A Complete Guide to Understand Sleeping Pills
Disturbed sleep, staying awake throughout the night, or staying restless during the daytime are the major symptoms of Insomnia. Acute insomnia is where you might experience disturbed sleep, which lasts for a night or for a week, and does not require any treatment. But, in the case of chronic insomnia, in which you are sleepless for three days a week and for three months or longer might require a professional evaluation and treatment.
There are two broad general types of insomnia based on causation;
1. Primary insomnia in which sleep pattern or sleep disorder is caused due to stress, change of routine, or change of lifestyle.
2. Secondary insomnia in which the sleep disorder is caused due to health issues such as depression, diabetics, blood pressure, and cancer, etc.
Insomnia can also be caused due to the consumption of certain food products, such as caffeine and alcohol. Health problems like asthma, heartburn and injury pains, mental health problems like stress and anxiety also affect your sleep.
Around 30% of the overall population suffers from disturbed sleep, and over 10% of the people are diagnosed with insomnia. It is more prevalent in women and the elderly population.
Diagnosis
Insomnia is generally diagnosed in people who show the symptoms of sleepless nights for 3 days a week for 3 months. Some of the symptoms persistently seen and observed for a month include (1) (2):
- Poor quality sleep
- Vivid dreams
- Daytime sleeping
- Anxiety,
- Lack of interest in sex
- Stress
- Memory impairment
- Headaches, mood swings
- Lack of concentration
- Fatigue
Consider getting professional help to ease your symptoms.
Treatment
Insomnia is treated in various ways; in the case of acute or mild insomnia, medication is often not recommended. Lifestyle changes and behavior therapy can help to relieve mild symptoms of insomnia.
In the case of chronic insomnia, you should consult a health professional to get diagnosed and treated often with the help of medications. Sleeping pills are medications used to induce and maintain sleep.
Over-the-counter(OTC) Sleeping Aids
Antihistamine: The most common OTC prescribed for insomnia is diphenhydramine, an antihistamine. This drug has a soothing and relaxing effect, which can help you to fall asleep.
Commonly faced side effects are dizziness, dry mouth, drowsiness, blurred vision, confusion, and vomiting.
Benzodiazepines: It increases the effect of the neurotransmitter receptors in the central nervous system, which results in a sleep-enhancing effect. It reduces anxiety and helps in muscle relaxation. Benzodiazepines are used to treat various health conditions, such as drug addiction, anxiety, depression, and insomnia.
You may experience side effects such as dizziness, drowsiness, poor coordination, depressed feeling, and addiction to medicine. Long-time usage of benzodiazepines can reduce the effectiveness of this drug. It does not act as a cure for the disease; it only helps you to get sleep.
Nonbenzodiazepines: They are known as ‘z drugs’ and have slight modulation in their structure, and the mechanism remains the same. Non-benzodiazepines result in less disruption of normal sleep than benzodiazepines. For the long-term treatment of insomnia, however not recommended, zolpidem and zopiclone can be good options because there is a reduced risk of development of tolerance with these drugs (3).
Side effects can be headaches, dizziness, fatigue, nausea, drying mouth, difficulty swallowing, sleepwalking, depression, and suicidal emotions. Generally, non-benzodiazepine are considered safer than benzodiazepines.
Melatonin agonist: Ramelteon (Rozerem) is a synthetic drug that works like the sleep regulation hormone melatonin. It is generally used in treating insomnia and can help you to get a fast sleep. Melatonin reduces sleep-onset latency, increases total sleep time, and improves overall sleep quality (4).
Side effects of this drug are tiredness, vomiting, drowsiness, sleepwalking, memory impairment, and itching or swelling in the facial region.
Off Label Drugs
Even Though the FDA has not approved antidepressants for the treatment, some antidepressants are recommended off-label for their seducing effects.
Commonly used antidepressants are;
Valerian: Valerian is a herb and most commonly used for sleep disorders. It promotes relaxation and sleep and reduces anxiety.
Side effects are headaches, disturbed minds, dullness, uneasiness, heartburn, dizziness, dry mouth, and vivid dreams.
Melatonin: Melatonin is a biologically produced hormone in the body. It is produced by darkness, and its levels remain higher during the night and decrease by the light. It is not an effective treatment for sleep disorders, but it can help sleep problems caused due to changes in work shifts and jet lag.
It can interfere with certain levels of blood pressure and diabetes. It is best at very low dosages; you may experience drowsiness the next day.
Chamomile: Chamomile is an herb from the Asteraceae plant family. It has been used for ages as a natural remedy for many diseases. It is said people used to drink chamomile tea for its sedative properties.
Side effects are drowsiness, vomiting and also causes allergic effects when consumed more in quantity.
Antipsychotics: Typical antipsychotics are dopamine antagonists. During insomnia, the patient’s dopamine signals are an abnormality, and they are blocked by these drugs.
Antipsychotics may influence your motor control, resulting in loss of control and coordination of muscle movement. These symptoms may become permanent in some cases, even after the medication is stopped.
Atypical Antipsychotics: They are similar to typical antipsychotics, which have an influence on blocking abnormal dopamine signals; they also act on serotonin, which is a chemical messenger.
They cause fewer side effects such as weight gain, metabolic problems, dry mouth, and anorexia.
Tips for Safer use of Sleeping Pills
Some of the safety guidelines to follow before consuming sleeping pills are;
- Do not mix the sleeping pills with alcohol or another sedative; this will be fatal
- Consume a sleeping pill and plan enough sleep for 8-9 hrs. Do not interrupt your sleep
- Start with the lowest dosage and limit it to one dosage, and do not consume two pills on the same night
- Do not consume frequently
- Do not drive a car after consumption of the medicine
- Any adverse side effects seen, kindly report to a doctor
Behavior Therapy and Healthy Habits to Sleep Better
Studies have shown that a healthy lifestyle and food habits in your everyday life is the best way to prevent insomnia. Changes in your mental and physical activities can have a more effective impact on sleep than any medicines without side effects and risks.
Few things we can do as alternatives to sleeping pills:
Relaxation Techniques
Meditation: Practicing meditation every day for 15 min has many advantages. It helps to reduce stress, anxiety, blood pressure and increases concentration. It is a safe method and helps to get adequate sleep without medication.
Exercise: Simple yoga, like breathing exercises, abdominal breathing, and walking, can help you build better sleep hygiene.
Bedtime routine: Do not use your phone, laptop, or any screen one hour before bed and focus on staying quiet. Spend time reading books, yoga, and meditation for 10 mins, or try listening to soft music. Keep the light low in the bedroom to boost melatonin naturally.
Cognitive-behavioral therapy (CBT): CBT is a psychotherapy that helps change your habits and thoughts for better sleep. It also helps to train yourself to promote good sleeping habits.
Stimulus control therapy: This method helps to train your mind to sleep; they train to set your bedtime and wake time and to avoid naps. Bed to be used only for sleep and sex, and do not stay on the bed for a long time if you don’t get sleep.
Sleep restriction: This treatment will train you to reduce the time you spend on the bed. Avoiding the bed when you are not sleepy and getting yourself involved in some strainful work can help you to get better sleep the next day.
Sleep hygiene: In this method, people are trained to have healthy sleep habits. Wake up at around the same time every day. Avoid screen time for a couple of hours before sleep. No TV in your bedroom. Nothing but sleep and sex in bed! You should avoid having caffeine 6 hrs before bed. Follow a healthy lifestyle, such as no consumption of alcohol and no smoking. Practice exercise and meditation before going to bed.
Sleep environment improvement: This will train you to keep your bedroom lights dim, no television in your bedroom, having plants around to see, and not having the clock.
Final words
Insomnia is a sleep disorder seen among 30% of the population, the most affected people are women and older adults. Lack of sleep is one of the primary reasons for several other diseases.
If you are experiencing mild sleep problems, meditation, yoga, walking, and doing physical activity, and changing your lifestyle to a healthy lifestyle can help you get adequate sleep.
Sleep disorder differs from person to person. Diagnosis and treatment take time to show the results. If you have severe insomnia, seek medical help. If you experience any side effects with existing treatment, then report to the doctor or health professional. Do not stop the ongoing treatment abruptly, which might result in health issues.