Sleeping Pills

Sleeping Pills side effects

Sleeping pills are one of the most commonly prescribed medications to manage insomnia and other sleep-related issues. While effective in the short term, these medicines have many adverse effects that users should be aware of. The side effects of sleeping pills can affect both physical and mental health. Depending on the type of sleep medication, the severity of these impacts can vary, potentially leading to serious health outcomes if not properly managed. This article examines the side effects of sleeping pills, helping individuals understand how these medicines interact with the body and what to watch for during use.

How do Sleeping Pills Work?

Sleeping pills work by targeting the brain’s central nervous system, making users fall and stay asleep more easily. The following process explains how a sleep medication works:

Enhancing GABA Activity

Most sleeping pills work by adding to the effects of GABA, a neurotransmitter responsible for reducing brain activity. GABA naturally blocks the transmission of specific nerve signals to induce a relaxing impact that promotes sleep. By enhancing GABA’s activity, sleeping pills slow down the communication between brain cells. This process also reduces anxiety, which is also a contributor to sleeping issues.

Slowing Brain Activity

In addition to enhancing GABA, sleeping pills also decrease the activity of neurotransmitters that assist in wakefulness. For instance, some medicines function by reducing the activity of glutamate, a neurotransmitter that increases brain activity and vigilance. By inhibiting these signals, the brain enters a more relaxed state, making it easier to fall asleep. In short, the dual action of the sleeping pills on both neurotransmitters balances the brain function to support sleep.

Sedative Effects

The relaxing effect of sleeping medicines can also promote sleep; however, the duration of this effect may differ. Once a sleep medication reaches the bloodstream, its impacts are generally immediate and short-lasting. However, the soothing effects may persist, specifically in individuals using longer-acting sleep aids. These lasting effects are one reason why some individuals feel drowsy the next day after taking a pill.

Are Sleeping Pills Bad for Your Brain – Potential Negative Effects

While sleeping pills can effectively promote a restful state, they often come with various potential side effects, such as:

Drowsiness and Fatigue

One of the most common side effects of sleeping pills is drowsiness or fatigue that often extends into the next day. Even though these pills are meant to help individuals sleep, studies show their soothing effects can frequently persist, making it challenging to feel alert or maintain focus for hours. [1]

Dizziness and Impaired Coordination

Sleeping pills can impact balance and coordination and cause dizziness. This side effect is specifically risky for older adults, elevating the risk of falls, accidents, and injuries. Individuals taking sleeping pills may feel lightheaded when standing or face difficulty maintaining their balance when walking. These issues can also make it unsafe to perform certain activities after taking sleep medication. For instance, driving or operating heavy machinery under the effects of sleeping aids can have dangerous consequences.

Digestive Problems

Sleeping pills can sometimes lead to gastrointestinal problems such as nausea or dry mouth. While less reported than other side effects, these issues can still impact an individual’s comfort. Some individuals may also experience stomach discomfort or bloating after taking sleep aids, which may persist for days or weeks.

Parasomnias

Research has linked certain types of sleeping pills to parasomnias, an umbrella term used to describe unusual sleep behaviors [2]. These behaviors can include sleepwalking, sleep-driving, or eating while asleep without memory of the event after waking up. Parasomnia-related behaviors can be harmful, mainly if the user performs risky activities with no consciousness.

Mood Changes and Emotional Instability

Sleeping pills can also impact mood, causing irritability and emotional difficulties. Some individuals also report elevated anxiety levels or mood swings while being under the effects of these medicines. For others, long-term use of sleeping pills exacerbates pre-existing mental health conditions.

Muscle Weakness

Some individuals reportedly experience muscle weakness after taking sleeping medicines, making physical tasks like walking or lifting objects more difficult than usual. Muscle relaxation is generally an expected effect of sleeping pills; however, it may exacerbate and prolong in some cases, leading to exhaustion. Hence, this side effect can particularly affect the work performance of people with physically demanding jobs.

What Are the Long-term Side Effects of Sleeping Pills?

Long-term use of sleeping pills can cause issues beyond the commonly reported side effects. Sometimes, these impacts can have lasting effects on the body and mind. Some of the side effects are:

Dependence and Addiction

One of the most dangerous health outcomes associated with sleeping pills is the potential for dependence. Over time, the body can rely on the medicine to fall asleep, making it challenging or even impossible to sleep without it. Dependence can also develop into addiction in some cases, particularly when the medications are misused or taken at higher than prescribed doses. 

Addiction to sleeping pills can lead to repeated use of the drug as individuals may feel the need to take more to experience the same effects, a condition known as tolerance. Managing tolerance and addiction usually requires medical intervention, as withdrawal signs from attempting to quit can include severe physical and psychological issues.

Cognitive Decline

Consistent use of sleeping pills may cause cognitive decline, especially in older adults. Studies have shown that long-term users often struggle with memory problems and difficulty concentrating [3]. Cognitive impairment, in many cases, cannot be reversed, even after stopping the medication. 

Some sleeping pills are known to interfere with the brain’s ability to process and store new information, leading to problems with memory retention. Over time, this can also affect daily functioning and decrease general quality of life.

Rebound Insomnia

Rebound insomnia is a problem that arises when individuals stop using sleeping pills after long-term use. While these medicines initially help induce sleep, research shows stopping them sometimes worsens the underlying sleeping issues [4]. Rebound insomnia is particularly problematic because it can make individuals re-start the sleep medication, increasing the risk of dependence.

Sleep Pills Side Effects – Who Is at Greater Risk?

Certain groups of individuals are more likely to experience side effects of sleeping medication than others. These may include: 

Older Adults

  • Cognitive Decline: Older adults are more likely to experience memory loss and confusion from sleeping pills, especially with long-term use.
  • Increased Risk of Falls: Sedatives can cause dizziness and coordination issues, raising the risk of falls and injuries in older individuals.
  • Drug Interactions: Older adults are usually on multiple medications, and taking sleeping pills can interact negatively with them. This cross-reactivity can sometimes result in more severe side effects.
  • Sleep Apnea: Sleeping pills can worsen sleep apnea by relaxing the airway muscles, making it harder to breathe while sleeping. 
  • Asthma and COPD: Individuals with respiratory issues like asthma or chronic obstructive pulmonary disease (COPD) may have exacerbated symptoms, as the pills can decrease oxygen levels.

People with a History of Substance Abuse

  • Higher Risk of Addiction: Individuals with a history of substance use disorder or addiction are more prone to developing a dependence on sleeping pills.
  • Relapse Potential: The soothing effects of sleeping pills carry a risk of triggering relapses in those recovering from substance abuse.

Individuals with Mental Health Conditions

  • Worsened Depression or Anxiety: In many cases, sleeping pills can add to the symptoms of anxiety or depression.
  • Mood Instability: Some users taking sleeping pills may experience mood swings, elevating the risk of further emotional disturbances.
  • Increased Risk of Suicide: In individuals with severe depression, sleep medication contributes to suicide ideation, particularly if misused or combined with other substances.

Pregnant or Breastfeeding Women

  • Fetal Health Concerns: Some sleeping pills can harm the developing fetus, leading to complications during pregnancy.
  • Breastfeeding Risks: Sleeping pills can negatively affect the health of nursing infants as they can pass through breast milk.

Which Sleeping Pill is Dangerous – Comparing different Medications

Not all sleeping pills carry the same level of risk. While some are considered safer for temporary use, others can cause more severe complications, mainly when misused. The following is an overview of the commonly used sleeping medicines:

  • Benzodiazepines: Benzodiazepines are a type of medicine typically given for the treatment of anxiety. However, they are also effective in addressing sleep issues. While effective in inducing sleep, benzodiazepines come with a high risk of dependence and addiction, particularly when used long-term.
  • Barbiturates: Barbiturates, such as phenobarbital, are an older class of sedative medications once prescribed as sleep aids. However, due to their high risk of overdose and dependence, they are now rarely used for sleep issues. Even at prescribed doses, they can cause various side effects, mainly when mixed with alcohol or other substances.
  • Non-Benzodiazepine Sedatives: Non-benzodiazepine sedatives, often referred to as Z-drugs, are associated with adverse effects such as an increased potential for parasomnias, which can lead to accidents and injuries with no recollection.
  • Over-the-counter antihistamines: Some over-the-counter sleep aids contain antihistamines like diphenhydramine or doxylamine, which are primarily used to treat allergies. These medications are generally safer than other typical sleep aids but can sometimes cause drowsiness that requires caution.

Comparing the Risk

While all sleeping pills have side effects, some have higher chances of causing serious issues than others. Research shows benzodiazepines carry an elevated risk of dependence and long-term problems, particularly with extended use [5]. Barbiturates, although not prescribed as often, are even more dangerous because of their narrow margin between an effective dose and a lethal dose, making them highly risky. Other drug classes are relatively safer; however, no medication comes without a risk of side effects. The best way to minimize these risks is by adhering to the doctor’s instructions regarding dosage and use. 

How to Use Sleep Aids Safely – Tips to Follow

While sleeping pills come with many side effects, implementing specific strategies can minimize the risk significantly. The following are some tips to consider:

  • Adhere to the Prescribed Dosage and Duration: Follow the exact dosage and duration of use prescribed by a healthcare professional. Increasing the dose or taking the medicine for a longer than recommended time can elevate the risk of side effects and pave the way for addiction. Remember that sleeping pills are generally given for temporary relief. Therefore, using them beyond the set period should be avoided unless explicitly advised by a physician.
  • Avoid Combining with Alcohol or Other Sedatives: Sleeping pills should not be mixed with alcohol or other sedatives like anti-anxiety medications, as this combination can severely depress the central nervous system. It can also increase the risk of respiratory suppression, extreme drowsiness, and confusion, which may result in accidents or overdose. To avoid such a situation, it is vital to discuss any potential drug interactions with a healthcare professional, especially for people already on multiple medications.
  • Time the Medication on Time: Taking sleeping pills requires a proper schedule to avoid lingering effects. Generally, it is better to take the medicine only when sleeping seven to eight hours is possible. If taken too late or without adequate sleep time, there’s a risk of residual drowsiness that can cause issues the next day.
  • Monitor for Side Effects: Check for any cognitive side effects, such as dizziness and confusion, mainly if sleeping pills are used for a long time. Monitoring and discussing these signs with healthcare providers is essential as they can adjust the dosage accordingly to prevent further side effects.
  • Gradually Taper Off When Discontinuing: Stopping sleeping pills abruptly, especially after long-term use, can cause withdrawal symptoms. Under medical guidance, a gradual reduction in dosage is needed to mitigate these effects. Tapering helps the body adjust to the decreased doses to minimize the risk of severe sleep disruptions and withdrawal signs.
  • Prioritize Alternative Methods: While sleep aids can provide short-term benefits, good sleep hygiene is recommended for lasting relief. A consistent sleep routine and relaxing activities can enhance sleep quality without needing pills.

Conclusion

While sleeping pills can offer temporary relief for those struggling with sleep issues, their side effects and risks need to be understood before use. From cognitive problems to the potential for dependency, these medicines carry significant consequences when abused or taken for an extended period. Understanding how these drugs impact the body and assessing who may be more prone to their effects is necessary for safe usage. 

When it comes to sleeping pills, safe use involves closely following guidelines from healthcare providers, avoiding harmful combinations like alcohol, and exploring non-drug alternatives for improved sleep health. For those who solely rely on medication to sleep every night, visiting a healthcare professional regularly to manage and eventually decrease usage is crucial for sustainable sleep patterns and long-term benefits.

FAQs

What are sleeping pills’ side effects for females?

Females may have side effects similar to those of males, such as drowsiness, confusion, and cognitive issues. However, hormonal differences can sometimes impact how women metabolize sleeping pills, making specific side effects like lethargy and sleep more severe. Additionally, women are more prone to issues like sleepwalking or other unusual sleep behaviors with particular medicines, like Z-drugs. Females may also be more likely to develop dependence on these medications, particularly with long-term use.

How can side effects of sleeping pills during pregnancy be avoided?

The use of sleeping pills during pregnancy is generally not recommended because of the risks to the fetus, such as respiratory issues or developmental delays. To prevent these side effects, pregnant individuals should consider non-medication alternatives for alleviating sleep problems, such as maintaining good sleep hygiene or engaging in relaxing activities. If medication is necessary, a healthcare provider must carefully assess the risks and advantages and consider giving the lowest effective dose of a safer alternative.

Are there any therapeutic alternatives to sleeping medications?

There are several therapeutic alternatives to sleeping medications, such as cognitive behavioral therapy for insomnia, a highly effective non-drug treatment that works by changing thoughts and behaviors around sleep. Other options include relaxation techniques such as deep breathing exercises and meditation. Environmental changes like creating a strict schedule, keeping the lights dim, journaling, and reading can also enhance sleep quality without taking any medicines.

References

[1] Fitzgerald T, Vietri J. Residual effects of sleep medications are commonly reported and associated with impaired patient‐reported outcomes among insomnia patients in the United States. Sleep disorders. 2015;2015(1):607148.

[2] Bollu PC, Goyal MK, Thakkar MM, Sahota P. Sleep medicine: parasomnias. Missouri medicine. 2018 Mar;115(2):169.

[3] Dokkedal-Silva V, Oliveira MG, Galduróz JC, Tufik S, Andersen ML. The effect of sleep medications on prospective and retrospective memory: a population-based study. Progress in Neuro-Psychopharmacology and Biological Psychiatry. 2021 Jan 10;104:110043.

[4] Roehrs T, Vogel G, Roth T. Rebound insomnia: its determinants and significance. The American journal of medicine. 1990 Mar 2;88(3):S39-42.

[5] Schmitz A. Benzodiazepine use, misuse, and abuse: a review. Mental Health Clinician. 2016 Jan 1;6(3):120-6.