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Sleeping pills are medications in the category of sedatives, used
primarily to treat patients who are suffering from insomnia or sleep
deprivation, both of which can have wide-ranging and serious knock-on
health effects.
Benzodiazepines are the most common drug choice when
treating insomnia.
They are sleeping pills which can be either long or
short lasting, and have proven efficacy over the years.
The most common
kinds of these drugs currently in use today include diazepam, tmeazepam,
nitrazepam, lorazepam and midazolam.
Benzodiazapines were developed
originally in the nineteen-sixties to treat patients with anxiety.
They work by targeting receptor sites in the brain which modulate
the effect of GABA, or gamma-aminobutyric acid, a neurotransmitter.
Benzodiazepines work non-selectively in targeting these receptor sites.
Some longer acting benzodiazepines such as nitrazapam,
can have side effects that last well into the next day.
Medium-term
benzodiazepines, like temazepam, are less likely to cause this prolonged
sedentary effect, but it is still common for patients to be less alert
and noticeably ‘groggy’ the morning after taking them.
Benzodiazepines
are classified as hypnotics, and they should not be used for any prolonged
length of time, due to the risk of a patient developing both tolerance
and dependence.
Benzodiazepines are also used quite often to sedate
a patient prior to surgery, and is especially effective for patients
who are inclined toward anxiety and nervousness.
The benziodiazepines
in this case will relieve the patient’s anxiety and also promote amnesia,
which can help to ward off some psychological consequences of surgery.
Non-benzodiazepines are a newer category of drugs developed
to replace the older benzodiazepines.
They have a shorter half-life,
meaning that the sedative effect of these drugs is faster acting,
and shorter lasting.
The upshot of which is that they help people
to get to sleep, without suffering the next day ‘hangover’ that older
types of sleeping pills can have.
Melatonin is a hormone found naturally in all living creatures, which
is becoming increasing popular as a sleeping aid due to its reputation
for both restoring a normal sleep cycle, and inducing more vivid dreams.
Melatonin plays a part in maintaining the circadian rhythm, or sleep
pattern. It is particularly effective for patients whose sleep patterns
have been disrupted, for example those suffering jet lag.
It is also
a powerful antioxidant, and recent studies suggest that the additional
benefits of melatonin may be wide-ranging, such as delaying the onset
of aging and other degenerative conditions, as well as prolonging
fertility.
Experiments carried out on mice in the laboratory found
that mice who were regularly administered melatonin lived up to twenty
percent longer than those who did not.
Sleeping pills bought over the counter tend to be in
the form of antihistamines. Diphenhydramine is a popular choice, usually
supplied in dosages of between fifty and one hundred milligrams.
Antihistamines
do have a drowsy effect, and may work well for temporary relief of
sleep deprivation and insomnia, but they are not a long term solution
as they become less effective over time, since the patient becomes
immune to the drugs, and also the prolonged drowsiness caused by antihistamines
make leading a normal life and holding down a job particularly difficult.
Some types of antidepressant drugs are prescribed in
low doses to treat insomnia. Physician’s favourites include doxepin,
trazodone and mirtazapine. Antipsychotic medications like quetiapine
also possess some sedative qualities and may be useful.
Both types
of drugs tend to be used to cover all the bases when insomnia or sleep
deprivation is presenting with other psychological symptoms.
Tricyclic antidepressants, or TCAs, can also be used
for sedative effects. They work by inhibiting the nerve cells’ reuptake
of serotonin, norepinephrine or dopemine, which are all neurotransmitters.
This has the effect of depressing the central nervous system. Tricyclics
are not considered to be addictive.
Some herbal remedies have proven effective over many
years in the treatment of mild to moderate insomnia and sleep deprivation.
These include lavender, chamomile, hops, passion flower, and particularly
valerian which is the most supported by independent medical testing.
It is essential when beginning a course of sleeping pills
or other sleeping medication to follow your doctor’s guidance, and to
always pay attention to the manufacturer’s advice.
Start with a small
dosage and increase that if necessary, and seek medical help immediately
if you suffer any unforeseen side-effects, including psychological side-effects.
If possible, take medication every other night, or every couple of nights,
rather than on an every day basis, to increase the length of time you
can stay on a particular type of medication without becoming tolerant
towards it.
Most sleeping pills should be taken between thirty minutes
and one hour before bedtime, so that their effects may usefully persist
throughout the night.
Some sleeping pills are rapidly effective and
short-lasting, and these can be used when a patient wakes during the
night and wishes to fall asleep again as soon as possible.
Non-addictive types of sleeping pills, for example the
non-benzodiazepines, can be discontinued at any time without the patient
suffering withdrawal or side-effects, but many older medications will
require a gradual reduction in dosage before a patient can be weaned
off them.
Most sedatives have the potential to cause both physical
and psychological dependence when taken regularly and for prolonged
periods of time.
In cases of both physical and psychological dependence,
proper medical advice should be sought, and counseling may be necessary.
If you suffer from insomnia, or have any of the classic
signs of sleep deprivation (exhaustion, inability to concentrate,
irritability, slowed reactions), you should seek medical help.
Keeping
a sleep diary may also help you and your doctor to better analyze
the problem and find a solution.
If you do not address the problem,
you are endangering your own health as well as the health of those
around you.
Sleep deprivation and insomnia can lead
to myriad physical and psychological problems.
Sleeping pills are
sedatives taken to assist the sleep process and help people get the
rest that they otherwise would not.
The most common type of drugs used to remedy insomnia are benzodiazepines.
These can be long or short lasting sedatives, the most common forms
of which are temazepam, diazepam, lorazepam, flurazepam, nitrazepam
and midazolam.
Originally developed in the 1960s to treat anxiety,
these drugs nonselectively target receptor sites in the brain that
modulate the effects of the neurotransmitter gamma-aminobutyric acid
(GABA).
Non-benzodiazepine drugs such as Ambien and Lunesta, are a newer kind
of sleeping pills.
These have a short half-life, which means that they
have their sedative effect quickly and are then removed from the body,
which provides relief from insomnia without the next-day ‘hangover’
that some other sleep remedies can cause.
Melatonin is a hormone found in all living creatures, which assists
in the maintenance of the circadian rhythm, or sleep pattern.
It is
commonly recommended as a solution to sleep problems such as insomnia
and jet-lag, but studies indicate that this powerful anti-oxidant may
have many other beneficial effects such as prolonging fertility and
delaying the onset of aging and degenerative conditions.
Some studies
showed that mice which were administered melatonin regularly lived 20%
longer than those which were not.
If you decide to start a course of sleeping pills, it is important
to:
• Educate yourself thoroughly about the drugs available, the potential
side effects, and any interactions with other medications you take.
• Follow directions closely, starting with a very small dose and increasing
gradually.
• Pay attention to your body, emotions, and actions to determine if
any negative side effects are occurring.
• Use the medications intermittently, rather than nightly, in order
to decrease the negative effects and to increase the effectiveness
when you do use them.
Most sleeping pills need to be taken just before bedtime or at
bedtime. This is due to the persistence of their effects over the
course of the night.
Some sleeping pills may be able to be taken
after bedtime, in response to symptoms or awakenings. You should always
follow the manufacturer’s advice when taking sleeping pills.
Newer types of sleeping pills, namely non-benzodiazepines, can be
discontinued immediately without suffering side-effects.
Older remedies,
including benzodiazepines, must be reduced over a period of time to
avoid withdrawal symptoms.
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