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Sleeping pills or sedative hypnotics, are prescription drugs that include benzodiazepine and non-bezodiazepine. Doctors don't usually encourage their patients to take prescription sleeping pills for more than a few weeks because they could be habit-forming. These drugs can be a useful short-term treatment combined with lifestyle and behavior changes.
Effect of Sleeping Pills on Insomnia
These drugs, also called sedative hypnotics, include benzodiazepine and non-bezodiazepine. Doctors don't usually encourage their patients to take prescription sleeping pills for no more than a few weeks because they could be habit-forming. Medicine works best as a short-term treatment combined with lifestyle and behavior changes.
- Benzodiazepine Hypnotics: Benzodiazepine was introduced in 1960's as an anti-anxiety drug. These drugs enhance the effects of the neurotransmitter gamma-aminobutyric acid, resulting in relaxation, sedation and anxiety relief. Benzodiazepine reduces wakefulness, moreover, it improves the quality of sleep by shortening the time spent in bed before falling asleep and prolonging the sleep time. Common Benzodiazepine Hypnotics: quazepam (Doral), diazepam (Valium) and lorazepam (Ativan)
- Non-benzodiazepine hypnotics: These drugs' pharmacological actions are similar to those of benzodiazipines but they are structurally unrelated to the benzodiazepines on a chemical level. Like benzodiazepines, they also act on the GABA-A receptor sites in the brain, however, non-benzodiazepines are more specific in the subunits they target. Non bezodiazepines induce sleep with fewer side effects. These drugs are recommended for short-term use, and should not be taken for more than 4 weeks. Common non-benzodiazepines: Zolpidem (Ambien, Ambien CR, generic), Zaleplon (Sonata), Eszopiclone (Lunesta)- the first sleep medication approved to be taken on a long-term basis and Ramelteon (Rozerem)
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How to Use Sleeping Pills
Benzodiazepine Medication should be taken 15 to 30 minutes before bedtime as directed by the physician. If stomach upset occurs, take medicine with food or milk. Do not discontinue or re-start treatment without consulting your physician. It may be necessary to gradually decrease the dose. Benzodiazepines should be taken exactly as prescribed. Tolerance is likely to develop with long-term or excessive use.
The prescribed dose of non-benzodiazepine hypnotics should be taken 30 minutes before bedtime. Elderly patients are prescribed smaller doses. Zolpidem should only be taken if you intend to get a full night's sleep. It you need to wake up for work or other activities just a few hours after sleep, you may feel drowsy and this increases your risk for injuries such as fall. Do not drive a car or operate machinery until you know how zolpidem affects you.
Some non-benzodiazepines come in extended-release forms, they must be swallowed whole. Do not chew or crush the tablet.
Benzodiazepine
While benzodiazepines can improve the quality of sleep, these drugs are known to cause a number of side effects including stomach upset, blurred vision, headache, dizziness, impaired coordination, depression, trembling, nightmares, weakness, memory loss and clouded thinking. If any of these effects persist or worsen, inform your doctor promptly.
Some benzodiazepine side effects should be reported immediately to the doctor. These include seizures, confusion, rapid heartbeat, yellowing eyes or skin, fever. Seek prompt medical care if you start to notice symptoms of allergic reaction such as rash, itching, swelling, dizziness, trouble breathing.
To lower your risk for dizziness and lightheadedness when rising from a seated or lying position, get up slowly. It is also important to limit your intake of alcoholic beverages. Do not start or stop drug treatment without your doctor's approval.
Drug interactions
Tell your doctor of any over-the-counter or prescription medication you may take including: medication for depression, anti-seizure drugs, narcotic pain relievers (e.g., codeine), sedatives.
Non-benzodiazepines
Patients taking non-benzodiazepines may complain of drowsiness and dizziness possibly impairing coordination, balance, or mental alertness.
These drugs must be used with caution in individuals with a history drug dependence. Some non-benzodiazepines work very quickly and should only be taken just before bed. Patients should not take more than the prescribed dose. Inform your doctor about the other medications that you're taking because there are several medicines known to interact with non-benzodiazepines Patients are also encouraged to use caution in the morning when getting out of the bed and when carrying out tasks such as driving or operating heavy machinery.
Drug interactions
Alcohol increases the sedative effects non-benzodiazepine. These sleeping pill interacts with drugs, including rifampin, ketoconazole, erythromycin, and cimetidine.
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I find that 10mg of Ambien is too much and I wake up with a "hangover". I tried 5mg pills and those are much better. Even 2.5mg (cut a 5mg pill in half) works well if I just need to be "pushed" into sleep.