Insomnia is one of the most common sleep disorder complaints in adults. It affects up to 30% of people over the age of 40. Trying to get sleep without success is not only distressing but can have adverse effects on your mental and physical health.

Sleep medication is one of the solutions used to address anxiety and sleeping problems. Due to the prevalence of these mental conditions, the number of people taking sleeping pills remains relatively high. According to a survey by the American Sleep Foundation, half of the respondents reported taking sleeping pills for insomnia routinely.

The survey also found that many Americans use alcohol, wine, marijuana and over the counter sleep medication to self medicate. Public health officials and health practitioners recognize that people need access to different solutions to their sleep deprivation problems. But accessibility to sleep medication, and the lack of information has increased the risk of abuse and addiction to sleeping medication.

What are Sleeping Pills?

Sleeping pills are under the class of drugs known as sedative-hypnotics. This class of drugs works on the Central Nervous System to suppress other overexcited neurons.  Sedative-hypnotics work on a region of the CNS known as GABA A. GABA A receptors are amongst the most abundant in the brain and control fear and anxiety.

These set of drugs are also referred to as tranquilizers and depressants. Because they have a calming effect on the brain they are also useful in the treatment of anxiety. A sedative medication can be divided into three categories:

• Barbiturates: This is one of the sedative-hypnotics that is most commonly used to treat sleep disorders, seizures, and anxiety problems. Barbiturates are often not prescribed to people with sleep problems. They are problematic in that they can cause exaggerated Rapid Eye Movement (REM) during sleep and serious withdrawal symptoms when discontinued. Also, there is a high risk of death even with a slight increase in dosage. Some common barbiturates include Pentobarbital and Nembutal.

• Benzodiazepines: Are used to treat a variety of conditions. Some of the medical applications of these drugs include treatment of anxiety, muscle spasm, sleep disorders, and management of seizure disorders. While Benzodiazepines are not as risky as barbiturates, they can cause toxicity in the body and lead to addiction and dependence.

• Z-drug Sleep medications (Non-Benzodiazepines): These are a set of drugs used to treat similar conditions as benzodiazepines but have a better safety profile. When used to treat sleep disorders, Z drug sleep medications are known to have fewer side effects compared to their benzodiazepines counterparts. They do not cause as much disruption to the sleeping structure. Non-Benzodiazepines also cause fewer cases of respiratory problems and patients develop tolerance to the drug less frequently. Some examples of this drug include Ambien (Zolpidem), Sonata (Zaleplon), and Lunesta (eszopiclone).

• Opiates: There has been a lot of concern in recent years about the use of opiates in the management of pain and treatment of sleep disorders. Some of the issues that experts in the medical field have had with opiates are that they cause dependency, addiction and a myriad of psychological and health complications. Especially given that there are conflicting findings on the efficacy of this type of medication in treating insomnia. However, there are certain instances where they can be useful in the treatment of sleep disorders. This includes conditions such as restless leg syndrome and seizure disorders. Some of the opiates used to treat sleep disorders include Codeine, Combunox ( Oxycodone HCI), Methadose (Methadone) and Darvone (Propoxyphene).

• Street Names: These include Forget-me Pills, Mexican Valium, R2, Roche, Roofies, Roofinol, Rope, Rophies.

Treatment of Insomnia

The different classes of sleeping medication have side effects. Patients are warned to use these drugs s with caution and preferably get a prescription from a doctor. Yet sleep disorders need to be treated for the following reasons:

• Sleep Disorders: Sleep disorders have a significant impact on the mental and physical health of many Americans. It is recommended that you should get at least 8 hours of sleep per night. Lack of sleep or poor quality sleep increase the risk of cardiovascular disorders, and a decline of brain function.

• Treatment is Essential: People with sleep disorders need their condition treated as soon as possible. It is not easy to compensate for sleep deprivation that has been extended for a long period of time. Adverse effects such as high blood pressure and obesity may have already begun manifesting in the patient.

• Maintaining Safety: Many Americans self medicate with sleeping pills. This can cause complications such as dependency and adverse psychological effects. Additionally, there are conditions that need to be addressed by a qualified professional. For example, patients taking Benzodiazepines may be treated with opiates as long as safety standards are observed. The health care professional can take the opportunity to educate patients on the risks of the drugs and the necessary precautions they need to take.

Tolerance, Addiction, and Abuse

Even though it is critical that sleep disorders should be treated in a timely manner, patients are cautioned against self-medication. Physical health complications are common with the use of these drugs. Studies show they can cause death or a comma, especially if the dosage is exceeded.

Sedative-hypnotics cause changes in your Central Nervous System in order to relax other regions of the brain so that you can sleep. Prolonged use of the drug forces your CNS to become dependent on the drug. Dependency implies that you need the drug to address anxiety and sleep deprivation issues. Over time you need more and more of it. You develop tolerance and the same dosage usually doesn’t have the same effect.

Not only is abusing these drugs dangerous but it can cause serious complications and even death since tolerance forces you to use a stronger dose.

Signs you are addicted:

• Failed attempt to quit

• Strong cravings for sleeping pills

• Need to increase the dosage and may see several doctors for refills

• Need sleeping pills to remain calm or to sleep

The side effects of different sedative-hypnotics depend on the composition and chemical makeup of the drug. Barbiturates and opiates have the most severe side effects. However, if you are abusing this type of medication you are likely to experience some of the adverse effects.

Some side effects include:

• Confused thinking

• Sleepiness throughout the day

• Memory impairment

• Impaired judgment

• Increase in severity of depression and anxiety problems

• Movement and motor skills impairment

• Tolerance and addiction

• Risk of overdose and death

Some drugs have shorter half-lives which reduce the duration of the hypnotic effects as well as its adverse effects. Drugs with longer half-life are likely to prolong the side effects and encourage the accumulation of the drug in the body.

It is therefore important for people with sleep deprivation problems to see a professional who can access their physical and psychological profile. Medication used to treat sleep disorders are also known to have a high risk of unwanted drug interactions. It is critical that patients who are on other types of medication to consult with their physician before trying to treat insomnia with sedative-hypnotics.