Frequently Asked Questions About Sleeping Aid Medications
1.What is a sleeping aid?
The modern era and the changes that have occurred in society over the last 50 years have led to an increased demand for sleeping aids. Firstly, it is important to define what is meant by a sleeping aid. In this context, a sleeping aid is anything that is ingested, which is taken specifically to improve the quality of sleep or to increase the amount of sleep. This covers a broad spectrum of preparations ranging from prescriptions and over-the-counter medications to herbal or alternative remedies. In addition to the medications, there are various types of equipment and technologies, which will be covered later, that are also made to help sleep improvement. It is estimated that between one third and one half of the population suffers from insomnia or other sleep-related conditions. This means that potentially billions of people worldwide could be considered candidates for trying some form of sleeping aid. This paragraph is important as it highlights sleep disorders that may need proper medical attention and defines a sleeping aid as something to improve sleep quality or quantity. It also reinforces the fact that there is a high demand for sleeping aids in the modern day.
One general issue that is evident with sleeping aids is the lack of public understanding and education. This applies not only to sufferers of sleep disorders but also to the general population. A great number of people who have no problems with their own sleep are still unaware of what a sleep disorder actually is and what the impact or implications can be. An example of this would be the expression "If I can sleep any more, I will grab some of that medication from the doctor" that is often used flippantly. This indicates that someone who is not clearly familiar with the concept of what a sleeping aid is or the drugs that are used to induce sleep. It is important to note that there are a great variety of sleep disorders, and there is no one-size-fits-all treatment. The lack of understanding can also lead to skepticism; the "I'm not a drug person" syndrome when faced with taking medication. This sort of attitude can prevent sufferers from both trying and getting the correct treatment. Overall, this paragraph emphasizes that there is currently an educational void in the area of sleep disorders and their treatments, and that this could be an inhibiting factor for taking a sleeping aid.
2.How do sleeping aids work?
The first group of sleeping pills is the benzodiazepines. These work on a specific chemical system in the brain which reduces anxiety and promotes sleep. Tablets such as temazepam and nitrazepam (brand names Temaze and Mogadon) have been prescribed for many years and are effective at promoting sleep. But they can have a hangover effect and may affect sleep quality by reducing the amount of rapid eye movement (REM) sleep. This is the type of sleep when you dream and is thought to be important for memory. Benzodiazepines can be useful for the treatment of severe anxiety or agitated depression so they may be more suitable for people whose insomnia is secondary to emotional illness. But doctors are often reluctant to prescribe them and they are recommended to be used in conjunction with other non-drug treatments such as CBT. Flunitrazepam (brand name Rohypnol) is a short-acting benzodiazepine that was initially used as a hypnotic, but is now prescribed only for the treatment of severe or refractory insomnia. It is no longer available in many countries, but may be obtained on prescription in others. Due to its highly addictive potential and the amnesia it can cause, it has been associated with the abuse of alcohol and is used as a date rape drug.
How do sleeping aids work? There are four primary types of sleeping aids, ranging from those that treat direct medical causes of insomnia such as sleep apnea, to those that reduce symptoms like early waking or disturbed sleep. Most sleeping pills work on the brain to promote drowsiness or sleep. Some are more selective for certain brain chemicals that promote sleep, and others are more general in their effects. Most medications can be used on a short or longer-term basis, depending on individual needs.
3.Can I become dependent on sleeping aids?
Yes. The risk of dependency must always be considered in the decision to use hypnotic medication. This is particularly important where an individual is considering long-term use of medication for chronic insomnia. Though not all patients who take hypnotics develop an addiction to them, hypnotics have a higher potential for abuse than most other types of prescription medications. This is because their intended effect, CNS depression and induction of sleep, is similar to the effects of many medications and substances that are used recreationally. The risk of hypnotic abuse increases in combination with abuse of other substances. Individuals with a personal or family history of alcohol or drug abuse and/or depression are at higher risk of hypnotic abuse.
4.Are sleeping aids safe to use?
5.Can sleeping aids help with insomnia?
6.Can sleeping aids help with insomnia?
Most sleeping aids are designed to help with staying asleep rather than getting to sleep. There are some exceptions. If a person has insomnia, the following is a guide to the main issues to consider when choosing whether to use a sleeping aid. Insomnia has many causes. A medication might only need to be used for a short time until the insomnia resolves. Otherwise it may need to be used long term, or on-and-off to troubleshoot episodes of poor sleep. It is important to identify and if possible treat the causes of the insomnia. If these are circumstantial, such as a bereavement or moving home, the insomnia may resolve on its own. Short-term use of the sleeping aid is best in this situation. If the causes are complex, such as chronic pain, anxiety and depression, or primary sleep disorders, the sleeping aid might be started before these are well treated, and continued until the sufferer judges that sleep is adequate, or until he is in a position to reduce the aid and see how things go without it.
The sedative hypnotic drugs are effective for inducing sleep, but it is the quality of sleep which is more important in determining how refreshed and restored a person feels afterwards. Some people with chronic insomnia say that the sleep is worsened for a few days whenever they try reducing their sleep medication. They suspect that their normal sleep pattern is being disrupted, and studies have often shown that sleep medication does indeed alter the balance of different stages of sleep, and sometimes reduce the time spent in REM sleep.
7.Are sleeping aids safe to use?
8.Can I become dependent on sleeping aids?
Users may begin to feel anxious or restless when they do not take the medication and find it difficult to revert back to their regular sleeping pattern. Others may not be able to sleep at all without the medication and find the return of a normal sleeping pattern very difficult. The best way to avoid a dependency is to use sleeping aids on a short-term basis only and take them according to the instructions. When used correctly, sleeping aids can be a very effective short-term solution for insomnia. It is often a good idea to discuss the use of sleeping aids with a doctor, who can determine the cause of the insomnia and decide whether the use of medication is the best way to treat it. Doctors are able to prescribe a vast number of medications that are not available over the counter and can help to select a medication that is suitable for the individual and less likely to cause a dependency.
Sleeping aids can be habit-forming and create a dependency if they are not taken properly. This can happen to people who have used sleeping aids and found they help to improve their sleep. After prolonged use, the body may develop a tolerance to the medication, and the same dose may not be effective at improving sleep. At this point, some users may increase the dose they are taking or change to a more potent form of the medication, and this may lead to an increase in the severity of the dependency.
9.How long should I take a sleeping aid?
It is best to avoid giving children medications to help them sleep unless it is absolutely necessary. There is very little information about the safety and effectiveness of sleeping aids in children, and in general, their use is not recommended. A much better alternative is to talk to your children about their fears and concerns about the accident. After a traumatic event such as a car accident, children are at risk for developing a variety of anxiety and mood disorders. Open lines of communication with parents have been shown to be one of the best preventative factors for children developing such problems.
My young children were recently in a car accident. They were both shaken up, though neither had any injuries that required hospitalization. They have been having trouble falling asleep and keep waking up from nightmares about the accident. What is the best way to help them sleep without increasing their risk of developing sleep problems in the future?
How long should I take a sleeping aid? You should use sleeping aids for the shortest time possible. It depends on the type of sleeping aid you are using. There are several types of sleeping aids such as hypnotic medications, antidepressants, and over-the-counter sleeping aids. Usually, hypnotic medications are used for weeks to months, while antidepressants are usually used for at least 6 to 12 months. Over-the-counter sleeping pills, such as Nytol/antihistamine, might be useful and short-term, and are best used on an occasional basis or when traveling. If you are taking sleeping aids and you feel that you are still not able to sleep, then it would be best to seek help from a professional to seek alternative methods of managing sleeping problems.
10.Can I take a sleeping aid while pregnant or breastfeeding?
Most sleeping medications have not been tested for safety on an unborn baby. The potential danger for pregnant women who take sleep aids is the risk of birth defects or complications with the pregnancy. It is recommended that pregnant women avoid all medications if possible. For some pregnant women who suffer from sleeplessness, resorting to over-the-counter or prescription sleep aids may seem like the only way to get a good night's sleep. However, it is important to look at the underlying cause of the sleep problem and try other remedies first. Developing good sleep habits (also known as sleep hygiene) and dealing directly with any anxiety or depression are excellent ways to make positive changes in sleep.
Breastfeeding mothers should also avoid sleep medications, as they are often transferred into the breast milk. For example, small amounts of hypnotic sleep aids may be transferred and can cause sedation in the baby. It is also possible that the ingredients in a sleep aid can cause an allergic reaction in a baby. Remember that changes in the mother's diet can affect the infant as well. Always consult with your doctor first before taking any medication as a mother who is pregnant or breastfeeding.
11.What factors should I consider when selecting a sleeping aid?
12.Are there any natural alternatives to sleeping aids?
Melatonin supplements can be a natural alternative to prescription sleeping pills. Melatonin is a hormone related to the regulation of the sleep-wake cycle. This hormone is obtained as a relief and has been investigated as a sleeping aid for several conditions. It has been useful for many other conditions and there is a substantial amount of evidence to support that melatonin is beneficial in treating shift work-related sleep disorders, such as jet lag.
The pitfall of its use is its limited effectiveness as a long-term sleeping aid and in the UK it is not available on prescription but instead can be bought at formal supermarkets and health food stores. A warm tea or a high warm extract in the evening may be a relaxing alternative to a sleeping medication. Warm extracts and decaffeinated teas that contain a non-vegetative amino acid called theanine may help to promote anxiolytic effects and improve drowsiness. Recent research suggests that green tea extract and theanine promote relaxation and reduce stress and result in an improvement in the quality of restful sleep.
Several herbal products are used as sleeping aids, which include chamomile, valerian, hops, and passionflower. Chamomile is a flowering plant that originated in Europe and Asia. The flowers from the Chamaemelum nobile plant are used to make teas that have been used for many years to help promote relaxation and reduce anxiety. German chamomile contains certain compounds that bind to nerve receptors in the brain to produce anxiolytic effects and aid in sedation for restful sleep.
13.What are the side effects of sleeping aids?
14.Can I take a sleeping aid with other medications?
It is also important to know that sleeping aids will increase the effects of alcohol and certain medications. Sleeping aids should never be mixed with alcohol, antidepressants, pain relievers, anxiety medications, or antihistamines. If you do, it could lead to excessive tiredness, confusion, and a decreased heart rate or breathing which could be very dangerous and even fatal. Always be aware of the side effects and interactions of your other medications and the sleeping aid you have or wish to take.
If you are considering taking a sleeping aid and also take other medications, it is recommended that you first consult with your doctor, physician or pharmacist. It is important to choose a sleeping aid which will not interfere with your other medications. Some sleeping aids are a combination of an antihistamine and a decongestant, so you should always check with your pharmacist or doctor before taking these as they may interfere with other medications. If you are taking sleeping aids and your other medications at different times, it is best to take the sleeping aid closer to bedtime, as to decrease the chance of it interfering with the other medications.
15.What are some lifestyle changes that can improve sleep?
Establishing a regular, relaxing bedtime routine can be an important first step. Relaxing before bed is key, so try to avoid emotionally upsetting conversations and activities. This is not the time to bring up an issue with your adolescent teenager or to chat about your finances. Watching television should be avoided because it is overly stimulating to the brain. Keep work materials, computers, and televisions out of the bedroom so that the bedroom becomes a place only to relax and sleep. Try reading a calming book or listening to some calming music. If your child has a clico or infantile spasm syndrome, we want to take specific care that they are not getting activated or upset right before bed. The first half of the day would be a better time to work on coping with recent changes in medication, so that by bedtime the child can relax.
Physical activity is stimulating, so try to make sure your child has regular daily exercise. But try to schedule the exercise in the morning or afternoon. This one change could make a big difference in the ability to fall asleep at night. But don't let your child exercise too close to bedtime because it can be stimulating and counterproductive. A couple of hours before bedtime, try giving your child a warm bath. This will help the body reach the temperature optimal for sleeping, as it will then cool down and help induce sleep.
16.How can I establish a bedtime routine?
Some time-honored bedtime routines can help you fall asleep more easily. Begin by setting aside some time to relax before going to bed, and then follow some of these practices: Try a light snack.
Warm milk and foods high in the amino acid tryptophan, such as bananas, may help you to sleep better. Try these snack ideas an hour or so before going to bed.
Try relaxation exercises.
Relaxation exercises, or calming activities can improve sleep. For some people, listening to music and exercise in aroma therapy by using essential oils or candles help to improve sleep.
Use the bedroom only for sleeping and sex.
By not eating, reading, watching TV or working in bed you will strengthen the mental association between bed and sleep. This can make it easier to fall asleep.
17.Are there any relaxation techniques that can aid sleep?
The most well-known and regularly practiced technique is progressive muscle relaxation in which muscle tension is released by first tensing then relaxing muscle groups. This technique has been shown to be effective when measured by sleep-onset latency, total sleep time, number of awakenings and improved self-report of sleep. PMR was also combined with autogenic training and analgesia in a study comparing the addition of a hypnotic drug and a placebo with 20 insomnia patients over 18 sessions. This combined technique produced similar effectiveness in helping patients fall asleep, stay asleep through the night and feel better in the morning. A further enhanced application of the technique was to divide 22 older adults with late-life insomnia into a PMR only group and a combined group in order to teach the combined group to cope with general life stress and stress specifically pertaining to insomnia. Completion of a 6-week sleep diary between groups favoured the combined group in wake time after sleep onset and a trend favouring the combined group in total sleep time. A placebo technique (body scan relaxation) has been found to be inferior to PMR; too few CBT studies use relaxation techniques and there is insufficient evidence the technique is substantial in treating insomnia.
Currently, cognitive-behavioural therapy (CBT) is the most effective treatment for insomnia. However, an understanding of relaxation techniques may be an important part of the treatment process and they may also have a role as a stand-alone treatment for subclinical insomnia. Relaxation techniques are generally considered to be most effective when used regularly as a bedtime routine, and can take between 1-20 weeks to become effective according to the intensity and nature of the sleep problem. At least ten controlled trials have been conducted on progressive muscle relaxation.