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Sleeping Pills Side Effects

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Edited & medically reviewed by THE BALANCE Team

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CONTENTS

Insomnia is very often dealt with sleeping pills, and the side effects can vary from mild to serious, affecting both physical and mental health. Overreliance on these drugs can lead to falls, memory problems, and even dependency, so it’s important to know the risks. Though it works in the short term, sleeping pills are not a reliable cure for all sleep disorders.

Sedative hypnotics (sleeping pills) are medications used to treat sleep disorders, most commonly insomnia. These act by targeting the central nervous system, slowing down brain activity to induce relaxation and make you sleep. Most of these pills are benzodiazepines (e.g., temazepam), non benzodiazepine hypnotics (e.g., zolpidem) or melatonin receptor agonists (e.g., ramelteon). Each class works differently, but all aim to achieve the same goal: It helps to facilitate a restful night’s sleep.

There are sleeping pills that are meant to be used over a short period to treat acute sleep disturbances, and then some are prescribed for more lengthy issues. But they work and are safe in different ways for different people, depending on factors like age, overall health, and the reason for sleep problems.

Why Sleeping Pills Use Is On The Rise

Insomnia is the most common reason people take sleeping pills. Millions of people around the world suffer from insomnia, and it can be caused by stress, anxiety, or other medical conditions such as chronic pain or depression.

Sleeping pills may also be used by shift workers or frequent travelers, to help combat jet lag or shift work disorder. Moreover, sleeping aids may be offered to other individuals who have some specific medical problems such as restless leg syndrome or obstructive sleep apnea.

Though sleeping pills are effective in bringing sleep, they often have physical side effects. The most common problems are dizziness, daytime drowsiness, and a prolonged feeling of grogginess (a “hangover effect”). Dry mouth, headaches, and gastrointestinal upset (ie, nausea or constipation) are other possible side effects.

The side effects of these drugs may be different for men and women. For example, studies indicate that women metabolize sleeping pills more slowly than men, and so women often have a stronger reaction to the effects of sleeping pills. The difference can put you at greater risk of next-day drowsiness or impaired alertness.

Psychological Side Effects: Short-Term Impacts

Psychological side effects include confusion, memory problems, or difficulty concentrating in older adults. In some cases, some sleeping aids cause users to wake up at night, and experience vivid dreams or nightmares, particularly after the drug’s effects wear off.

More concerning psychologically are parasomnias—abnormal behaviors during sleep. Sleepwalking, sleep driving, or doing other activities while not fully awake, and not remembering it afterwards are some examples. While sleeping pills have rare but serious effects, these pose great risks to one’s safety, which mandates that sleeping pills are only to be used with medical supervision.

How Prolonged Use Can Affect Your Physical Health

Sleeping pills can help to temporarily get better sleep but continued use can cause serious health risks. The most worrisome physical side effect is that you may become dependent on these drugs. The increasing amounts of potent synthetic compounds required to get an effect over time raise the chance of overdose or other adverse reactions.

Sleeping pills have also been linked to respiratory problems in regular users, especially for those with preexisting problems such as asthma, obstructive sleep apnea (OSA) or chronic obstructive, pulmonary disease (COPD). Some medications can suppress breathing during sleep, making these breathing problems worse. In addition, long-term use could hamper your immune defenses, making your body less able to fend off infection.

Other risks include a greater risk of falling and fracturing, especially among older adults. It’s because of the sedative effects that linger on the day after, potentially acting as a hindrance to balance and coordination. There is evidence that chronic use of sleeping pills elevates cardiovascular risk, primarily through an increased chance of a heart attack or irregular heart rhythm [2].

Are Sleeping Pills Bad For Your Brain

Another impact of long-term sleeping pill use is its negative effects on brain health. Long-term use has been linked to cognitive decline, memory problems, and an increased chance of dementia in older people. Frequent use of benzodiazepines and other drugs of the same class may interfere with normal brain activity and interfere with the brain’s ability to form and retain memories [1].

Sleeping pills are thought to interfere with our natural sleep cycle if we use them on a chronic basis, and decrease the restorative benefits of deep sleep. It can disrupt cognitive functioning and mood as well as overall mental well-being. Those who take sleeping pills over a longer period may feel more anxious, depressed, or emotionally unstable, and must once again take this care with these kinds of medication and only if their doctor recommends that they do.

Maternal Health Risks

Sleeping pills can have special risks for pregnant women. Many sleeping medications pass through the placental barrier and could affect the mother and the developing baby. Expectant mothers may experience common side effects, such as increased drowsiness, dizziness, and nausea. They can impair daily functioning and put you at risk for accidents, such as a fall.

Also, some sleeping pills, such as barbiturates and benzodiazepines, can become habit-forming in the mother if taken often during pregnancy. The withdrawal symptoms that occur if the medication is suddenly stopped can complicate childbirth and postpartum recovery.

Effects On The Developing Baby

Sleeping pills can have a major impact on a developing fetus. Some medications are thought to increase the risk of congenital abnormalities, especially if taken in the first trimester. Some links have also been made to exposure to sedatives during pregnancy with low birth weight, preterm birth, and developmental delays [3].

Sleeping pills at later stages can cause neonatal sedation or withdrawal symptoms in newborns if given during pregnancy. For example, babies who have been exposed to benzodiazepines in the womb may be sedated, and have trouble breathing or feeding after birth.

However, given the risks involved, healthcare providers often recommend trying nonmedical sleep aids during pregnancy. Although sleeping pills may sometimes be necessary, they are only prescribed where it is judged to be essential, and in the minimally effective dose for the shortest time to minimize potential harm.

Which Sleeping Pills Are The Most Harmful

Not all sleeping pills are the same and some pose much higher risks than others. Barbiturates, an older class of sedatives, are among the most dangerous because their effects are very strong. While their use is diminishing, these pharmaceuticals are still prescribed in the rarest of cases and abuse can result in serious problems, such as respiratory depression and coma.

Risks also are notable with benzodiazepines such as diazepam (Valium) or lorazepam (Ativan). Although short-term use of these drugs rarely causes serious side effects, these drugs can cause dependence, withdrawal symptoms, and cognitive impairment when misused or used for longer periods. Even the safer non-benzodiazepine medications, such as zolpidem (Ambien) or eszopiclone (Lunesta) have the potential to cause next-day drowsiness, parasomnias (such as sleepwalking), and impaired judgment, especially when taken in higher doses than prescribed.

That being said, over-the-counter (OTC) options, such as diphenhydramine (found in Benadryl or some sleep aids), are also not risk-free. Long-term use of these drugs can cause side effects including problems with memory and confusion and increased risk of falling, especially in elderly people. In addition, these medications are often thought of as ‘safe,’ causing people to accidentally use them in large doses as well.

Overdose And Severe Reactions: What To Watch For

Sleeping pills are a big overdose concern when combined with other depressants such as alcohol or opioids. Symptoms associated with an overdose include extreme drowsiness, shallow respiration, and unconsciousness in severe cases.

Some sleeping aids cause severe allergic reactions, though they are rare. A severe rash, difficulty breathing, or swelling of the face or throat require immediate medical attention.

Another important risk is drug interactions. Most sleeping pills can react with other medications, for example, antidepressants, and antihistamines, resulting in exaggerated sedation and perhaps dangerous side effects. However, it is always important to speak with a healthcare provider to check that a single use is safe, particularly if you have a health problem or are on other substances.

Sleeping Pills: Medical Conditions And Situations To Avoid

Certain medical conditions make sleeping pills especially risky. For example, people with sleep apnea should usually avoid sedatives because they can make breathing problems during sleep worse. Just as with substance abuse or addiction, those with a history of addiction are more likely to become dependent on sleeping pills too.

Another group at risk from sleeping pills is older adults. People older than 65 have age-related changes in metabolism, and thus are more sensitive to medications, which gives them greater rates of also having grogginess, confusion, and fall risks. As mentioned earlier, pregnant women should use sleeping pills only with great caution, because they can be harmful for both mother and baby.

Never mix sleeping pills with alcohol or recreational drugs as this can dramatically increase the chance of an overdose, or of nasty side effects. Even with prescription medications, you need to review them to make sure you’re not going to interact with other drugs that will increase sedative effects or make it not safe to stay awake.

Non-Medical Sleep Aids And Behavioral Therapies.

Nonmedical sleep aids and behavioral therapies are usually effective for those looking for safer alternatives. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a tested approach that educates individuals on how to recognize and alter thoughts and offers strategies that improve rest.

Even simple things such as getting into a regular sleep routine, limiting the amount of caffeine and screen time just before bed, and establishing a relaxing wind-down time can help. It’s also good to know that natural remedies such as melatonin supplements, herbal teas (such as chamomile), meditation, or deep breathing exercises can help you feel better without the risk of the side effects that go with medication.

If you have chronic or severe sleep problems, the best thing to do is work with a healthcare provider to create a personalized plan that involves the least amount of medication and promotes long-term sleep health.

How To Identify Dependency And Misuse

It is easy to become dependent on sleeping pills, sometimes starting with occasional use to help you sleep through a sleepless night. The fact is over time individuals may require higher and higher doses to achieve the same effect, a clear indicator of tolerance. It is a dependency because you rely on the medication to fall asleep and have withdrawal symptoms when you try to stop. Rebound insomnia, anxiety, irritability, or even physical discomfort may be among these symptoms.

One more red flag is to use of sleeping pills for a purpose other than intended, including the use of pills while awake for relaxation or taking the pills with other substances like alcohol. Equally concerning is emotional dependency, in which the person can’t function without the medication.

How To Safely Stop Taking Sleeping Pills

Never quit sleeping pills abruptly, especially if you’ve been taking them for a long time. Withdrawal symptoms can occur when you stop suddenly, including severe insomnia, agitation, or rare seizures. The safest way to get off this stuff is through a gradual taper under an experienced healthcare professional.

For people with very serious dependency medical detox programs can provide further support. With supervised environments, these programs help to carefully monitor the withdrawal symptoms and can assist with appropriate care to reduce the risk of complications during withdrawal.

Since behavioral therapies are proven to work quicker than medications and are considered safer, they hold a very important place in recovery — Cognitive Behavioral Therapy for Insomnia (CBT-I) teaches sustainable techniques for healthy sleep on a medication-free basis. For people seeking recovery, ‘support groups’ online and offline can also be an important source of both emotional encouragement and practical advice from those who have gone through what they’re going through.

If you are worried about continued side effects from sleeping pills, you need to speak to a healthcare provider. This will assist in identifying the underlying health issues and making strategies to bring back holistic well-being.

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

2. Mayo Clinic. Prescription sleeping pills: What’s right for you? https://www.mayoclinic.org/diseases-conditions/insomnia/in-depth/sleeping-pills/art-20043959

3. Everyday Health. 6 Risks to Know About Before You Take Sleeping Pills. https://www.everydayhealth.com/news/risks-taking-sleeping-pills/

FAQs

Do Sleeping Pills Cause Allergic Reactions?

Some people can have allergic reactions to sleeping pills, but that’s rare. Allergic reaction symptoms could include itching, rash, swelling, dizziness or trouble breathing. Certain medications (such as zolpidem or benzodiazepines) can increase your risk of experiencing these reactions, and you should seek immediate medical attention. Before you start a sleeping pill, it’s important to tell your doctor about any allergies.

Do Sleeping Pills Affect Your Heart Health?

Certain sleeping pills — most notably those in the benzodiazepine or sedative-hypnotic class — can affect the heart. They can lower heart rate and blood pressure, which could be unsafe for people with existing heart problems. Use of some sedatives for a long time may also raise your risk of arrhythmias (disturbing the heartbeat rhythm), but this varies depending on the drug and dose.

Are Sleeping Pills Addictive To Short-Term Users?

Even short-term use of powerful sleeping pills can result in psychological dependence, even though this is more common with long-term use. After a few weeks, people may start to think they can’t sleep without the medication. This highlights the need to stick exactly to designated doses and use only for brief periods, generally amounting to no more than four weeks.

Do Sleeping Pills Affect Hormones Like Melatonin?

Yes, regular use of sleeping pills can disrupt your body’s natural production of sleep hormone (melatonin). These medicines — such as zolpidem or sedative antihistamines — will eventually disrupt your circadian rhythm.

What Happens When Sleeping Pills Are Mixed With Mental Health Medications?

Taking sleeping pills may affect medications for depression, anxiety or bipolar disorder. Th,ese interactions can boost sedation, raise the risk of side effects or even flip the effect, of mental health therapies. For example, using sedatives together with antidepressants such as SSRIs can raise the chance of dizziness or confusion. It’s always important to tell your doctor about all the medications you’re taking to prevent dangerous drug interactions.

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