With a global increase in insomnia and other sleep-related issues, the use of sleeping pills is on the rise. These pharmacological medications facilitate sleep onset and maintenance throughout the night. Available as over-the-counter and prescription-only options, most sleeping pills work by attaching to the gamma-aminobutyric acid (GABA) receptors to promote sleep and relaxation. [1]

While extremely popular for higher efficacy and benefits profile, sleeping pills are not a permanent solution for insomnia. Their long-term use also comes with various side effects, one of which includes an overdose. Sleeping pills overdose is a highly risky side effect that typically occurs due to an underlying addiction and can prove fatal if left untreated. [2]

Is overdose on sleeping pills possible? Can you die from taking too many sleeping pills? These questions can commonly pop into the minds of the people dependent on these pills for everyday sleep regulation. Understanding more about the phenomenon can answer these questions while raising awareness about how to avoid the risk.

An Overview of Sleeping Pills

Sleeping pills constitute a diverse group of medicines commonly used to manage insomnia and other similar sleeping issues. Each type of sleeping pill has a specific benefit and may induce different side effects. In general, most sleeping pills work by altering brain chemicals responsible for regulating the sleep-wake cycle and are typically reserved for the management of severe cases of insomnia. Milder cases, on the other hand, may respond to milder forms of sleeping pills, including melatonin and antihistamines.

Prescription sleeping pills are more likely to cause an overdose due to their strong addiction potential. Following are some common types of these sleeping pills:

Antidepressants: Despite not being a conventional sleeping pill, the sedative effects of antidepressants can help induce sleep.
Benzodiazepines: These sedative medications can help induce and maintain sleep. These sleep aids can be extremely habit-forming and can potentially lead to an overdose. [3]
Z-Drugs: These drugs, such as zaleplon and zolpidem, are short-acting sedative drugs and can help induce sleep. [4]
Miscellaneous Hypnotics: These medications include ramelteon and eszopiclone and use different mechanisms of action to induce sleep.

It is important to understand that all sleeping pills can induce side effects, though their safety profile may vary. It is ideal to use them under the supervision of a healthcare provider, especially for people who are breastfeeding, pregnant, or belong to an older age group, as they are more vulnerable to experiencing a sleeping pills overdose.

Can You Overdose on Over the Counter Sleeping Pills? Possible Risk Factors

An overdose is possible with both prescription and over-the-counter sleeping pills, particularly in the presence of the following risk factors.

Old People: Aging can considerably slow down the metabolism, prolonging the process by which the body breaks down, processes, and excretes sleeping pills. Due to this prolongation, older adults may have sleeping pills accumulated in their systems for a longer time, increasing the risk of an overdose. Moreover, older people are also more likely to overdose due to factors like memory impairment and confusion about dosage.
People With Liver/Kidney Disease: Both the liver and kidneys are critical organs involved in the breakdown and excretion of sleeping pills from the system. In case of functional impairment in either of them, the body may keep accumulating the pills, eventually leading to a toxic buildup that makes an overdose possible.
People With Existing Addiction: Individuals who are already addicted to other substances, like alcohol and other sedatives, and taking sleeping pills simultaneously are at a higher risk of experiencing an overdose
People with Pre-Existing Mental Health Issues: Pre-existing mental health issues, such as anxiety and depression can also increase the risk of experiencing a sleeping pills overdose. Some people may use this as a method to harm themselves.

What Happens If You Take Too Many Sleeping Pills? Signs of Overdose

Sleeping pills primarily work by slowing down the central nervous system. Taking too many such pills may make a user excessively drowsy and even unresponsive. Additionally, an overdose of sleeping pill symptoms includes the following:

Shortness of breath
Dizziness
Confusion
Vomiting
Slurry speech
Slowed response time
Hypothermia or low body temperature
A slow heart rate
Reduced respiratory rate and effort
Cyanosis, a phenomenon where the lips, fingers, and skin become blue due to a lack of oxygen
Coma

The presence of any of the symptoms mentioned above may raise a suspicion of a sleeping pills overdose. In such circumstances, calling emergency medical services may be necessary to save a life.

How Can You Overdose on Sleeping Pills? Possible Causes

The following are some causes leading to sleeping pills overdose:

Accidental Overdose: Some individuals may unintentionally take too much of their regular sleeping pills due to issues like memory problems, errors in reading instructions, or underlying tolerance. Such incidences are more common in older people due to their underlying cognitive impairment.
Suicidal Intention: Sleeping pills are one of the most commonly used drugs to induce suicide. As they are easier to get than other medications, many people consider it an accessible way to take a life. Benzodiazepines, for instance, are frequently used for this intention, especially in combination with alcohol.
Recreational Use/Abuse: Individuals who abuse sleeping pills for recreational purposes are at risk of taking them in higher than prescribed amounts to experience a high. Consumption of larger doses may induce a temporary relaxation before quickly escalating to unconsciousness, indicating an underlying overdose.
Polydrug Use: Many people on sleeping pills may use other substances, such as opioids, alcohol, or other brain depressants, precipitating an overdose. Regardless of whether it is intentional or unintentional, the combination may slow down the brain to a dangerously low level, leading to respiratory depression or even death.

Overdose on Sleeping Pills: Long-Term Complications

A sleeping pills overdose is an acute emergency that requires urgent medical intervention to save a life. Even if it is acutely managed, the overdose can sometimes lead to lingering side effects and consequences. Some of these long-term complications of an overdose involving sleeping pills include the following:

Respiratory Depression: As sleeping pills slow down the brain, it may lead to a critical lack of oxygen and brain damage in the long run.
Neurological Issues: An overdose may cause excessive dizziness or confusion causing some people to slip into a coma or acquire permanent cognitive damage.
Cardiovascular Problems: Overdosing on sleeping pills can generate abnormal heart rhythms, cause blood pressure abnormalities, or even trigger heart failure.
Mental Health Issues: Long-term side effects of sleeping pills overdose may include the development of anxiety and depression while worsening of the pre-existing mental health problems.
Gastrointestinal Distress: This may appear as vomiting, nausea, and abdominal pain.

Suspecting Sleeping Pills Overdose: What To Do?

Immediate medical intervention is necessary to manage a sleeping pills overdose while minimizing fatality. This process may include the following:

Call For Help: Someone who is overly sedated, unconscious, or displaying other signs of an overdose requires urgent help. Calling the local emergency response service is critical to safe life. If no signs of life are present, commencing CPR is recommended until help arrives.
Gastric Lavage: Doctors may consider doing a gastric lavage to clear sleeping pills from the stomach. The process is beneficial for people who present to the hospital early following an overdose as it can stop the medication from entering the bloodstream.
Activated Charcoal: Administering activated charcoal can remove any unabsorbed sleeping pills from the gut, preventing it from entering the bloodstream and exacerbating the overdose symptoms. [5]
Supportive Treatment: Doctors may provide intravenous fluids to support the dropping of blood pressure. Some people may also require oxygen to assist with breathing, especially if they are slipping into respiratory depression.
Flumazenil: This agent acts as a benzodiazepine antagonist and can reverse the side effects caused by a benzo overdose. Flumazenil must only be used under medical supervision as it may cause seizures.
Close Monitoring: Patients with underlying sleeping pills overdose typically require strict monitoring of their vital signs, including blood pressure, heart rate, and respiratory count. Some people may also need admission to an intensive care unit.

How to Prevent Sleeping Pills Overdose: Strategies to Consider

People reliant on sleeping pills to manage their daily sleep-wake schedule must particularly be wary of the potential overdose risk. It is possible to minimize this risk and safeguard health by adhering to the following strategies:

Always use sleeping pills under the supervision of a doctor.
Keep close track of how many pills you are taking and note down their timings and frequency to avoid accidental overdoses.
Do not mix sleeping pills with other substances, such as alcohol and other sedative drugs.
Keep your sleeping pills secure and away from the reach of children.
Always use sleeping pills in the prescribed dosage and avoid increasing the dose or taking two doses too close together as it may increase the risk of an overdose.
Familiarize yourself with the common symptoms of an overdose and formulate a management strategy to tackle an emergency. Some measures to take include keeping emergency contact details readily available for others along with a dose of opioid reversal medication.
Keep in touch with your doctor by scheduling regular consultations for re-assessment of your need to use sleeping pills and their dosage.

The implementation of the strategies mentioned above can significantly cut down the risk of an overdose while preparing individuals to tackle emergencies as safely as possible.

Long-Term Management For Sleeping Pills Overdose: Tackling an Underlying Addiction

Sleeping pills are generally considered a short-term solution for insomnia, particularly due to their side effects profile. Moreover, they can be highly addictive and often lead to rebound insomnia, forcing users to depend on them for a long time.

If you or someone you know is experiencing sleeping pills addiction, addressing it is crucial to avoid potential overdose risk. Following are the treatment options available to tackle an addiction:

Inpatient Detox: This level of care is typically the first step in sleeping pills addiction treatment. A detailed detox program provides around-the-clock supervision by trained medical professionals who keep them comfortable and safe.
Inpatient Treatment: Following a detox, most individuals enter an inpatient treatment program where they typically stay for up to 90 days while receiving rigorous treatment in a well-structured environment. The elements of an inpatient treatment program vary according to individual needs and may include a combination of individual, group, and family therapy.
Outpatient Treatment: After completing an inpatient program, most people move out of the rehab back to their homes but continue to get support from outpatient programs. These programs enroll them in therapy a few days a week while letting them return to their homes in the evening.
12-Step Meetings: These meetings provide people with sleeping pills addiction a chance to receive peer support as they recover. These meetings are often available in the community free of cost and are open for everyone to join regardless of where they are in their journey.

Summary

Sleeping pills overdose is a growing concern in the modern world, especially due to the increasing prevalence of insomnia and the demand for pharmacological treatment. Despite being effective, sleeping pills come with a lot of risks and can easily lead to dependence and overdose, especially if not monitored and used properly. Understanding the causes, risk factors, symptoms, and emergency management of sleeping pills overdose is necessary to avoid short- and long-term complications and can even save a life.

FAQs

Is overdosing on sleeping pills painful?

Some people who have overdosed on sleeping pills may complain of discomfort, usually secondary to vomiting or nausea. However, most people are under strong sedation due to the relaxing effects of the sleeping pills which reduces their awareness and pain sensitivity.

How many sleeping pills to overdose is required?

The amount of sleeping pills needed to experience an overdose can vary from one person to another. In general, an overdose may occur if an individual takes up to 2 to 4 times the recommended dose.

What happens if you take 8 sleeping pills?

Taking 8 sleeping pills may have variable consequences based on the type of pill used, its amount, individual health, and co-existing diseases. Some people, especially those with underlying tolerance, may not experience anything whereas others may end up developing symptoms, like confusion, sedation, nausea, vomiting, and respiratory depression.

Which sleeping pill is the most dangerous?

Experts consider modern sleeping agents relatively safer than the old ones; however, the risk of an overdose can occur with both. For example, zolpidem is typically prescribed at 10 mg per day and can lead to an overdose when taken at a dose of 600 mg at once. Eszopiclone, on the other hand, may cause an overdose when taken in quantities 90 times higher than its usual dose.

Can I use any alternative solution for insomnia management?

The best way to minimize the risk of sleeping pills overdose is to consider using alternative treatment methods. For instance, cognitive behavioral therapy is an effective non-pharmacological way to manage sleep-related issues with minimal side effects. Additionally, adopting a healthy life which includes regular exercise and good sleep hygiene can also help. Consider getting medical help if all other alternatives fail and sleeping pills are the only treatment option left.