When over-the-counter sleep aids or changes in sleep habits don’t work to improve your insomnia symptoms, it may be time to consider prescription sleep aids. Here’s what you need to know to decide whether sleeping pills are right for you.
TCAs, or tricyclic antidepressants, are usually prescribed these days for chronic pain or depression. Elavil, Sinequan, and Trazodone are some commonly used drugs in this class. They can help people who suffer from chronic pain or depression and insomnia find that TCAs can have a significant impact on nightly sleep and daytime function. But TCAs act on multiple brain centers, and can produce a range of side effects from difficulty urinating to dry mouth to blurred vision. They are usually used at lower doses for sleep activation than for depression or pain, and so can be successful treatment options for those who have suffered side effects or a lack of positive improvement when using other sleeping pills.
Benzodiazepines are the original sleep aids, in use since the 1960s. They include Ativan, Valium, Xanax, and Restoril. These drugs activate all types of gamma-aminobutyric adic (GABA) inhibitors in the brain, and induce a range of other effects – minimizing anxiety, relaxing muscle tone, even creating a sense of euphoria. Benzodiazepines have a high risk for abuse and can develop physical dependence on the drugs. They’re not appropriate for long-term use and should be taken only under a doctor’s guidance.
Selective GABA Inhibitors
Most newer prescription drugs are selective gamma-aminobutyric acid (GABA) medications that work on one of 3 types of GABA receptors in the brain. These more targeted drugs tend to minimize morning drowsiness since they’re usually completely metabolized by dawn – but they can produce disturbing side effects. Ambien, Lunesta, and Sonata are popular examples. Ambien in particular has been shown to produce sleepwalking and other dangerous side effects in users, which I’ve explored briefly in my blog on Ambien.
The newest sleep-inducing prescription drug is Ramelteon (Rozerem). It’s the only drug currently in its class, and it is the only drug to act on the body’s circadian rhythm, or natural sleep-wake cycle. It acts on very targeted aspects of the brain and as such tends to have fewer side effects or potential for addiction than other sleep aids. The drug does affect hormone levels if taken over extended periods, potentially changing sex drive or complicating attempts at conception.
No pill can fix your sleep problems by itself or forever. Sleeping pills are meant as a short term aid to helping you build healthy sleep habits and stick to a sleep schedule. According to Psychology Today, sleeping pills don’t produce the same sleep patterns as normal, natural sleep. Sleeping pills encourage changes in slow-wave sleep and can inhibit REM sleep, causing dangerous side effects if used over long periods. Talk with your doctor to decide whether prescription sleeping pills are right for you.