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Sleeping Pills Overdose

10 Minutes

Edited & medically reviewed by THE BALANCE Team

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CONTENTS

An overdose on sleeping pills occurs when any individual either intentionally or accidentally takes an excessive dose, more than the one prescribed by a health professional, which can result in potentially life-threatening consequences. Thousands of people are hospitalized in the US every year due to sleeping pill overdoses.

An overdose can cause severe respiratory depression, cognitive impairment, and in rare cases, coma or death, which means you should follow dosage instructions and use alternatives whenever possible.

Medications to treat sleep disorders, most commonly insomnia, are called sleeping pills. They are usually taken to induce or maintain sleep, and they come in two forms: Prescription sleeping pills and over-the-counter (OTC) aids. Over-the-counter sleeping pills are usually milder pills, used only for occasional sleep problems, while prescription sleeping pills are usually stronger medications used for more problematic sleeping issues.

Overview Of Sleeping Pills Overdose: Scope Of The Issue

A sleeping pill overdose happens when you take too much of a sleeping pill, either on purpose or by accident. Such an event, if severe, can lead to respiratory failure; coma; in severe instances, death. Sleeping pills overdose has been increasing as more and more people are taking these medications for recreation or self-medication.

Sleeping pill misuse is on the rise in the US. Dependence on these medications has spiked, as more and more people struggle with sleep problems caused by stress, especially after the pandemic, and as a result, we have seen more overdosing. One problem contributing to the ease of accessibility of both prescription and OTC sleeping aids, especially when people use these drugs in combination with alcohol or other substances.

Factors That Increase The Risk Of Overdose

When people take higher doses than the recommended, mix sleeping pills with alcohol, or take them along with another sedative, the risk is higher [1]. A few people may accidentally overdose because they forget that they have already taken a pill, or in extreme cases, use sleeping pills to commit suicide.

Other factors that elevate the overdose risk include:

Tolerance: The more it is used, the more the body needs to have to provide the same effect, which can lead to accidental overdose.

Mixing Medications: When taken with other depressants (such as alcohol, opioids, and anti-anxiety medications), sleeping pills raise the risk of overdose.

Underlying Health Conditions: Overdose of a sleeping pill may make people with respiratory problems or other pre-existing conditions more vulnerable.

Why It Is Important to Follow Prescribed Dosage

Following the doctor’s prescribed dosage or the instructions provided for OTC sleeping pills is important to prevent overdose. Unintentional misuse happens when people think that taking more pills makes them sleep faster or longer. This can be overwhelming for the body and can be dangerous.

Common Prescription Sleeping Pills

Benzodiazepines, non-benzodiazepines (such as Z drugs) and certain sedative antihistamines are prescription sleeping pills.

Some of the most commonly prescribed sleeping pills are:

Benzodiazepines (e.g., diazepam, lorazepam): These tranquilizers are given for short-term insomnia relief and have sedative effects. But they are highly addictive [2].

Z-drugs (e.g., zolpidem, zaleplon): These are newer medicines that target sleep problems and are less likely to cause side effects than benzodiazepines. Although they can be misused, overdose is still possible.

Sedative Antihistamines (e.g., promethazine): Although not originally intended for sleep, they are sometimes prescribed for their drowsiness-inducing effects.

Over-The-Counter Sleeping Aids

The OTC sleeping aids are less potent, but they can still be dangerous when misused.

Common OTC sleep aids include:

Antihistamines (e.g., diphenhydramine): These are often in allergy medications to promote drowsiness. They are popular for occasional insomnia, but not for long-term use.

Melatonin: Melatonin is a natural sleep hormone sold as a supplement that can be used to regulate the sleep-wake cycle [3].

Why People Use Sleeping Pills: Purpose Vs. Misuse

Insomnia or other sleep disorders are the main reasons why sleeping pills are used. However, inappropriate use occurs when people use these medications for anything other than what they are intended to be used for, like for anxiety, stress, or to just escape or get away from emotional problems.

Others, however, take sleeping pills for sedative effects or to enjoy long, uninterrupted sleep on a recreational level. This use increases the chance of overdose especially if used with another substance or with alcohol.

The symptoms of a sleeping pill overdose will depend on the type of medication taken, the amount, and the person’s health. It’s important to spot these symptoms early to prevent serious damage or death.

Physical Symptoms

Severe drowsiness: An overdose can cause extreme sleepiness that is hard to shake off while mild drowsiness is expected.

Slow or shallow breathing: The overdose can cause the breathing to slow dangerously, especially when the brain is so affected that it no longer controls breathing [1].

Unresponsiveness: In bad cases, the person may become unconscious and unresponsive to outside stimuli.

Blurred vision: An overdose may cause problems with your vision, like blurred or double vision.

Loss of coordination: You may become clumsy or uncoordinated with your physical movements [1].

Seizures: Overdose can cause convulsions in some people.

Psychological Symptoms

Confusion: Disorientation, confusion, or delirium can result from overdose.

Hallucinations: An overdose can cause some people to have vivid hallucinations or delusions.

Agitation: Some individuals will react with agitation or anxiety instead of sedation from an overdose.

How Symptoms Can Vary By Medication Type

Overdose symptoms will vary depending on the specific sleeping pill. For example, benzodiazepines can cause severe respiratory depression; Z drugs such as zolpidem can lead to more marked confusion and hallucinations [2]. An overdose of some OTC sleep aids can cause dry mouth, heart palpitations, or dangerously fast heart rate [2].

Physical Health Consequences

Not all sleeping pills overdoses have survived to a complete return to normal health. There are potential long-term effects on physical health, including:

Organ Damage: A lack of oxygen during an overdose can cause permanent damage to vital organs, such as the brain, heart, and lungs. Cognitive deficits, memory loss, and even permanent disability can follow brain injury [1].

Respiratory Issues: Severe respiratory depression during the overdose can lead to some people developing chronic respiratory problems.

Cardiovascular Complications: Pills for sleeping can affect heart rate and blood pressure, and over the long term can lead to long-term cardiovascular issues like heart failure or irregular heartbeats.

Mental Health And Cognitive Function Impact

Other than physical consequences, an overdose can also wield its weight on mental health. Some of these include:

Cognitive Impairment: Cognitive decline has been linked to long-term and particularly high-dose use of sleeping pills. Those who have overdosed may have trouble concentrating or making decisions and may have problems with memory.

Mental Health Disorders: The overdoses are often related to an underlying mental health issue like anxiety and depression or a substance abuse disorder. After an overdose, people can get worse mental health and will need ongoing psychological support.

Emotional Distress: If an overdose was a suicide attempt, surviving an overdose can leave you feeling guilty, ashamed, or traumatized. These emotional challenges may require ongoing therapy and counseling.

Recovery from a sleeping pill overdose takes a long time and usually needs medical and psychological help.

Mechanism Of Action: How Sleeping Pills Affect The Body

The main use of sleeping pills is to slow down brain activity and promote sleep. Benzodiazepines and Z-drugs, both prescription drugs, increase the effects of the brain chemical gamma-aminobutyric acid (GABA) which inhibits certain brain signals and quiets the nervous system. Antihistamines—OTC sleep aids—block histamine receptors, which makes you sleepy. Because melatonin supplements are a copy of the natural sleep hormone, they help regulate the sleep-wake cycle.

If someone takes too many sleeping pills the brain gets far too sedated, slowing down important functions like breathing heart rate, and blood pressure. Excessive sedation from this drug can cause serious, life-threatening conditions such as respiratory depression, coma, and death.

The Body’s Response To Overdose: Short-Term Effects

When someone overdoses, the body very quickly shuts down vital functions — especially those controlled by the central nervous system. Some of the short-term effects of a sleeping pills overdose include:

Respiratory Depression: The brain may not be able to tell the lungs to breathe properly, and breathing may become dangerously slow or shallow. This can reduce the oxygen going to vital organs, causing hypoxia and leading to brain damage.

Decreased Heart Rate: Sleeping pills slow heart function, causing irregular heartbeats (arrhythmias) or heart failure.

Loss of Consciousness: In severe overdose, the person may go to sleep deeply and unresponsively, or even into a coma.

Seizures: Sometimes sleeping pills, especially at high doses, can contribute to seizures, as the electricity of the brain becomes unbalanced.

Coma or Death: An overdose, if left untreated, can lead to coma or even death by failure of the organs in particular from lack of oxygen due to respiratory depression.

The degree to which these short-term effects occur depends on the dosage taken, what type of sleeping pill is taken, and if other substances (such as alcohol or opioids) are involved.

First Aid Steps For Recognizing An Overdose

If you recognize a sleeping pill overdose early and act quickly, you can save a life. Here are some critical steps to follow if an overdose is suspected:

Check Responsiveness: Try to wake the person up by speaking loud or lightly shaking them. This could be a serious overdose if they don’t respond.

Monitor Breathing: To see how they are breathing; look to see if they are breathing slowly, sometimes, or not at all. Stops breathing or shallow breathing are signs of overdose.

Call Emergency Services: If you suspect an overdose, dial emergency services straight away. Tell them all about the sleeping pill you took, the dosage, and any other substances that were part of it.

Perform CPR (if needed): If the person isn’t breathing or their heart has stopped, and you are trained and it is safe to do so, begin CPR.

Position the Person Safely: Place the person in the recovery position (on their side) if they are unconscious but breathing so they don’t choke if they vomit.

When To Seek Medical Help: Urgency And Importance

A sleeping pill overdose is a medical emergency. If the person looks stable, even then you should get them medical help because the situation can worsen quickly. Medical professionals can administer life-saving treatments, such as:

Activated Charcoal: In some cases, this can be used to absorb the excess medication before it actually enters the bloodstream [2].

Intubation and Ventilation: If the person’s breathing becomes so slow that they are likely not getting oxygen to the brain and other organs, they may need to be placed on a ventilator to assist breathing.

Flumazenil: Although its use requires close monitoring to avoid seizures, this is an antidote for benzodiazepine overdose.

Early medical intervention can prevent long-term damage and the possibility of recovery.

Safe Practices For Taking Sleeping Pills

Safe practices when taking sleeping pills should be adopted to prevent sleeping pills overdose. Key steps include:

Follow Prescribed Dosages: You should always take the exact dosage that your healthcare provider prescribes. Don’t take more of this medicine or use it more often without medical advice.

Avoid Mixing Medications: Sleeping pills should not be mixed with other sedatives (such as alcohol or drugs that depress the central nervous system) as the risk of taking too much is greatly increased.

Limit Long-Term Use: Sleeping pills are prescribed for short-term use. If you have insomnia that persists, talk to your doctor about other treatments that won’t result in dependency or tolerance buildup.

The Role Of Healthcare Providers In Preventing Overdose

Patients can learn from healthcare providers about the risks of sleeping pills and whether to take them. Doctors should:

Assess for Risk Factors: Healthcare providers should not prescribe sleeping pills unless they consider the patient’s history of substance abuse, mental health conditions, and other medications a patient may be taking.

Regularly Review Prescriptions: Long-term sleep medication users need to keep in touch with their doctor regularly to avoid misuse and detect dependence.

Provide Alternative Solutions: Healthcare providers should instead speak with patients about other treatments for sleep disorders, like using cognitive behavioral therapy (CBT) or making lifestyle changes.

Consider Alternatives To Sleeping Pills

Sleeping pills can be helpful under some circumstances but aren’t a long-term solution for chronic insomnia or other sleep disorders. Several alternative methods can promote better sleep without the risks associated with medication:

Cognitive Behavioral Therapy for Insomnia (CBT-I): A structured program of CBT-I helps people to change negative thoughts and behaviors related to sleep. A very effective long-term treatment for insomnia and does away with the need to take sleeping pills [3].

Sleep Hygiene: One of the best ways to overcome sleep problems is to develop good sleep habits. This includes:

Consistency with your sleep schedule
Making the sleeping environment comfortable
Not spending too much time on screens before bed.
Cutting back on Caffeine and Alcohol consumption
Reading or meditation before going to bed

Exercise: Physical activity that is regular can help to reduce stress and regulate the body’s internal clock thus helping sleep improve. But it’s best not to engage in vigorous exercise just before bed.

Mindfulness and Relaxation Techniques: Anxiety and stress can be reduced and we can fall asleep more easily by doing things like meditation, deep breathing, and progressive muscle relaxation.

Herbal Remedies: Natural remedies such as chamomile, valerian root, and lavender help some people get some relief from their sleep disturbances. These should however be used cautiously and under the supervision of a healthcare professional because they may interfere with other medications.

1. Very Well Health. Can You Overdose on Sleeping Pills? https://www.verywellmind.com/the-danger-of-sedative-overdose-66578

2. Cleveland Clinic. Sleeping Pills. https://my.clevelandclinic.org/health/treatments/15308-sleeping-pills

3. WebMD. Understanding the Side Effects of Sleeping Pills. https://www.webmd.com/sleep-disorders/understanding-the-side-effects-of-sleeping-pills

FAQs

Could Sleeping Pills Provoke Allergic Reactions That Look Like Overdose Symptoms?

Yes. Some people may have severe allergic reactions to sleeping pills that mimic overdose symptoms. Possible reactions to these drugs can include difficulty breathing, swelling of the face, lips, tongue, and throat, and extreme drowsiness. These symptoms could easily be confused with an overdose, but they are an allergic reaction that needs to be treated immediately. Look for possible allergic reactions on the medication label and see a doctor if any symptoms occur.

Do Sleeping Pills Affect People With Pre-Existing Medical Conditions Differently During An Overdose?

Those with known medical conditions, such as asthma, chronic obstructive pulmonary disease (COPD), heart disease, or liver or kidney disorders, may be at greater risk of complications from a sleeping pills overdose. For example, people with respiratory problems tend to have more serious respiratory depression than others, and those with liver problems tend to metabolize the drugs more slowly, increasing the chance of overdose. People with such conditions must be under strict medical supervision when they use sleeping pills.

Can You Get An Overdose From Suddenly Stopping Sleeping Pills?

Stopping the use of sleeping pills suddenly, and especially after long-term use, can cause withdrawal symptoms such as insomnia, anxiety, and agitation. Because these symptoms may cause some people to take higher doses than is recommended to get over it, there is a danger of overdose. However, under a doctor’s guidance, it is very important to gradually taper your sleeping pills to avoid such risks and to do so safely.

How Do Interactions Between Sleeping Pills And Food Impact The Risk Of Overdose?

Some sleeping pills can be enhanced or reduced in their effects depending on how they interact with some foods and beverages. Drinking alcohol or grapefruit juice while taking sleeping pills can raise the sedative effects, increasing the risk of overdose. However, contrary to that, taking pills with food sometimes slows the absorption of pills, and people sometimes believe the initial dose was not effective and take more pills. When using sleeping pills, it’s important to follow prescription guidelines on what food and drink to have.

HOW THE BALANCE CAN HELP WITH Sleeping Pills

The Balance RehabClinic is a leading provider of luxury addiction and mental health treatment for affluent individuals and their families, offering a blend of innovative science and holistic methods with unparalleled individualised care.

Sleeping Pills Overdose

Overview Of Sleeping Pills Overdose: Scope Of The Issue

Factors That Increase The Risk Of Overdose