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The truth about sleeping pills for insomnia

Sleeping medication is often used to 'treat' acute bouts of insomnia. But just how helpful is it really?


Some medications can be bought from a pharmacy and induce drowsiness, such as antihistamines or medications with natural ingredients (melatonin, lavender, etc). Other more powerful medication is prescribed by a doctor.


Historically, benzodiazepines were prescribed for insomnia but they have been found to be highly addictive and it is easy to become dependent on them. Now, some medications can be bought from a pharmacy and induce drowsiness, such as antihistamines or medications with natural ingredients (melatonin, lavender, etc). Other more powerful medication is prescribed by a doctor, these are 'Z-drugs' such as zopiclone or zolipdem.


How do sleeping pills work?

Z-drugs such as zopiclone and zolpidem are hypnotics. This means they affect our brain activity, increasing the feeling of sleepiness and altering sleep stages.


When we sleep, although we are unresponsive, our brains are active. Our brains cycle through four different sleep stages; N1, N2, N3 and REM (rapid-eye movement). Each stage has a different function and if we have enough of each, the combination of all four stages allows our body to wake up naturally in the morning feeling mentally and physically rejuvenated. Sleeping medication such as zopiclone and zolpidem are sedatives. They reduce brain activity which causes the initial sleepiness, but whilst you are asleep your brain is less able to cycle through all of the different processes it needs to function healthily.


Sleeping medication increases the amount of N2 and N3 sleep and decreases the amount of REM sleep you get. Because of these changes, you may feel that you have a much deeper sleep and are less responsive or alert to the external environment. Although sleeping medication may send you to sleep quicker by reducing your brain activity and making you feel sleepy, it acts like a tranquiliser and will not be allowing your brain the functions it needs and so you may continue to wake up feeling tired or groggy despite sleeping for more hours.


Generally, sleeping medication begins to make you feel sleepy within an hour of taking it and so it is recommended to take it just before bedtime. The drugs are designed to make you fall asleep quicker but their effects don't always last long and many people find that they continue to wake up several hours after taking them, in the middle of the night (sleep maintenance insomnia).


Are sleeping pills dangerous?

Z-drugs such as zopiclone and zolpidem are much less addictive than benzodiazepines which are no longer advised for the treatment of insomnia. However, the body can become dependent on them and after a period of time, you may have to increase the dose to have the same effects. For this reason, sleeping medication is only recommended as a short-term treatment for insomnia.


Because sleeping pills and similar medication affects how the brain works, they are considered hypnotics. You should not drive or operate machinery for at least eight hours after taking sleeping medication, and you should take regular breaks to assess how alert you feel throughout the day.


You should avoid drinking alcohol or taking other sedatives if you are using sleeping medication. This is because the effects on the brain are magnified and behaviours such as sleepwalking are increased. Sedatives reduce central nervous system activity and although you may feel asleep, your brain activity reduces and it is similar to being unconscious rather than reaping the restorative benefits of sleep.


Should I take sleeping pills to help my insomnia?

Although still commonly prescribed for the treatment of sleeping difficulties, it's important to do some research before taking any medication. As a short-term solution, sleeping medication is proven to increase sleepiness and help you get to sleep faster. However, it does not solve the underlying cause of your insomnia. The most effective treatment for long-term insomnia and getting to the bottom of why you are not sleeping well is cognitive behavioural therapy for insomnia, or CBTI.


CBTI is drug-free, it helps you to understand why you have insomnia and provides you with the tools to resolve those underlying problems. CBTI can be completed over a course of several weeks, giving you the time and support to work through the underlying cause of your insomnia and prevent it from coming back in the future. Because of its proven effectiveness, cognitive behavioural therapy for insomnia is now recommended by clinical guidelines as the first line treatment for sleeping difficulties.


Interested in finding out how CBTI could work for you? Get in touch for a free sleep consultation.