How sleeping pills help treat Insomnia.

How sleeping pills help treat Insomnia.

Sleeping problems are commonplace, and one of the most prevalent sleep disorders is insomnia, which affects between 10 and 30 percent of adults in the United States.

Insomnia occurs when a person has problems falling asleep (sleep onset) and/or staying asleep (sleep maintenance), and those problems cause sleepiness, slowed thinking, or other impairments during the day. Insomnia is often tied to sleep deprivation, which can have serious consequences for physical and mental health.

To address insomnia, many people turn to sleep aids. These include prescription drugs, over-the-counter medications, and dietary supplements. Every sleep aid for insomnia has potential benefits and downsides, and it’s important for individuals to be informed about their treatment options and talk with a doctor about the best option in their personal situation.

How Commonly Used Are Sleep Aids for Insomnia?

Sleeping pills or other sleep aids are a common component of treatment for insomnia. Studies have found consistently rising rates of sleep aid use with one study estimating around 19% of adults taking at least one sleep medication in the last month.

Data from the CDC shows that many adults take sleep aids frequently with more than 8% of adults using a sleep aid at least four times in the previous week. The use of prescription insomnia medications has increased among the elderly, including among people without a formal diagnosis of insomnia.

This research also reflects a trend toward higher usage of over-the-counter (OTC) sleeping pills as well as dietary supplements such as natural sleep aids. A survey by Consumer Reports, for example, found that about 20% of adults said that they used a natural sleep aid in the past year.

How Do Sleep Aids for Insomnia Work?

Most sleep aids for insomnia work because they have a sedative effect, which means that they make you feel sleepy. That sleepiness may happen rapidly to help you fall asleep or can have a prolonged effect to make it easier to sleep through the night.

The way that a sleep aid produces a sedative effect varies on its chemical composition. Depending on how they work and how they are regulated, sleeping pills for insomnia can be organized into several distinct types.

What Are the Types of Sleep Aids for Insomnia?

There are three types of sleep aids for insomnia: prescription medications, over-the-counter drugs, and dietary supplements.

Prescription Drugs

Before a prescription drug can be sold, it must be approved by the Food and Drug Administration (FDA), which carefully reviews data from research studies about its effectiveness and safety. Once the drug is approved, a patient must get a prescription from their doctor in order to obtain the drug from a pharmacy.

Different classes of drugs cause sleepiness based on their chemical composition and how they affect the brain. Types of prescription drugs that are approved by the FDA for insomnia include:

  • Z Drugs: These medications slow down activity in the brain, which prompts a sedative effect.
  • Orexin receptor antagonists: These drugs block production of orexin, a chemical in the brain that makes you feel alert.
  • Benzodiazepines: Benzodiazepines are like Z drugs in that they decrease brain activity to induce sleepiness. These were among the first prescription drugs to be used for insomnia.
  • Melatonin receptor agonists: This type of medication increases the level of the hormone melatonin in the body, which promotes sleepiness.
  • Antidepressants: These drugs were first designed to treat depression but were later found to have a sedative effect. Only one antidepressant is formally approved by the FDA for insomnia.

Once a drug has been approved by the FDA for one use, doctors can prescribe it for other conditions, which is known as “off-label” use. Drugs such as antipsychotics and anticonvulsants are occasionally used off-label for insomnia, but there is less data about their safety and effectiveness in treating sleep problems.

Over-the-Counter Medications

Over-the-counter medications can be purchased without a prescription. These pills do not go through the same level of FDA review as prescription medications, but they still must meet certain regulatory standards before they can be sold.

Over-the-counter sleep aids are composed of antihistamines. Antihistamines are frequently used to manage allergies, but because of their sedative effect, they are also marketed as sleeping pills.

Antihistamine sleep aids may be sold as one-ingredient products, or the antihistamine may be combined with active ingredients for other issues such as cough, fever, or congestion. When added to other chemicals, OTC sleep aids are often labeled for “PM” use.

Dietary Supplements

Although people may use them for health reasons, dietary supplements are not formal medications. They do not have to be approved by the FDA, and there is considerably less oversight of sleep aids sold as dietary supplements.

Natural sleep aids, such as melatonin, valerian, or kava, are examples of dietary supplement sleep aids. Brands can create sleep aids made of just one ingredient or a blend, which is why there is a huge diversity of these sleep aids available on the market.

Among the types of sleep aids for insomnia, dietary supplements tend to have the least amount of evidence from studies documenting their benefits and downsides.

What Sleep Aids for Insomnia Work the Best?

Not everyone has the same reaction to a sleep aid, so there’s no hard-and-fast rule about which one works the best. Instead, doctors suggest insomnia treatments based on their patient’s specific situation, including their symptoms and their overall health.

To make these suggestions, doctors may draw on guidance from expert organizations like the American Academy of Sleep Medicine (AASM). AASM organizes panels of sleep experts who review the existing research and make general recommendations about sleep aids.

In the latest AASM guidelines for sleep aids for insomnia9, certain prescription drugs are recommended depending on whether a person’s problem is with sleep onset or sleep maintenance. This is because certain sleep aids work quickly and wear off fast, and others start slowly and last a long time. AASM recommends against the use of over-the-counter sleeping pills and dietary supplements like melatonin and valerian.

What Are the Potential Risks of Sleep Aids for Insomnia?

Potential side effects can vary based on the specific sleep aid and whether the person taking it has any other health problems or medications that they take. In general, there are potential negative effects that can occur with almost all sleep medications, although the likelihood of these effects may be higher with some sleep aids.

  • Lingering next-day effects: As many as 80% of people taking sleep aids say that the sedative effect may persist after they have woken up, creating excess drowsiness or slowed thinking when a person should be alert. This issue is most worrisome for people who drive in the morning and may be at a higher risk of auto accidents.
  • Confusion or loss of coordination: A strong sedative effect can make a person feel confused, dizzy, or unable to concentrate. As a result, they may be at risk for falls or other accidents right before bed or during the night.
  • Abnormal behavior: After taking sleep aids, some people engage in strange behavior while remaining partially asleep and unaware of their actions. This behavior can range from simple things like talking, to more complex actions like sleepwalking or trying to drive.
  • Allergic reaction: These responses are quite rare, but some people have allergic reactions to sleep aids.
  • Drug interaction: A sleep aid may interact with other medications and potentially change their potency or how they affect the body.

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