shorten the time to get to sleep by 15-30 minutes
- Give people 15-30 minutes more sleep per night
- Reduce the number of awakenings
These results are very different from what is sometimes expected from medications, and highlights that if people rely on medications alone they may be disappointed.
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How Sleep Aids Work: Diphenhydramine Hcl Vs Doxylamine Succinate
The main way to distinguish between different OTC sleep aids is by looking at their active ingredients. Most products on the market contain either Diphenhydramine HCl or Doxylamine Succinate. Both are antihistamines, which are typically used to treat allergy symptoms, like a runny nose or itchy eyes. When you have an allergic reaction or a cold, histamines are released in your body to increase blood flow to the site of invasion. Antihistamines work by blocking histamine receptors in cells to reduce the allergy symptoms related to the histamine response.
Many first-generation antihistamines, like Diphenhydramine HCl and Doxylamine Succinate, also make you drowsy. Thats because they dont differentiate among various histamine receptors and inhibit histamines that regulate sleep. That might not be desirable if youre taking an antihistamine for allergy relief, but it makes both compounds ideal for use in sleep aids.
Diphenhydramine HCl and Doxylamine Succinate function fairly similarly, but there are some marked differences:
Diphenhydramine HCl
Doxylamine Succinate
Zolpidem Side Effects And Risks
Zolpidem considered is a safe, effective medication. However, as with many other prescription medications, there are some potential side effects and risks that you should be aware of if youre considering zolpidem to treat sleep difficulties.
During short-term trials of zolpidem, the most frequently reported side effects were headache, dizziness, drowsiness and diarrhea. In longer-term testing, patients given zolpidem reported a wider range of side effects, although most of these only affected a small percentage of users.
A small percentage of people who use zolpidem report abnormal nighttime behavior, such as sleep-walking, sleep-driving or unusual dreams. Zolpidem can also cause some feelings of drowsiness in the morning, especially if its taken very late at night.
Zolpidem does come with an increased risk of abuse and dependence. If youre prescribed zolpidem, follow your healthcare providers instructions carefully to avoid overusing or abusing this medication.
You should also speak to your healthcare provider if you have a history of depression. You should also not take zolpidem with alcohol. Taking zolpidem with food also isnt recommended, as food can slow down the effects of the medication.
Overall, zolpidem is widely used for a reason it works. However, its typically only used as a short-term treatment for insomnia and may cause next-morning impairment.
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Alternatives To Sleeping Pills
Therapy
Prescription sleep aids are not recommended as a long-term solution for sleep problems. The official recommendation is to look for a primary psychiatric disorder or underlying medical illness if insomnia is not eliminated in 7 10 days of treatment with a prescription sleep aid. They also should not be the first line of defense. Health care providers are advised to carefully evaluate patients for underlying physical or mental issues prior to prescribing a sleep aid.
Individuals with a healthy mind and body will be able to sleep naturally. Insomnia is a symptom of something else. In many cases, anxiety and depression are the underlying cause. Sometimes the cause has a physical basis.
One form of Cognitive Behavior Therapy is very effective on insomnia with benefits seen in as little as one session and complete remission of insomnia symptoms following six sessions. Although the cost of therapy is initially more than the cost of a prescription, across time, the cost is significantly lower from the perspective of dollars spent as well as wear and tear on the mind and body.
Stress Management Skills Development
Most insomnia, including the inability to get to sleep and back to sleep after waking, is related to stress and anxiety. When the mind repeatedly brings up troublesome thoughts, relaxing into sleep becomes difficult.
Sleep Hygiene
Improving sleep hygiene can help you go to sleep faster: How to Fall Asleep Faster
How To Use Sleeping Pills Safely
According to the Medical News Today, always follow a doctors instructions for using hypnotic sleeping medication.
The American Academy of Sleep Medicine advises the following for people taking sleeping pills:
- Never take a pill without a doctors approval.
- Start with the lowest recommended dose.
- Never mix sleeping pills with alcohol or other sedative drugs.
- Take the first dose when you have planned no activities for the next morning.
- Never drive a car or operate machinery after taking a sleeping pill.
- Carefully read the package insert that comes with your medication.
- Contact a doctor right away if any complications occur.
CAUTION: People taking prescription sleeping pills should contact their healthcare team if they experience:
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Common Sleep Aid Options
The two most common classes of OTC sleep aids are antihistamines like Diphenhydramine and Doxylamine Succinate, and natural solutions that usually feature melatonin supplements and/or valerian. Melatonin is a natural hormone produced in the body, and valerian root is a plant.
One of the biggest benefits of OTC sleep aids is that you dont require a time-consuming and sometimes costly trip to the doctors office for a prescription. Instead, you can simply walk into a health food store or pharmacy and find a sleep aid that may solve your problem without the hassle of an appointment.
Both OTC sleep aids and natural sleep aids can cause mental and physical dependence, making it difficult to go without them. They can also become less effective over time and require bigger and bigger doses. In some cases, they may stop working altogether and you could be forced to find a new solution.
How To Maintain A Healthful Circadian Rhythm
There are several important factors to consider when maintaining a healthful circadian rhythm.
If possible, go to bed and wake up at the same time each day. Setting a regular time may help the body set its rhythms around these times. Some choose to set a morning alarm to wake up at the same time each day. This may help the body adjust and encourage tiredness when they need to sleep to wake up on time.
This regular sleep-wake schedule also includes days off from work, such as weekends.
As light can disrupt the circadian rhythms, it is important to choose when to limit exposure. The CDC note that the 2 hours before a person falls asleep appear to be most crucial. Avoiding blue light at this time may help ensure a regular circadian rhythm, which includes limiting screen time and any bright sources of white or blue light, such as in shops.
Other tips may help promote a healthful circadian rhythm, including:
- going outside or in bright light in the morning
- avoiding caffeine late in the day
- taking small naps in the early afternoon if a person needs to nap
- avoiding long naps or napping later in the day
- avoiding heavy meals
- performing calming activities before bed, such as reading or doing gentle stretches
Some calming herbal teas or supplements may help promote a sleepy state in people with trouble falling asleep. However, talk with a doctor before taking products with active ingredients.
Poor quality sleep or sleep deprivation can lead to health complications, including:
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A Word About Prescription Sleep Aids
Prescription sleep medications are powerful drugs that work on different parts of the brain.
Benzodiazepines like lorazepam and temazepam target gamma-aminobutyric acid , a brain chemical that reduces nerve activity and promotes sleep. These medications can be habit forming, may cause daytime sleepiness, and may be associated with dementia.
Nonbenzodiazepines such as zolpidem and eszopiclone also work on GABA, but they leave the body faster and have fewer side effects, allowing for regular waking and daytime functioning the next day. However, they still increase the risk for sleepwalking and daytime sleepiness, which can lead to falls and injury.
Melatonin-receptor agonists such as ramelteon target melatonin receptors in the brain. They leave the body quickly and are not thought to be habit forming.
These medications are meant for short-term use only, under the direction of your doctor. “They’re most helpful for the treatment of insomnia. But medications are just one option to treat insomnia. Behavioral therapy, which involves looking at your sleep habits and ways you think about sleep and routines, is equally effective,” says sleep expert Dr. Lawrence Epstein, an instructor in medicine at Harvard Medical School.
Best Natural Sleep Aid: Nature’s Lab Valerian Root
This herbal supplement is a natural sedative that dates back to ancient times and comes in many different formulations, from supplements to teas. Though studies have shown mixed results about its effectiveness, valerian root can be an effective treatment for some because of how it interacts with GABA , a neurotransmitter that encourages sleep in your brain, according to Dr. Dasgupta.
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