What are the side effects of sleeping pills? Risks and problems

Heather Campbell
 min read

What are the side effects of sleeping pills? These are categorized into short, medium, and long-term side effects. We also discuss the types of sleeping pills available and explain what each of these do.

What are the side effects of sleeping pills? Risks and problemsOther frequently asked questions will also be addressed in this post, such as:

  • Is it safe to take a sleeping medicine when you are worried about not falling asleep or waking up in the night?
  • Isn’t there a risk of falling if you have to get up in the night, of not being quite the same when you wake up?
  • Or are there any risks in the longer term of experiencing memory problems?

If you’d like more sleep-related information after reading this post, have a look at our other posts:

What are the side effects of sleeping pills? Introduction

A sleeping pill contains chemicals that induce and/or maintain sleep. There are several types:

  • melatonin and its agonists
  • medications specially designed to boost and maintain sleep
  • neuroleptics
  • anti-histamines often sold in pharmacies without a prescription
  • hypnotics
  • sedative drugs used in psychosis
  • some antidepressants have the effects of easing sleep, in addition to their role on mood
  • certain plants (phytotherapy)

Selective melatonin agonists and sustained release melatonin

Melatonin is a hormone that’s produced by the pineal gland or epiphysis.

It is released into your brain at night and has a central role in regulating biological rhythms. It has an extremely short half-life of about 40 min. Its therapeutic effects have been confirmed on:

  • many disorders of the circadian rhythm of sleep
  • work shift related issues
  • jet lag
  • sleep phase delay type disorder

It does not act on sleep itself but on the circadian rhythm of wakefulness and sleep, hence its name of chronotropic.

Circadian rhythms are the natural mental, physical and other changes in the body that follow a 24-hour cycle.

Neuroleptics

Some neuroleptics are sometimes used, especially by psychiatrists, to treat severe insomnia. Examples are:

  • clozapine
  • loxapine
  • risperidone
  • olanzapine

However, there are no clinical studies of the effects of these drugs on sleep. At the same time, they have metabolic and neurological risks.

Therefore, their use must be strictly limited to their psychiatric indications, which essentially is schizophrenia.

Anti-histamines

Anti-histamines are products that can counteract the arousing effects of histamine. For example, H1 anti-histamines pass the blood-brain barrier well and have a sedative action.

Sedatives slow down your brain activity and are typically used to make you feel more relaxed. So it’s no surprise that insomniacs often reach out to them.

They are sold without a prescription and under different names in pharmacies. They trigger drowsiness during the day without any real hypnotic action at night. They are also not without side effects:

  • sedation
  • blurred vision
  • urinary retention
  • constipation

They have no advantage over benzodiazepines and non-benzodiazepines.

Hypnotics

Current hypnotics are divided into two families of products:

  1. benzodiazepines, and
  2. non-benzodiazepines.

Their mode of action is identical. They bind to a receptor called the benzodiazepine receptor.

Hypnotics do a number of things:

  • reduce the time to fall sleep
  • the amount and duration of awakenings
  • a moderate increase in total sleep time
  • an improvement in the subjective impression of sleep

Antidepressants

Certain antidepressants have a presumed lower risk of tolerance and dependence while also having no restrictions on the duration of treatment. This is why they’re sometimes used to treat insomnia since it’s closely related to depression.

The antidepressants used to treat insomnia are primarily doxepin, amitriptyline, and mirtazapine. Their mechanism is variable. Doxepin and amitriptyline block the reuptake of a monoamine, while mirtazapine blocks alpha 2 receptors.

However, the possible negative effects of these products are much greater than those of benzodiazepines and non-benzodiazepines. These negative side effects mainly have psychiatric, cardiovascular, and hepatic origins.

Clinical studies of the hypnotic effect on non-depressed patients showed that the effect was almost non-existent. On the other hand, the same studies on depressed patients generally proved that they suffer from methodological deficiencies.

For these reasons, antidepressants should not be used to treat sleep disorders in non-depressed patients. They should be used with caution on depressed patients.

Herbal medicine

Some plants are sedative and have a reputation among the general public for being harmless because they are natural. Examples of these plants are:

  • hawthorn
  • passionflower
  • valerian

But in fact, very few of these plants went through controlled clinical tests. And if they did, their results are borderline at best. Their standardization remains delicate.

What are the side effects of sleeping pills? Short, medium, and long term effects

Short-term effects include: 

  • sedative effects:
    • daytime sleepiness
    • decreased psychomotor performance
  • excitability-type effects
    • rebound insomnia
    • anxiety upon discontinuation
  • adverse cognitive effects, especially memory impairment

Sedative effects are more expected with slow elimination half-lives, while excitability-type effects are more frequent with rapid or ultra-rapid elimination half-lives.

Medium-term effects

The first kind is tolerance, which is a decreased effect of the drug that leads to increasing doses of the product to get the initial effect.

The second kind is physical and psychological dependence, which is the repeated and irrepressible need to take the drug despite the patient’s efforts to avoid it.

Long-term effects include:

The long-term negative effects are caused by the psychological effects of the prolonged use of the hypnotic.

The user may no longer need the drug for its effects on sleep, but because of the withdrawal symptoms (symptoms that appear when the user stops taking the drug).

These symptoms are:

  • exaggeration of sleep disorders
  • anxiety
  • irritability
  • tremors
  • palpitations
  • hypersensitivity to light, noise, or touch

The patient feels obligated to continue taking the drug because he refuses to experience these withdrawal symptoms.

What are the side effects of sleeping pills? Conclusion

Side effects of sleeping pills can be categorized as short, medium, and long-term effects as explained in detail in this post.

While we’ve also touched upon a number of different types of sleeping pills, you may still be wondering whether you should take these drugs.

If the insomnia is occasional and if the rules just mentioned are obeyed, the prescription of a hypnotic is perfectly legal and without risk. Consult with your physician to assess your personal situation and discuss your options.

But can a sleeping pill be prescribed for someone with chronic insomnia?

A priori not, for the reasons previously pointed out. Nowadays, we have cognitive-behavioral therapies that are more active in the long term and completely free of negative side effects.

However, it should be noted that some patients, especially elderly patients, seem to be helped by taking a hypnotic on a daily basis, with no noticeable adverse effects.

Sadly, we cannot determine in advance which patients may fall into this category.

About Heather Campbell

As a nutritionist, my field of specialization is science-based nutritional advice but more importantly, it is my goal to share capturing and inspiring stories, examples and solutions which can help plus-size individuals overcome their specific difficulties. Read More