Prescription Sleeping Pills

Reviewed by: HU Medical Review Board | Last reviewed: March 2023

A wide variety of prescription drugs are available to treat insomnia. These sleep aids generally are prescribed for chronic insomnia, not short-term sleep problems. Chronic insomnia means a person has trouble falling or staying asleep at least 3 times a week for more than 3 months.1

Chronic, or long-term, insomnia may improve more with changes to sleep habits and cognitive behavioral therapy (CBT) than with drugs. However, sleep aids can play a role in helping someone get much-needed rest.1,2

Types of prescription sleeping pills

Sleeping pills may help you fall asleep or help you stay asleep. Some do both. Half-life is another difference between sleeping pills. Half-life is how long a drug remains active in the body. The main types of prescription sleeping pills include:2

  • Benzodiazepines (Prosom, Doral, Halcion, Valium, Lorazepam)
  • Non-benzodiazepines (Ambien, Sonata, Rozerem, Lunesta, Edluar, Intermezzo, Zolpimist)
  • Orexin antagonist (Belsomra, Dayvigo, Suvorexant, Quviviq)

Barbiturates are prescribed less often for insomnia now that other classes of drugs are available. Anticonvulsants may be prescribed for insomnia related to bipolar disorder, restless legs syndrome, or periodic limb movement disorder.2

Sometimes antidepressants and nerve pain drugs are prescribed for insomnia. These drugs are not approved by the U.S. Food and Drug Administration (FDA) for use as a sleep aid but are widely prescribed anyway. That is because insomnia is common in people with depression or anxiety, and antidepressants may improve both conditions.3

Despite their popularity, studies show these drugs do not treat long-term insomnia as well as changes to sleep habits and cognitive behavioral therapy (CBT). CBT is a sort of sleep coaching, where the person learns to think differently about sleep.1

How do prescription sleeping pills work?

Prescription drugs used for insomnia generally work by increasing certain chemicals in the brain. Some work on gamma-aminobutyric acid (GABA). GABA is a neurotransmitter, or a chemical, that helps nerves inside the brain communicate with each other. When GABA increases in the brain, you feel drowsy and either fall asleep or stay asleep.2

Other insomnia drugs work on melatonin receptors. Still others work on histamine receptors, while some newer drugs work on orexin receptors. Orexin is a neurotransmitter that affects our ability to stay awake. People with narcolepsy can have a problem with this neurotransmitter, which causes them to fall asleep suddenly. Doctors have been able to use this information to develop drugs to treat insomnia.2

Who takes sleeping pills?

A 2013 survey by the Centers for Disease Control and Prevention (CDC) found that 4 percent of adults had taken a sleep aid in the last month. The people most likely to use sleep aids included:4

  • 5 percent of women used sleep aids compared to 3 percent of men
  • Non-Hispanic whites were more likely to use sleep aids than non-Hispanic Blacks
  • Mexican Americans used sleep aids the least of any ethnic group
  • People who sleep less than 5 hours were most likely to use a sleep aid
  • People with a diagnosed sleep disorder

Side effects of prescription sleeping pills

Many prescription sleep aids are sedatives. Sedatives are a class of drug that reduce irritability and excitement, which helps make you calm or sleepy. The most common side effects of sedative-type sleeping pills include:2,3

  • Dizziness, lightheadedness, drowsiness
  • Headache
  • Nausea, diarrhea, constipation
  • Daytime problems with sleepiness, memory, and concentration
  • Driving, eating, or texting when not fully awake

Many of the sedatives used for insomnia can lead to dependence. This means a person has trouble falling asleep or staying asleep without the drug.3

Sleeping pills with a long half-life tend to build up in the body if used every night. This can cause problems with daytime performance in thinking and movement. Insomnia drugs with longer half-lives also are more likely to interfere with other drugs you may take.2

Antidepressants used for insomnia have similar side effects as sedatives, plus:3

  • Dry mouth
  • Irregular heartbeat
  • Weight gain

These are not all the possible side effects of prescription sleeping pills. Talk to your doctor about what to expect when taking prescription sleeping pills. You also should call your doctor if you have any changes that concern you when taking prescription sleeping pills.

Things to know about prescription sleeping pills

You should only take a sleeping pill if you have time to rest for 7 to 8 hours. Also, sleeping pills should be taken just before going to bed to prevent falls and accidents.

Any drug can interact with other drugs or supplements you are taking. Keep yourself safe by asking your doctor or pharmacist about possible drug interactions. Certain sleeping pills should not be prescribed if you are also taking:

  • Prescription pain medicine
  • Over-the-counter cold and allergy drugs
  • Birth control pills
  • SSRI antidepressants
  • Antifungals

Smoking can make some prescription sleep aids work less well. Drinking alcohol while taking prescription sleep aids can slow the heart and breathing too much and even lead to death.1

Prescription sleep aids may not be safe for people with these health conditions:2,3

  • Depression
  • Heart disease
  • History of seizures
  • Kidney disease
  • Liver disease
  • Lung disease

Insurance companies may limit the type of sleeping pills they will pay for. They also may require you try other methods first, such a cognitive behavioral therapy.3

Prescription sleeping pills may not be safe for women who are pregnant or breastfeeding and older adults.3

Before beginning treatment for insomnia, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.

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