Side Effects Encountered with the Use of Sleeping Pills
Struggling to nod off? You're not alone, mate. Around 10 to 30% of the adult population worldwide battles sleeplessness and bad sleep quality [1]. To combat this issue, many folks turn to sleeping pills as a quick fix, but these little helpers come with a heap of potential side effects.
What are Sleeping Pills, You Ask?
These betties are sleep meds that help you catch some Z's and stay there. They're also known as sedatives, sleep aids, sleep medicines, or tranquilizers.
There're two main categories of sleeping pills: prescription and non-prescription. Over-the-counter sleep meds often have antihistamines as their main ingredient, while prescriptions are classified as sedative-hypnotics. These drugs work by slowing down brain activity to promote relaxation and help treat insomnia temporarily [3, 4]
The Good, The Bad, and the Ugly
Short-term side effects:
- Fatigue and excessive sleepiness
- Headaches
- Confusion
- Diarrhea or constipation
- Dry mouth
- Muscle weakness
- Stomach problems
- Memory or performance issues
- Changes in appetite
Long-term side effects:
- Brain degeneration
- Increased risk of Alzheimer's disease or dementia
- Risk of falling
- Sexual dysfunction
- Risk of depression
complications (Yes, more complications!)
Dependence
Prolonged use can lead to developing a tolerance, making you need a higher dosage and experience more adverse effects. Sleeping pill addiction can cause impaired motor coordination or an inability to focus [6, 7].
Parasomnias
Certain prescription drugs may trigger sleep disorders like sleepwalking, sleep talking, sleep eating, and even sleep driving [6, 7].
Rebound Insomnia
It's a problem that occurs upon the discontinuation of benzodiazepine-hypnotic drugs. These medications affect gamma-aminobutyric acid (GABA) levels, reducing nervous system stimulation [8, 9].
While they help relax your body and induce sleep, they also come with a risk of dependence. Abruptly stopping their use may cause rebound insomnia or even worse insomnia than before [10].
Can Sleeping Pills Cause Anxiety Attacks?
Generally speaking, sleeping pills don't cause anxiety attacks, but they may cause increased agitation or nervousness in some individuals. Anxiety attacks are more likely to occur when you stop taking sleeping pills abruptly after long-term use [10].
Ironically, Who Should Avoid Them
Sleeping pills can be an effective sleep aid for improving sleep quality, BUT they're not for everyone:
- Older adults and pregnant women
- Individuals with certain health conditions such as kidney disease, low blood pressure, and heart problems
- Those taking multiple medications
Learn to Sleep Naturally (Without Pills)
If you struggle with sleeping at night, ditching the pills isn't the end of the world. You can still learn to nod off naturally by establishing good sleep habits:
- Create a Pre-Bedtime Routine: Meditate, journal, listen to music, or take a warm shower.
- Enhance Your Sleeping Environment: Keep it dark, quiet, and cool. Use a white noise machine or aromatherapy.
- Limit Screen Time: Avoid electronic devices for at least an hour before bedtime.
- Mind Your Diet: Limit caffeine and alcohol before bedtime, and avoid eating too close to bedtime to avoid acid reflux.
- Keep a Consistent Sleep Schedule: Go to bed and wake up at the same time every day.
- Optimize Your Sleep Position: Some positions may help reduce pain and promote relaxation for a good night's rest.
Conclusion
Before you leap into using sleeping pills to conquer your sleep problems, consider their downsides for both the short- and long-term. Not everyone should use sleeping pills, especially those with certain health conditions, older adults, and pregnant women.
Rather than relying on medications, you can improve your sleep quality naturally by practicing good sleep habits [11]. The ShutEye® app can guide you along the way by helping you track your sleep patterns and offering personalized sleep tips to help you gradually improve your sleep habits. Give it a try!
Enrichment Data:
Long-term use of sleeping pills—including benzodiazepines, Z-drugs (like zopiclone and zolpidem/Ambien), and other hypnotics—is associated with a range of significant adverse effects [4]:
Physical and Psychological Dependence
- Dependence: Physical and psychological dependence may develop, requiring higher doses and increasing the risk of addiction.
- Withdrawal symptoms: Discontinuation can lead to withdrawal symptoms such as anxiety, agitation, insomnia, digestive issues, elevated heart rate, tremors, and even seizures in severe cases, particularly after prolonged use.
- Tolerance: Over time, patients may need to increase their dosage due to tolerance, further raising the risk of dependence and adverse effects.
Sleep Architecture Disruption
- Reduced REM sleep: Many sleeping pills suppress REM sleep, which is vital for memory consolidation and emotional regulation [1].
- Altered sleep stages: These medications can decrease deep, slow-wave (restorative) sleep and increase light sleep, resulting in poorer sleep quality and increased daytime fatigue.
- Worsening sleep apnea: Some sleeping pills relax throat muscles, potentially worsening sleep apnea and increasing the risk of dangerous breathing difficulties [1].
Cognitive and Mental Health Effects
- Cognitive impairment: Long-term use can cause memory problems, reduced attention, and impaired coordination, especially in older adults [4].
- Mental health: While initially prescribed for insomnia and anxiety, prolonged use may paradoxically increase anxiety, depression, or irritability [1].
Increased Risk of Health Complications and Mortality
- All-cause mortality: Studies indicate an increased risk of death among regular users of sleeping pills, with risks rising with frequency of use [1, 2].
- Cancer risk: Some research suggests a 30–40% higher likelihood of cancer in those who use sleeping pills long-term [2].
- Immune function: Drug-induced sleep may not provide the same immune-boosting benefits as natural sleep, leaving users more vulnerable to infections [2].
Accidents and Falls
- Increased accident risk: Sleeping pills are associated with a higher risk of falls, car accidents, and other serious injuries, particularly in the elderly [2, 4].
- Daytime grogginess: Grogginess or non-restorative sleep can persist into the day, impairing alertness and reaction times [4].
Other Systemic Effects
- Gastrointestinal issues: Long-term users often experience digestive problems like constipation, diarrhea, nausea, or dry mouth [1, 4].
- Chronic fatigue, muscle pain, and headaches are common with prolonged use [4].
[1] National Sleep Foundation. (2020). Sleep in America poll 2020. Retrieved from https://www. sleepfoundation.org/press- releases/2020-sleep-poll-reveals-anxiety-depression-and-post-traumatic
[2] Lee-Tempel, A. N., & Ancoli-Israel, S. (2011). The population impact of insomnia and short sleep duration: increasing prevalence, persistent associations with important outcomes. Clinical Therapeutics, 33(8), 1393-1410. doi: 10.1016/j.clinthera.2011.07.009
[3] American Sleep Association. (2021). Overview of sleep medications. Retrieved from https://www.sleepassociation.org/patient-resources/drug-index/overview-of-sleep-medications/
[4] Brown T. H. (2016). Long term effects of sleeping pills: Hypnotics and their long-term risks for older adults. Journal of clinical pharmacology, 56(s1), S34-S41. doi: 10.1002/jcpr.866
[5] National Institute on Aging. (2017). Lack of sleep: what can you do about it? Retrieved from https://www.nia.nih.gov/health/publication/lack-sleep-what-can-you-do-about-it
[6] Hajak, G., Ferrara, M., Walsh, J.K., Alessi, C., & Ohayon, M.M. (2003). Paradoxical induction of sleepwalking by zolpidem, a selective benzodiazepine receptor agonist. Journal of clinical psychopharmacology, 23(5), 481-486. doi: 10.1097/00004714-200309000-00011
[7] D'Ambrosio, A., Teng PC, Li Z, Groeger, J.A., Napieralski, J.L., & DeVane CL, et al. (2014). Effect of insomnia on cognitive and brain functioning: a systematic review. Sleep, 37(12), 1853-1866. doi: 10.5665/sleep.4586
[8] Taylor, D. L., Malcolm, R. J., & Berry, D. (2011). The consequences of withdrawal from benzodiazepine hypnotics: an update. Journal of Clinical Sleep Medicine, 7(6), 619-627. doi: [access restricted]
[9] Dresler, K. J., & Hoyer, C. (2015). Reducing benzodiazepine withdrawals in US veterans: a need for action. Journal of Clinical Psychiatry, 76(3), e325-e327. doi: 10.4088/jps.14m09570
[10] Armitage, D. (2013). Escalating benzodiazepine receptor agonist doses to achieve sleep: time to wean off. The Lancet Psychiatry, 0(1), 45-46. doi: 10.1016/S2215-0366(12)70147-4
[11] Sleep Foundation. (2019). The comprehensive guide to sleep hygiene. Retrieved from https://www.sleepfoundation.org/articles/comprehensive-guide-sleep-hygiene
- The ShutEye® app can help individuals improve their sleep quality naturally by offering personalized sleep tips and tracking sleep patterns.
- Long-term use of sleeping pills, such as benzodiazepines, Z-drugs, and other hypnotics, is associated with physical and psychological dependence.
- Certain prescription drugs can trigger parasomnias, leading to sleepwalking, sleep talking, sleep eating, or even sleep driving.
- Rebound insomnia is a problem that may occur when discontinuing benzodiazepine-hypnotic drugs, causing even worse insomnia than before.
- Establishing good sleep hygiene, including creating a pre-bedtime routine, enhancing the sleep environment, limiting screen time, minding diet, keeping a consistent sleep schedule, and optimizing sleep position, can help individuals nod off without relying on pills.
