How Do Sleeping Pills Work? Are They Addictive?

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The New York Times publishes that nearly 20 percent of older adults in the United States Prescription use some kind of sleep aid, and many people use them every day.

Prescription sleeping pills typically fall under two main categories: sedative-hypnotic drugs or benzodiazepines and non-benzodiazepine “z-drugs.”

Benzodiazepines, or benzos for short, act on levels of gamma-aminobutyric acid (GABA) in the brain, which helps to shut down the fight-or-flight reaction and lower anxiety, thus promoting relaxation and sleep as functions of the central nervous system, like respiration, heart rate, blood pressure, and body temperature, are depressed. Non-benzodiazepine z-drugs act much in the same manner, except they are more targeted in their approach. While initial reports hailed these drugs as having fewer potential side effects than traditional benzodiazepines, recent research published in the Journal of Medical Toxicology reports that they may have similar toxic and adverse effects.

Over-the-counter sleep aids are another form of sleep medication. They usually contain antihistamines (like diphenhydramine), which cause drowsiness. Common sleep aids include are outlined below.

Benzodiazepines
  • Klonopin (clonazepam)
  • Dalmane (quazepam)
  • Xanax (alprazolam)
  • Ativan (lorazepam)
  • Restoril (temazepam)
  • Serax (oxazepam)
  • ProSam (estazolam) 
Z-drugs
  • Lunesta (eszopiclone)
  • Ambien (zolpidem)
  • Sonata (zaleplon)
  • Ramelteon (rozerem) 
Antihistamines
  • Tylenol PM (diphenhydramine and acetaminophen)
  • Sleep-eze (diphenhydramine)
  • Nytol (diphenhydramine)
  • Sominex (diphenhydramine)
  • Excedrin PM (diphenhydramine, aspirin, and acetaminophen)
  • Benadryl (diphenhydramine)
  • Unisom (doxylamine)

Sleep aids can lead to dependence, and they can even be addictive when taken regularly. Prescribing information for the popular drug Lunesta warns of its ability to cause dependence when used regularly. For this reason, many professionals recommend only taken these medications for a short period of time and not at all if there is a history of drug addiction. These medications can also lead to daytime drowsiness and next-day impairment. Instead of taking these drugs, alternative measures may be ideal.

Alternative Treatments for Enhancing Sleep

Good sleep habits are important for promoting healthy sleep. Stick to a similar sleep schedule each night; plan to go to bed and wake up at the same times, and try to make sure that the overall sleep duration is sufficient. Schedules promote good sleep.

Avoid caffeine and stimulation, like TV and other electronics, in the time before bed. Try not to nap during the day. Alcohol, while it may cause drowsiness, also interferes with restful sleep and can also lead to further issues like addiction and substance abuse and should be avoided. The journal American Family Physician postulates that exercise may be just as effective for enhancing sleep as benzodiazepines may be. Healthy doses of exercise during the day can support healthy brain functioning, thus helping a person to relax and sleep at night.

Cognitive Behavioral Therapy (CBT) and relaxation techniques may be beneficial in helping a person to design better methods for easing tension and stress, and thus promoting relaxation and sleep. Lower levels of stress and anxiety usually mean an easier time falling and staying asleep. Mindfulness meditation, yoga, and other forms of alternative medicine that help to connect the mind and body can promote healthy sleep patterns as well. Nutritious and balanced meals can enhance whole body wellness, which can also impact sleep.

In some cases, insomnia and poor sleep may be symptoms of a bigger medical or mental health issue. It is important to get assessed by a medical professional in order to rule out other possible causes of sleep disturbances.

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