Sleep aids (natural or synthetic) are indicated in somnipathy also known as sleep disorders (a medical disorder of the sleep pattern of an individual) which sometimes may interfere with the subject’s physical, mental, social and emotional functioning.
Insomnia (difficulty in falling asleep or staying asleep), sleep apnea (a sleep disorder characterized by pauses in breathing or shallow/infrequent breathing), narcolepsy, hypersomnia (sleeping excessively), cataplexy (a sudden or transient loss of muscle tone while awake) and sleeping sickness (infection-induced disruption of the sleep cycle) are some of the common sleep disorders. Other sleep disorders may include restless leg syndrome, night terrors and bet wetting.
Sleep aids can be can be obtained over the counter and can as well be prescribed (prescription sleeping pills). A good number of over the counter sleep aids are synthetic medications. The best over the counter sleep aids contains a class of drugs called antihistamines. These are usually the best sleep aids owing to their tendency to cause fewer or less dangerous adverse effects.
In spite of the sedative effects of these classes of drugs (antihistamines), tolerance may set in when used for a long time.
Additionally, over the counter sleep aids can have a hangover effect on the subject under its use, that is the person feels malaise and/or groggy the next day. Sleep aids are meant for short term use unless specified and they vary in safety and effectiveness depending on the condition they are used for.
Regarding the use of OTC sleep aids also referred to as over the counter sleep pills and prescription sleep aids, the following should be taken into consideration. They include:
- Side effects: This can be severe and a prolonged feeling of being drowsy may occur the next day; confusion inclusive. Common side effects of the prescription sleeping pills are headache, muscle ache, forgetfulness, constipation, dry mouth, unsteadiness and difficulty in concentration.
- Tolerance: Tolerance (more of the drug concentration will be required to achieve the same effect) to these over the counter sleep pills may occur. More doses OTC sleep aids/prescription sleep pills mean more side effects.
- Dependence: (one will always need to take a particular drug to function normal) and an abrupt stop of these drugs can lead to withdrawal symptoms.
- Withdrawal symptoms: excessive sweating, nausea and shaking may occur.
- Interaction: interaction of a sleep aid with other medications can be dangerous and most at times may worsen side effects. Such interactions as with prescription pain medications and/or other sedatives.
- Can cause a misdiagnosis of an underlying medical problem associated with a subject’s sleep disorder.
- Disorders may become worse than before owing to prolonged use of these pills. Example; “rebound insomnia”.
Sleep disorders can occur after opiate withdrawal (whether cold turkey or dose tapering). Opiates also referred to as narcotics are used as pain medications, cough medications and others. These groups of drugs are usually abused (opiate addiction), hence pose a number of problems after withdrawal.
Common OTC sleep aids include:
Diphenhydramine with brand names Benadryl, Unisom SleepGels e.t.c As sedating antihistamines, the side effects may include dry mouth, blurred vision, constipation, urinary retention, day time drowsiness.
Doxylamine succinate; a sedating antihistamine with brand names Night time Sleep Aid, Unisom Sleep Tablets. Doxylamin cause side effects similar to those of diphenhydramine.
OTC sleep aids are intended for use in short term insomnia some of which are combinations of antihistamines with pain reliever (acetaminophen) with brand names such as Tylenol PM and Aspirin Free Anacin PM. NyQuil is a combination of antihistamine and alcohol.
Prescription Sleeping pills and/or medications can be prescribed in some cases of sleep disorders most of which can either induce sleep in a subject or make the subject stay asleep. They are referred to as the sedative hypnotics. These sleeping pills act by eliciting effect on receptors in the brain which in turn affect the nervous system. As sedative hypnotics, some have a longer half life (effect last longer) while others could be habitual (habit forming).
Examples of prescription sleeping pills are the benzodiazepines (estazolam, flurazepam, quazepam, temazepam and triazolam) and they have higher risk of dependence. Drawbacks in their use may include physical/psychological dependence, tolerance, reduced quality of sleep, hangover and sometimes rebound insomnia.
Newer sleep prescription medications though have similar mechanisms of action, differ in chemical structure, have fewer side effects and are called the non-benzodiazepine sedative hypnotics. They are zalepon, zolpidem and eszopiclone.
The U.S Food and Drug Administration (FDA) at recent gave directives to zolpidem manufacturers and other sleep aids; to reduce the standard dosage owing to the serious risk of morning grogginess while operating machinery (driving) especially in women subjects. Other side effects are tolerance, rebound insomnia, headache, dizziness, difficulty in breathing or swallowing, new or worsening depression, suicidal tendencies and sometimes sleep related behaviors like sleep-driving, sleep-walking, and sleep-eating may ensue.
Melatonin receptor agonist hypnotic sleeping pills: Ramelton (Rozerem); a new sleeping medication acts by simulating the effect of a sleep regulation hormone called melatonin. Its common side effect is dizziness and should be avoided in subjects with severe liver damage.
The following guidelines are vital before a sleeping aid/pill therapy. Inform the doctor about:
- Other drugs you are taking;
- Using the drugs concomitantly with other drugs;
- Previous/existing medical conditions;
- The instructions for minimizing or terminating pill usage.
Subject can stick to the following hints while on sleep aid therapy:
- Take sleep aids/pills when you are about to sleep (night time);
- Read drug label carefully;
- Avoid alcoholic drugs;
- Do not operate machinery after pill therapy;
- Stick to the instructions stated about the medication.
Melatonin supplements, as suggested by studies, can help in treating jet lag or reducing the interval taken before sleep. Side effects may include day time sleepiness and headache.
Valerian: some supplement derived from this plant may be employed as sleep aids. This is classified as a herbal sleep aid and in higher doses may cause vivid dreams, blurred vision, changes in heart rhythm and excitability. Other herbal sleep aids are chamomile, lemon balm, lavender and St. John’s wort.
Cognitive Behavioral Therapy (CBT); a form of psychotherapy can serve as an alternative to sleep aids and/or pills that alleviates ones problem by modifying ones dysfunctional or destructive thoughts, emotions as well as patterns of behavior.
Also, relaxation techniques can relieve stress and achieve a desired resting state and/or sleep.