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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.

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