Why I Wish You Wouldn't Use Sleep Aids

I’ll be blunt: I wish you didn’t use sleep medications to treat your insomnia. I wish I could convince you to get behavioral treatment instead. If I knew you personally, I’d nag you about it until you told me to shut up.

OK, that last sentence is a bit of an exaggeration. I am aware that medication may be a reasonable part of an insomnia treatment plan for some people. Unfortunately, as a psychologist who specializes in cognitive behavioral therapy for insomnia (CBTI), I have seen some scary risks and side effects in my clients.

Many people use sleep aids

Many people with insomnia rely on sleep medications, both prescription and over-the-counter (OTC), to help them sleep. In one study, over 16 percent of American adults with a diagnosed sleep disorder used a prescription sleep aid in the past month. Another study found that about 18 percent of adults with sleep difficulties used an OTC sleep medication.^1,2

Clearly, medications are commonly used by people with insomnia. But just because it’s common, does that mean it’s a good idea?

A disclaimer: I am not qualified to prescribe medications. I work alongside prescribers when my clients are taking sleep medications. But I can tell you about some of the common concerns that I’ve heard from clients and their prescribers over the years.

Common risks associated with sleep aids

Side effects

Every medication comes with a risk of side effects, and sleep aids are no exception. Some side effects may be relatively mild, such as headaches, dry mouth, dizziness, and diarrhea. Some are bizarre, such as eating while asleep. And some are outright dangerous, such as driving while asleep or a high risk of falling in elderly patients.¹

Tolerance

People may develop a tolerance to sleep medications so that a dose that worked initially no longer works over time. Over months or years, patients require larger doses in order to get the same effect on their sleep.¹ And higher doses increase the risks of side effects and interactions.

Impact on other medical conditions and concerns

Some sleep medications can worsen other conditions, such as renal or liver conditions. Additionally, some medications should not be used by pregnant or breastfeeding women and may pose additional risks for elderly patients. Finally, sleep medications may interact with other prescribed medications, making them less effective.¹

Long-term use

Sleep medications are only recommended for short-term use, typically 2 to 3 weeks. After that length of time, medications may lose their effectiveness and/or lead to tolerance. There is no evidence to support long-term use of sleep aids.³

They don’t address the root of the problem

In addition to the risks noted above, there is one very important fact that makes me dislike sleep medications: they don’t address the root of insomnia.

Once insomnia takes hold, it is typically behaviors and thoughts that keep it going. Sleep medications can help reduce arousal and promote sleep for a while. But since they don’t address the factors that perpetuate insomnia, clients often find themselves in the same sleepless spot when they discontinue medication.

Are you willing to consider other options?

I’m not trying to be a buzzkill. If you’ve found a medication regimen that helps your insomnia, then I’m happy for you! But I hope you’ll keep talking with your doctor about minimizing your risks and developing a plan to discontinue medications over time. Treatments exist that carry a lot less risk and offer long-term benefits.