Prescription sleeping pills

[Guest guest]

Prescription sleeping pills

What's right for you?

Sleeping pills help when stress, travel or other disruptions keep you awake. If you have chronic insomnia, a better approach may be to remove the cause by changing your lifestyle.

By Mayo Clinic staff

If you're regularly having trouble either falling or staying asleep (insomnia), make an appointment with your doctor. Treatment is available — but it depends on what's causing your insomnia. In many cases an underlying medical or sleep disorder can be diagnosed and treated, a much more effective approach than just treating the symptom of insomnia itself.

Behavior changes are generally the best treatment for persistent insomnia. For occasional sleepless nights, however, prescription sleeping pills may be helpful. Although sleeping pills don't treat the underlying cause of your sleeping problems, they may help you get some much needed rest.

Today's prescription sleeping pills don't carry the same level of risks of dependence and overdoses as sleeping pills of the past. But risks remain — especially for people who have certain medical conditions, including liver and kidney disease. Always talk with your doctor before trying a new treatment for insomnia.

Here's information on some of the most common types of sleeping pills used today.

Types of prescription sleeping pills

Prescription sleeping pills are available to help you fall asleep easier, stay asleep longer — or both. Before prescribing a medication to help you sleep, your doctor will ask you a number of questions to get a clear picture of your sleep patterns. He or she may also order tests to rule out any underlying conditions that may be causing difficulty sleeping.

To reduce the risk of side effects and of becoming reliant on drugs to sleep, your doctor likely will prescribe medications for two weeks or less. If the first medication you take doesn't work after the full prescribed course, call your doctor. You may need to try more than one prescription sleeping pill before finding one that works for you.

Some prescription sleeping pills are available as generic drugs, which are typically less expensive than brand names. Ask your doctor whether there is a generic version available of the medication he or she prescribes.

Sleeping pills that help you fall asleep

The following medications are used mainly to help you fall asleep.

Drug

May not be safe if you:

Considerations

Eszopiclone (Lunesta)

Have a history of drug or alcohol abuse, depression, lung disease, or a condition that affects metabolism.

May be used for a longer period of time than zolpidem or zaleplon.

High-fat meals may slow absorption of the drug and make it less effective. Stopping the drug suddenly may cause symptoms of withdrawal, such as anxiety, unusual dreams, stomach and muscle cramps, nausea, vomiting, sweating, and shakiness.

Ramelteon (Rozerem)

Are pregnant or breast-feeding. Have a history of kidney or respiratory problems, sleep apnea, or depression.

May interact with alcohol.

High-fat meals may slow your absorption of the drug. A manufactured drug similar to melatonin. Not likely to be habit-forming.

Triazolam (Halcion)

Are pregnant or breast-feeding. Have a history of drug abuse, depression or respiratory conditions.

May interact with grapefruit juice, alcohol and many other medications.

Can be habit-forming. Seldom prescribed by sleep specialists. Drug must be stopped gradually.

Zaleplon (Sonata)

Have severe liver impairment.

Are pregnant. Have a history of depression, liver or kidney disease, or respiratory conditions.

Can be habit-forming.

Very short acting, so can be taken in the middle of the night following precautions from your doctor.

Zolpidem (Ambien, Edluar)

Have a history of depression, liver or kidney disease, or respiratory conditions.

May become less effective if you take it for longer than two weeks.

Sleeping pills that help you stay asleep

The following prescription medications are used to help you get to sleep and stay asleep.

Drug

May not be safe if you:

Considerations

Estazolam

Are pregnant, breast-feeding, or are an older adult.

May interact with many other medications. Can be habit-forming. Seldom prescribed by sleep specialists.

Eszopiclone (Lunesta)

Have a history of drug or alcohol abuse, depression, lung disease, or a condition that affects metabolism.

May be used for a longer period of time than zolpidem or zaleplon.

High-fat meals may slow absorption of the drug and make it less effective. Stopping the drug abruptly may cause withdrawal symptoms such as anxiety, unusual dreams, stomach and muscle cramps, nausea, vomiting, sweating, and shakiness.

Temazepam (Restoril)

Have a history of severe depression.

May interact with alcohol and many other medications. Can be habit-forming. Seldom prescribed by sleep specialists.

Zolpidem (Ambien CR)

Have a history of depression, liver or kidney disease, or respiratory conditions.

This extended-release formula may be used for a longer period of time than regular zolpidem or zaleplon.

Side effects of prescription sleeping pills

Side effects associated with prescription sleeping pills include:

Dizziness

Facial swelling

Headache

Gastrointestinal problems, such as bloating, abdominal pain, constipation and nausea

Prolonged drowsiness, though less so than with drugs that help you stay asleep

Severe allergic reaction

Sleep behaviors, such as sleep-driving and sleep-eating

Medications to help you stay asleep may not be safe if you're pregnant, breast-feeding or are an older adult. Sleeping pill use may increase the risk of nighttime falls and injury in older adults.

Sedating antidepressants

Sometimes prescription drugs used mainly to treat depression may ease insomnia when taken in lower doses. Although widely used, these are not approved by the Food and Drug Administration for insomnia only. Discuss alternatives with your doctor. When insomnia is secondary to depression or anxiety, antidepressants can improve both conditions at the same time.

Drugs for when you can't sleep and you're depressed

Drug

May not be safe if you:

Considerations

Amitriptyline

Are recovering from a heart attack or using a monoamine oxidase inhibitor (MAOI). Have a history of seizures, hyperthyroidism, liver disease, diabetes, glaucoma, trouble urinating (urinary retention), schizophrenia or bipolar disorder.

May interact with many other medications.

Doxepin (Sinequan, Zonalon)

Are using a monoamine oxidase inhibitor (MAOI). Have a history of glaucoma, trouble urinating (urinary retention) or bipolar disorder.

May interact with many other medications.

Trazodone

Have a history of high blood pressure.

Interacts with warfarin (Coumadin) and many herbal supplements.

Side effects of sedating antidepressants

Side effects associated with sedating antidepressants include:

Blurred vision

Constipation

Dizziness

Headache

Prolonged drowsiness

Weight gain

These medications may not be safe if you're pregnant or breast-feeding or have a history of heart problems. And they may lead to suicidal thoughts or worsen existing depression, particularly in children and adolescents.

Taking sleeping pills

If your best attempts to get a good night's sleep have failed, prescription sleeping pills may be an option. Use them safely.

Get a medical evaluation. Before you take sleeping pills, see your doctor for a thorough exam. Often your doctor may be able to find specific causes for your insomnia. Your doctor also likely will recommend trying nondrug approaches, such as cognitive behavioral therapy. Sleeping on a regular schedule, exercising regularly, avoiding caffeine and daytime naps, and keeping stress in check also are likely to help.

Never take a sleeping pill until you're going to bed. Sleeping pills can make you less aware of what you're doing, increasing the risk of dangerous situations. Wait to take your sleeping pill until you've completed all of your evening activities.

Avoid alcohol. Never mix alcohol and sleeping pills. Alcohol increases the sedative effects of the pills. Even a small amount of alcohol combined with sleeping pills can make you feel dizzy, confused or faint. And, alcohol can actually cause insomnia.

Quit carefully. When you're ready to stop taking sleeping pills, follow your doctor's instructions or the directions on the label. Some medications must be stopped gradually.

Watch for side effects. If you feel sleepy or dizzy during the day, talk to your doctor about changing your dose or weaning off your pills.

If you continue to have trouble sleeping, ask your doctor for help.

http://www.mayoclinic.com/health/sleeping-pills/SL00010