Sleeping Pills, Sleep Aids & Medications.

There are various types of prescription sleeping pills or sleep aids to treat short-term as well as chronic insomnia and help you sleep. They are called sedative hypnotics and they generally act on the brain receptors and slow down the nervous system. Some of them help you to fall asleep while others help you to stay asleep.

Some of them have the disadvantage of becoming habit-forming (dependence). Their proper use as advised in doses and duration is important as else improper use can make insomnia worse in the long run.

Prescription sleeping aids are to be used only after lifestyle and behavioral changes have failed to cure symptoms of insomnia and only as advised by your doctor.

Benzodiazepines.

Benzodiazepines are the oldest and the most commonly prescribed sleeping pills and the most likely to cause dependence. Diazepam (eg, Valium and Calmpose) is a benzodiazepine and these drugs help to induce sleep and cause less awakening at night.

How They Act|Mode of Action.

Gama-aminobutyric acid (GABA) is a brain chemical – an amino acid- that blocks the transmission of signals between the brain cells, thereby decreasing the excitability of the neurons and calming nervous activity.  Benzodiazepines enhance the effect of GABA which results in a sedative and hypnotic effect.

Examples of benzodiazepines include diazepam (Valium), estazolam (ProSom), flurazepam (Dalmane), quazepam (Doral), temazepam (Restoril), and triazolam (Halcion).

Nowadays non benzodiazepines are more used because of the drawbacks of using benzodiazepines which include physical and mental dependence, development of tolerance, hangover effects and  loss of sleep quality.

Read the full note on benzodiazepines.

Non Benzodiazepines.

Non-benzodiazepine hypnotic sedative drugs are a newer type of hypnotics, introduced about 10 to 12 years back and which are prescribed for mild to moderate insomnia. They act by slowing down the brain activity thereby promoting sleep. Though their mode of action is similar to benzodiazepines, they are more specific for making you fall asleep. These sleeping pills do cause dependency but to a lesser extent than benzodiazepines and do not cause hangover effect and have no adverse effect on sleep apnea.

Examples of Non-Benzodiazepines.

• zalepon (Sonata),
• zolpidem (Ambien, ZolpiMist), and
• eszopiclone (Lunesta),

Drawbacks and Side Effects of Non-Benzodiazepines Sleeping Pills.

Side effects of these drugs are much less than the benzodiazepines

• Headache and nausea.
• Dizziness
• Next day morning grogginess and drowsiness
• Drug tolerance resulting in lesser efficacy of the drug when taken over time.
• Rebound insomnia when the drug is stopped.
• Rarely the person may develop complex sleep related behaviors such as sleep walking and sleep driving.

 Ramelteon (Rozerem)

Ramelton (Rozerem) is the latest sleep medication to induce sleep and works similarly to melatonin. Though it has side effects, its risk of dependency is less. It is more effective in inducing sleep and not so effective in staying asleep.

Side effects.

• Dizziness
• It may worsen symptoms of depression, if present.
• It is contraindicated in persons with liver damage.

It is to be taken 30 minutes before bedtime

Antidepressants.

Antidepressants are usually prescribed as sleeping aids in cases where insomnia and psychiatric problems co-exist. All antidepressants do not work in the same way and some may even worsen the quality of sleep. The most commonly used antidepressant is trazodone.

Sedating tricyclic antidepressants like amitriptyline, nortriptyline, doxepine and clomipramine improve sleep quality while stimulating tricyclics trimipramine, desipramine and protriptyline make it worse.

Of the SSRIs, only escitalopram improved sleep while fluoxetine, paroxetine, citalopram, venlafaxine and duloxetine damaged sleep.

These antidepressants act by increasing the levels of naturally occurring substances which maintain mental balance. 

Related posts:

1. Sleep Aids To Help You Sleep.
2. Over The Counter and Natural Sleep Aids to Help You Sleep.
3. Benzodiazepine Sleeping Pill – Use, Side Effects and Contraindications.
4. Deep Sleep – An Important Sleeping Stage.
5. Cognitive Behavioral Therapy – An Effective Sleep Treatment.
6. Why I Can’t Sleep|Causes of Insomnia.
7. Symptoms and Signs of Insomnia.
8. Insomnia Treatment and Cure.