When to take sleeping tablets

Given what we know about the negative impact on your health if you aren’t sleeping well, sleeping tablets may help. However, there can be a real stigma attached to the notion of sleeping tablets. A possible reason for this stigma is that when we read about sleeping pills, it is often attached to a negative story of misuse. Nevertheless, if used correctly there could be significant benefits to the individual’s health and well-being.

What do sleeping tablets do?
Sleeping tablets are designed to induce drowsiness. They are usually short-acting and are not necessarily effective in maintaining sleep (keeping you asleep).

Some sleeping tablets are made specifically to aid sleep, while others are used because their side effect includes sedation.

You must only ever use sleeping tablets when prescribed by a qualified doctor.

Types of sleeping pills
Sleeping pills may be prescribed by a doctor to help in the temporary treatment of mild sleeping disorders like infrequent insomnia.

Sleeping pills are NOT recommended to treat chronic sleep problems as they can have severe side effects and can become addictive.

The following are just a few examples of the types of sleeping pills that are often used to manage insomnia.

Benzodiazepines
These pills have sedative effects that are typically short acting and therefore can quickly help you fall asleep. You can only get them on prescription because they can cause physical dependence and addiction. Common brand names are Temazepam, Mogadon, Serepax. Some benzodiazepines (Xanax and Valium) are primarily prescribed to treat anxiety (see anxiolytics below).

Non-benzodiazepines
These pills also have sedative effects but have a different mechanism that regulates inhibitory GABA receptors in the brain. They are prescription-only. Some common brand names are Ambien, Stilnox, Lunesta, Sonata.

Anxiolytics
Two of the most commonly prescribed tablets, Xanax and Valium are not designed to aid with sleep; instead, they are used to treat anxiety. Since they are benzodiazepines, they also have sedative effects and as such may induce drowsiness and help someone get to sleep. Unfortunately for this reason, they are often misused. Xanax is the number one prescribed medication in the US across all kinds of drugs.

Anti-depressants
Tri-cyclic anti-depressants are primarily used to treat depression (in Australia and the UK) but can also be used to treat insomnia in the USA. Some common brand names are Silenor and Sinequan.

Anti-histamines
These drugs are typically used to treat allergic reactions (e.g., itching, sneezing) and inflammatory responses and can typically be bought over the counter. They have sedating effects however, which can sometimes be long-lasting and may affect activities like driving in the hours after waking.

Side effects of sleeping tablets
This list is not exhaustive and not all types of sleeping tablets result in all of the following. Side effects are dependent on the type of tablet you have, how often you take it, and your own personal health. They may include:

• Dizziness
• Blurred vision
• Headache
• Stomach pains
• Shaking
• Headache

If you suffer from any of the above, consult your doctor.

How sleeping pills are misused
When they are used as a long-term solution
As you likely already know, you should not take sleeping pills for more than a few weeks as they are what we call “habit-forming”. Those who take sleeping pills beyond when they need to can quickly develop a reliance on them, resulting in severe withdrawal when use is stopped.

Once a habit is formed, it is even harder to break. Stopping chronic use of sleeping tablets can result in anxiety, shaking and an increased risk of injury and accidents. Ironically, it can also worsen insomnia.

The body will develop a tolerance to sleeping tablets after three to 14 days. This means that within two weeks you will require a higher dosage to get the same effect as earlier. Other potential effects include developing a physical dependence on the pills which can lead to difficulty getting to sleep and anxiety when stopping use of the pills.

When they are mixed with other medication or alcohol
We all know this: mixing sleeping tablets with alcohol can be dangerous.

Both are sedatives, and a potent combination may cause someone to stop breathing and suffer cardiac arrest. It can also result in sleepwalking which can end in injury and accidents.

Finding solutions to a sleeping issue
While sleeping tablets can help with mild or short-term insomnia, if your sleeping problems persist for longer than a week or two, sleeping tablets will not help.

They should not be used to treat chronic sleep issues – there are other things you should do if you are persistently suffering from sleep problems and we explore them below.

Improving your sleep habits
Sleeping pills aren’t the only choice you have when it comes to resolving persistent sleep issues or improving the quality of sleep you receive.

Relaxation techniques
Do something relaxing in the 30-60 minutes leading up to bedtime
Avoid working on a laptop or using your smartphone before bed – the short wavelength blue light emitted from the screens can suppress melatonin production
If you can’t fall asleep within 20 minutes, get up, leave your bedroom and do something relaxing like reading a book or listening to music (but don’t use electronic devices)
Read this blog post to find out why you may be having trouble sleeping.
Develop (and stick to) a sleep schedule
Try to go to sleep and get up at roughly the same time every day
Avoid caffeine in the afternoon and evenings
Restrict daytime naps to 20-30 minutes
Look at your bedroom
Remove the TV
Make sure your room is not too hot or cold
Make sure window coverings are sufficient to block out light and help muffle external sound
Do not eat or use your laptop in bed
If sleeping problems persist, the best thing you can do is see your doctor who will be able to prescribe or recommend treatment, or ascertain whether there is any underlying sleep disorder, like insomnia or sleep apnoea.