about one third of adults Many people around the world say they sometimes have trouble falling asleep or staying asleep. If you're one of them, you may have tried sleeping pills for temporary calm.
There is a growing category of prescription drugs approved specifically for sleep, such as suvorexant (Belsomra) and ramelteon (Rozerem). Doctors can also prescribe off-label drugs for insomnia, such as the antidepressant mirtazepine (Remeron). Over-the-counter antihistamines, such as diphenhydramine (Benadryl) and doxylamine (Unisom), can also be used as sedatives.
Dr. David Neubauer, a sleep specialist at Johns Hopkins University, says “we're really in a golden age” for insomnia drugs. Doctors will suggest different treatments depending on the type of sleep disorder you have, such as whether you're feeling confused or waking up multiple times during the night.
However, all sleeping pills come with risks such as daytime grogginess, and some can become habit-forming. That's why experts say it's best to limit how much you rely on it.
“Ideally, you would use these drugs only when needed, so I would say only for short periods of time, maybe two or three times a week,” said Dr. Alcibiades Rodriguez, a sleep medicine specialist at New York University Langone Health. says.
When should you use sleeping pills?
There are some situations where judicious use of sleeping pills can be helpful, such as when a specific event has been causing insomnia for two to three weeks. If you've tried lifestyle changes like avoiding screens at night, or cognitive behavioral therapy tactics designed specifically for sleep, and you still can't get a restful night's sleep, your doctor may recommend sleeping pills as a last resort. there is.
Always talk to your health care provider before you start taking sleeping pills and plan how long you will take them. If you still need sleeping pills after a month, talk to your doctor to see if another treatment or medication might be more effective, or if you have a medical condition that's causing your sleep deprivation that sleeping pills can't address. Please check if it is there.
What works for you depends on the cause of your insomnia, Dr. Neubauer said. Rozerem helps maintain normal sleep cycles by stimulating melatonin receptors in the brain. If you can't sleep, your doctor may prescribe drugs called benzodiazepines to reduce anxiety and make you drowsy. These include alprazolam (Xanax) and clonazepam (Klonopin). There are also nonbenzodiazepine drugs that have similar effects, such as zolpidem (Ambien) and eszopiclone (Lunesta).
How bad is it to take sleeping pills every night?
Over-the-counter antihistamines have not been well studied for their effects on sleep, and the American Academy of Sleep Medicine recommends against Use them for insomnia. Many remain in the body and can cause daytime lightheadedness and falls. Long-term use may carry risks such as memory loss, confusion, and memory loss. constipation, all of which may be more pronounced in older people.Several the study Studies suggest that long-term use of antihistamines is associated with increased risk of dementia, but the association is not conclusive.
Although these are not considered sleeping pills, some people take supplements such as the hormone melatonin for insomnia. Experts note that many supplements have not been rigorously tested for effectiveness and may not contain the amount of melatonin listed on the label, or at all. said it was important.
Prescription drugs have their own side effects, from dizziness and headaches to gastrointestinal problems. Also, do not mix with certain drugs or substances such as alcohol, opiates, and antidepressants.By doing so, even more depresses the central nervous system As a result, breathing slows down, which can be dangerous, Dr. Neubauer said. Also, prescribed sleeping pills can cause sleepwalking and lead to serious symptoms. impaired driving.
Dr. Rodriguez says that over time, the body gets used to these drugs, so higher doses are often ultimately needed to achieve the same effect.and some of these drugs, especially for benzodiazepines, this dependence can escalate to addiction. This is why it is so difficult for people to get off sleeping pills and why many people remain on prescription drugs for years.
How do you give up?
Dr. Jade Wu, a sleep psychologist at Duke University and consultant at sleep wellness company Hatch, says you need a slow, strategic approach. For some people, abruptly discontinuing sleeping pills after more than a month of use can cause withdrawal symptoms such as increased anxiety, restlessness, and rebound insomnia, which can lead to sleep being disrupted again. . Most experts recommend gradually reducing the dose over several weeks or months with the help of your doctor.
Cognitive behavioral therapy for insomnia can also address the causes of insomnia, focusing on modifying behaviors and thought patterns that contribute to sleep problems. Research shows that CBT-I may provide the following benefits: more durable Alternatives to medicine.
It's also important to have good bedtime habits, such as sleeping in a dark room and avoiding screens, which can help prevent rebound insomnia.
“There may be some eventful nights here and there, and that's OK,” Dr. Wu says. “Trust me we're not actually going backwards.”
