What Are Sleeping Pills?
Sleeping pills are a type of sleep aid, generally best used sparingly and for short periods of time, which can help a person with insomnia and similar sleep issues sleep more soundly.
When people talk about sleeping pills, they usually specifically mean prescription-grade sleeping pills, not over-the-counter options, which have a weaker effect and fewer risks. Prescription sleeping pills work best as a stop-gap measure, with a patient working with their doctor to adopt healthier sleep habits and improve their ability to sleep without needing these types of aids.
Key Facts About Sleeping Pills
Key Facts
- Prescription-grade sleeping pills should only ever be used as prescribed. They can be very dangerous if misused.
- Before trying prescription sleeping pills, it is usually best to try adjusting your sleeping habits while also potentially trying milder sleep aids, such as over-the-counter antihistamines or melatonin.
- Sleeping pills should never be mixed with other types of drugs without first talking to a doctor, especially drugs that suppress breathing, such as alcohol.
- Sleeping pills should never be taken with or mixed with alcohol due to the possibility of dangerous and potentially deadly side effects.
Different Types of Sleeping Pills
Commonly used prescription-grade sleeping pills include the following. This chart can help you understand what they are and how they work.
| Ambien | Lunesta | Rozerem | Sonata | |
| Medication class | Hypnotic | Hypnotic | Hypnotic | Hypnotic |
| FDA-approved use | Short-term insomnia | Insomnia | Insomnia characterized by an inability to fall asleep | Short-term insomnia |
| Typical side effects | Drowsiness, dizziness, diarrhea | Unpleasant taste, headache, drowsiness | Drowsiness, dizziness, fatigue, nausea | Drowsiness, dizziness, lightheadedness |
| Addiction warnings | Not designed for people with. a history of drug abuse | Not designed for people with. a history of drug abuse | None | None |
| Overdose warnings | When used with depressants, overdoses have been reported | Possible, but most people recover fully unless they’re using other drugs at the same time | Possible | Possible and worsened when combined with depressants |
Zolpidem (Ambien)
Zolpidem, sold under the brand name Ambien, is one of the most commonly prescribed prescription-grade sleeping aids. It is a “Z-drug,” a type of medication comparable to benzodiazepines but that exhibits fewer side effects.
While this type of medication definitely has legitimate medical use, it’s important to note that it is also not as fully understood as benzodiazepines. As a result, it may have important health impacts we don’t fully understand.
This medication is used to treat chronic insomnia and short-term, acute insomnia. Evidence suggests it is effective for this purpose.
Eszopiclone (Lunesta)
Eszopiclone, sold under the name Lunesta, is a hypnotic medication that works by slowing down brain activity, which makes it easier to sleep.
Like most prescription sleep aids, it is meant to be used shortly before bedtime or if a person has already tried and failed to get to sleep, causing them to quickly become sleepy and remain sleepy for a long time.
Ramelteon (Rozerem)
This is a newer prescription sleep option of a class of medication called melatonin receptor agonists. It works by binding to melatonin receptors in the brain, mimicking the effect of melatonin.
It is notably a fairly safe sleep medication while still being effective. It lacks many of the dangers associated with prescription sleeping pills, even if it still has some side effects.
Zaleplon (Sonata)
Zaleplon, sold as Sonata, works very similarly to eszopiclone. While it’s important to always read any materials provided with your specific medication rather than making assumptions based on how other medications operate, most of what is written above about eszopiclone above applies to zaleplon.
What Is a Sleeping Pill Addiction?
The American Society of Addiction Medicine defines addiction as a treatable, chronic medical disease involving interplay between brain circuits, genetics, environment, and life experiences. Addictions can be treated, but they often require life-long management.
Sleeping pill addiction can develop when people use their medications, even as directed, for long periods.
Researchers say a “high” from these medications is very similar to alcohol intoxication. Some people abuse sleeping pills for the relaxing feelings they provide, and they struggle to quit.
Sleeping pills can also be abused by people dealing with difficult life circumstances, such as maritial stress or financial difficulties. Sleeping pills are relaxing and comforting, which can make them seem helpful for those dealing with distress.
People using sleeping pills for long periods often face withdrawal symptoms when they quit. Severe depression and insomnia are common, and troubling signs like seizures can develop in time. Some people keep using them because they’re afraid of the health problems they face when they quit.
Signs of a Sleeping Pill Addiction or Abuse Issue
There’s some debate about whether sleep pills are “addictive,” as these medications don’t typically cause drug cravings the way other addictive drugs do.
At the same time, it’s possible for these drugs to cause physical dependence, meaning they can cause negative side effects if you stop taking them. It’s also possible for these drugs to cause psychological dependence, where a person grows to believe they can’t sleep without using sleeping pills even if that isn’t true.
Whatever it’s called, a person may have a problem with sleeping pills if they frequently misuse their medication, even if it’s not for the purpose of “getting high” as misuse of other drugs tends to be. For example, if a person is using their medication to try to sleep, but not using it as prescribed, that’s an issue and can potentially be dangerous.
It’s a problem if a person is using sleeping pills but not following other suggestions their doctor made to improve their sleep patterns. Whenever possible, a person should plan to eventually stop taking sleeping pills and find other long-term paths toward improving their sleep.
It’s also possible to experience physical withdrawal when one stops taking sleeping pills suddenly, described more below. If you want to stop taking sleeping pills, talk to your doctor about the best way to do so. It’s often recommended that you slowly taper your daily dose rather than stop taking them all at once.
Can You Overdose on Sleeping Pills?
Most prescription sleeping pills have a serious overdose risk if misused, to the point where they have the unfortunate and well-known reputation as being used in suicide attempts. Signs of a sleeping pill overdose include the following:
- Moderate to severe drowsiness
- Confusion
- Problems with coordination
- Floppy or limp muscles
- Slowed, strained, or stopped breathing
- Coma
If a person has collapsed, had seizures, is having trouble breathing, or can’t be awakened, treat it as a medical emergency and call 911 immediately.
If you are uncertain about the situation but it doesn’t seem like an emergency, call poison control at 1-800-222-1222. They can advise you on how to proceed. If in doubt about the severity of the situation, call 911.
A sleeping pill overdose has the potential to be fatal or cause permanent brain damage. The risk of an overdose, both intentional and accidental, increases significantly if the pills are used in combination with other drugs that also suppress breathing, which is why you should never take sleeping pills with alcohol.
Withdrawal From Sleeping Pills
If a person stops taking sleeping pills suddenly, they can enter withdrawal, essentially rebounding and experiencing the opposite effect their sleeping pills had. They may become more wakeful and restless during bedtime, which is obviously not ideal for individuals who were taking prescription-grade sleeping aids in an effort to try and sleep.
Researchers say up to 20% of people who abuse sedative drugs can develop severe withdrawal symptoms, such as the following:
- Tremors
- Anxiety
- Agitation
- Rigid muscles
- Fast heartbeat and high blood pressure
- Seizures
Since withdrawal can be life-threatening, people are encouraged to taper their doses instead of quitting abruptly. By slowly reducing how much of a sleeping drug they’re taking, the risk of severe problems can be reduced.
How Does a Taper Work?
No taper schedule works for all people. Instead, doctors determine how much sleeping medications their patients are taking now and slowly reduce the dose over several weeks.
A typical taper schedule might look like this:
- Assessment: Your doctor determines what medication you’re taking now and how much you consume every day.
- Prescription: Your doctor might switch you from the medication you’re taking to something similar (like phenobarbital).
- Begin: You take your medication as directed by your doctor for several days.
- Taper: Your doctor reduces your dose by 30 mg to 60 mg per day while closely monitoring you for symptoms of withdrawal.
- Quit: In time, you’re using none at all.
If you experience discomfort (like severe insomnia), your taper might be moving too quickly. Remaining in close contact with your doctor during the tapering process is the best way to stay safe.
Treatment Options
If a person wants to stop taking sleeping pills, many people can safely and effectively do that by talking to their doctor and tapering their doses as recommended. However, some people may struggle to stop taking sleeping pills, feeling drawn to misuse them for one reason or another.
If you are in this situation, a traditional drug addiction treatment approach can help you recover from your dependence and regain control over your drug use. The focus will likely be on behavioral counseling for your drug problem and treatment of any associated mental health issues through whatever care plan is most appropriate, such as therapy and medication.
Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More
- Medicines for Sleep. (April 2020). National Library of Medicine.
- Eszopiclone. (December 2019). National Library of Medicine.
- Zaleplon. (December 2019). National Library of Medicine.
- By the Way, Doctor: Are Sleeping Pills Addictive? (March 2014). Harvard Health Publishing.
- Zolpidem. (November 2019). National Library of Medicine.
- Zolpidem Withdrawal Delirium. (December 2011). Indian Journal of Pharmacology.
- Treatment Approaches for Drug Addiction. (January 2019). National Institute on Drug Abuse.
- Ambien Prescribing Information. (February 2008). U.S. Food and Drug Administration.
- Lunesta Prescribing Information. (May 2014). U.S. Food and Drug Administration.
- Rozerem Prescribing Information. (December 2018). U.S. Food and Drug Administration.
- Zaleplon. (December 2019). U.S. National Library of Medicine.
- Prescription Sedative Misuse and Abuse. (September 2015). Yale Journal of Biology and Medicine.
- Definition of Addiction. (September 2019). American Society of Addiction Medicine.
- Sedative, Hypnotic, Anxiolytic Use Disorders Treatment and Management. (December 2023). Medscape.
