Sleep Aids Abuse, Addiction, And Treatment Options
Medically reviewed by
Isaac Alexis, M.D., AAMA, AMP-BCApril 29, 2019
Medications that help a person sleep are sleep aids, or sleeping pills. Prescription sleep aids are classified as sedative-hypnotics, and although helpful, people may become dependent or even addicted.
Prescription sleep aids are not intended for long-term use. Instead, they offer a short-term solution to issues with insomnia. These drugs are used to help people fall asleep or stay asleep. Many people find themselves taking sleeping pills for longer than recommended, increasing the risk of tolerance, dependence, and addiction.
In 2010, approximately four percent of people over the age of 20 used prescription sleep aids in the last 30 days. This number steadily increases as age increases, and about seven percent of people over 80 reported taking sleeping pills in the last month.
Almost nine million people take sleeping pills on a regular basis to help them sleep. Research studies are revealing links between sleeping pills and cancer, dementia, cardiovascular issues, and a number of other health-related problems, including some 21 percent of people experiencing thoughts of suicide related to the overuse of sleeping pills.
What Are Sleep Aids?
Sleep aids, or sleeping pills, belong to a class of medications called sedative-hypnotics. Like other medications in this class (benzodiazepines or barbiturates), these medications act as central nervous system (CNS) depressants. Sleep aids calm and relaxes the individual so they can sleep.
Sleep aids affect the GABA receptor in the brain, similar to benzodiazepines. However, sleep aids are believed to have significantly fewer side effects, such as daytime drowsiness.
According to a study published in 2017, researchers determined that the list of medications available as prescription sleep aids for chronic insomnia should be reduced to:
- zolpidem (Ambien)
- zaleplon (Sonata)
- eszopiclone (Lunesta)
- suvorexant (Belsomra)
- ramelteon (Rozerem)
- triazolam (Halcion)
- doxepin (Prudoxin)
- temazepam (Restoril)
According to the study, sleep experts concluded that medical professionals should not be recommending trazodone (Oleptro), tiagabine (Gabitril), diphenhydramine (Benadryl), melatonin, tryptophan, or valerian as sleep aids.
In addition, many medications being used as an off-label treatment of insomnia were not as effective as medications intended to treat insomnia. Overall, this study stressed the importance of taking sleep aids only as prescribed, due to the risk of dependence and addiction.
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Sleep Aid Abuse
There is a difference between actual insomnia and occasional sleeplessness. When a person struggling with insomnia has a prescription for sleeping pills, the medication is usually taken as needed. However, this perceived freedom can lead to taking sleep aid medications even when they are not necessary, which can lead to dependence.
An occasional sleepless night, or feeling anxious about the day are not reasons to take a sleeping pill. Taking sleeping pills for any reason or in any way that they are not prescribed is sleep aid abuse, whether a person has a prescription or not.
Effects Of Sleep Aid Abuse
When a person takes a sleeping pill, there is a risk of side effects. These risks increase significantly if the person is abusing prescription sleep aids, especially in higher than prescribed doses.
Some of the risks associated with sleeping pills include:
- decreased anxiety
- abnormal thinking
- nontypical sleeping pattern
- motor function impairment
- increased depression
- slurred speech
- lightheaded
- memory loss
- hallucinations
There have been reports of people engaging in everyday behaviors while under the influence of sleeping pills. People have been found to eat, talk, drive, and even have sex with no recollection of the events when they wake up.
Abusing sleeping pills by combining them with other substances can be fatal. Taking sleeping pills with alcohol, opioids (like hydrocodone or heroin), benzos, or other sedatives can slow the body down so much that a person stops breathing, or their heart stops beating.
Risk of overdose increases significantly when combining sleeping pills with any other substance of abuse.
Sleeping Pill Addiction
Abusing prescription sleep aids can lead to developing tolerance. This means that the individual will require higher doses to have the same effect. A person is also at substantial risk for dependence.
A person dependent on sleep aids will experience withdrawal if they attempt to stop taking sleeping pills, and feel as though they cannot function normally without them. These factors, along with the following, can manifest into a sleeping pill addiction:
- hiding sleeping pill use
- avoiding situations that sleeping pill use is discouraged
- spending large amounts of time and finances on using and obtaining sleeping pills
- asking for or stealing other people’s sleeping pills
- doctor shopping, having multiple prescriptions, or forging prescriptions
- cannot maintain responsibilities, like work, school, relationships
- overdose from sleeping pills
Sleep Aid Withdrawal
A person who is addicted to sleeping pills can experience withdrawal symptoms when they attempt to stop taking sleep aids. It is almost always suggested that a person seek a detox program when they are attempting to stop taking sleeping pills if they are addicted.
Withdrawal symptoms can range from uncomfortable to unmanageable, and include:
- mood swings
- nausea
- vomiting
- night terrors
- cravings
- sweating
- anxiety
- delirium
- hallucinations
- seizures
Another side effect of stopping sleeping pills is what is known as the rebound effect. This phenomenon occurs when a person’s insomnia returns, coupled with extreme anxiety after they stop taking sleeping pills. Rebound effect can last about a week.
Sleep Aid Addiction Treatment Options
Substance abuse treatment options for sleep aid addiction should begin with medically supervised detoxification. During this initial phase, medical professionals are available round the clock to check vitals and sometimes use alternative medications to ease discomfort.
Using this process, withdrawal from sleep aids takes approximately five to fourteen days, on average. The detox process can make withdrawal more manageable.
After detox, substance abuse treatment facilities work with the person to create a treatment plan that best meets their needs, and work with them to accomplish the goals created within the plan.
During inpatient rehab for sleeping pills, topics that focus on anger management, developing healthy coping skills and relationships, and creating a sober future, will be addressed. These professionals may also determine if additional medications may need to be prescribed.
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Article SourcesCenters for Disease Control and Prevention - Prescription Sleep Aid Use Among Adults: United States, 2005-2010
Journal of Clinical Sleep Medicine - https://aasm.org/resources/pdf/pharmacologictreatmentofinsomnia.pdf
BMJ - Hypnotics’ association with mortality or cancer; a matched cohort study
U.S. National Library of Medicine - Hypnotic drug risks of mortality, infection, depression, and cancer: but lack of benefit