Sleeping Pills
Sleeping pills are medications in the category of sedatives,
used primarily to treat patients who are suffering from insomnia
or sleep deprivation, both of which can have wide-ranging
and serious knock-on health effects.
Benzodiazepines are the most common drug choice when treating
insomnia. They are sedatives which can be either long or short
lasting, and have proven efficacy over the years.
The most common kinds of these drugs currently in use today
include diazepam, temazepam, nitrazepam, lorazepam and midazolam.
Benzodiazapines were developed originally in the nineteen-sixties
to treat patients with anxiety. They work by targeting receptor
sites in the brain which modulate the effect of GABA, or gamma-aminobutyric
acid, a neurotransmitter. Benzodiazepines work non-selectively
in targeting these receptor sites.
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Some longer acting benzodiazepines such as nitrazapam, can
have side effects that last well into the next day. Medium-term
benzodiazepines, like temazepam, are less likely to cause
this prolonged sedentary effect, but it is still common for
patients to be less alert and noticeably ‘groggy’ the morning
after taking them. Benzodiazepines are classified as hypnotics,
and they should not be used for any prolonged length of time,
due to the risk of a patient developing both tolerance and
dependence.
Benzodiazepines are also used quite often to sedate a patient
prior to surgery, and is especially effective for patients
who are inclined toward anxiety and nervousness. The benziodiazepines
in this case will relieve the patient’s anxiety and also promote
amnesia, which can help to ward off some psychological consequences
of surgery.
Non-benzodiazepines are a newer category of drugs developed
to replace the older benzodiazepines. They have a shorter
half-life, meaning that the sedative effect of these drugs
is faster acting, and shorter lasting. The upshot of which
is that they help people to get to sleep, without suffering
the next day ‘hangover’ that older types of sleeping pills
can have.
Melatonin is a hormone found naturally in all living creatures,
which is becoming increasing popular as a sleeping aid due
to its reputation for both restoring a normal sleep cycle,
and inducing more vivid dreams. Melatonin plays a part in
maintaining the circadian rhythm, or sleep pattern.
It is particularly effective for patients whose sleep patterns
have been disrupted, for example those suffering jet lag.
It is also a powerful antioxidant, and recent studies suggest
that the additional benefits of melatonin may be wide-ranging,
such as delaying the onset of aging and other degenerative
conditions, as well as prolonging fertility.
Experiments carried out on mice in the laboratory found
that mice who were regularly administered melatonin lived
up to twenty percent longer than those who did not.
Sleeping pills bought over the counter tend to be in the
form of antihistamines. Diphenhydramine is a popular choice,
usually supplied in dosages of between fifty and one hundred
milligrams.
Antihistamines do have a drowsy effect, and may work well
for temporary relief of sleep deprivation and insomnia, but
they are not a long term solution as they become less effective
over time, since the patient becomes immune to the drugs,
and also the prolonged drowsiness caused by antihistamines
make leading a normal life and holding down a job particularly
difficult.
Some types of antidepressant drugs are prescribed in low
doses to treat insomnia. Physician’s favourites include doxepin,
trazodone and mirtazapine. Antipsychotic medications like
quetiapine also possess some sedative qualities and may be
useful. Both types of drugs tend to be used to cover all the
bases when insomnia or sleep deprivation is presenting with
other psychological symptoms.
Tricyclic antidepressants, or TCAs, can also be used for
sedative effects. They work by inhibiting the nerve cells’
reuptake of serotonin, norepinephrine or dopemine, which are
all neurotransmitters. This has the effect of depressing the
central nervous system. Tricyclics are not considered to be
addictive.
Some herbal remedies have proven effective over many years
in the treatment of mild to moderate insomnia and sleep deprivation.
These include lavender, chamomile, hops, passion flower, and
particularly valerian which is the most supported by independent
medical testing.
It is essential when beginning a course of sleeping pills
or other sleeping medication to follow your doctor’s guidance,
and to always pay attention to the manufacturer’s advice.
Start with a small dosage and increase that if necessary,
and seek medical help immediately if you suffer any unforeseen
side-effects, including psychological side-effects.
If possible, take medication every other night, or every
couple of nights, rather than on an every day basis, to increase
the length of time you can stay on a particular type of medication
without becoming tolerant towards it.
Most sleeping pills should be taken between thirty minutes
and one hour before bedtime, so that their effects may usefully
persist throughout the night. Some sleeping pills are rapidly
effective and short-lasting, and these can be used when a
patient wakes during the night and wishes to fall asleep again
as soon as possible. Non-addictive types of sleeping pills, for example the non-benzodiazepines,
can be discontinued at any time without the patient suffering
withdrawal or side-effects, but many older medications will
require a gradual reduction in dosage before a patient can
be weaned off them.
Most sedatives have the potential to cause both physical
and psychological dependence when taken regularly and for
prolonged periods of time. In cases of both physical and psychological
dependence, proper medical advice should be sought, and counseling
may be necessary.
If you suffer from insomnia, or have any of the classic signs
of sleep deprivation (exhaustion, inability to concentrate,
irritability, slowed reactions), you should seek medical help.
Keeping a sleep diary may also help you and your doctor to
better analyze the problem and find a solution. If you do
not address the problem, you are endangering your own health
as well as the health of those around you. |