Last Updated: November 11, 2022

Sleeping pills are medications that help you relax and get to sleep. Many different kinds of sleeping pills exist. While some are available over-the-counter, others are controlled substances that can put you at risk of addiction and abuse. Knowing the risks of your sleeping pills is important to make sure that you and your loved ones stay safe while taking them.

Types of Sleeping Pills

Sleeping pills can work differently, although they have some common key characteristics. Most importantly, many sleeping pills work by slowing down central nervous system activity. While some slow the brain directly, others indirectly accomplish the action. Several different kinds of sleeping pills are either:

• Benzodiazepines
• Z-drugs
• Over-the-counter sleep aids

Benzodiazepines

Benzodiazepines, also called benzos, are commonly prescribed drugs for conditions like anxiety and insomnia. However, they have a downside: as Schedule IV controlled substances, they carry a risk of abuse, addiction and dependence. Many different benzodiazepines are available, including:

• Alprazolam (Xanax)
• Clonazepam (Klonopin)
• Diazepam (Valium)
• Lorazepam (Ativan)
• Midazolam (Nayzilam)
• Temazepam (Restoril)
• Triazolam (Halcion)

Z Drugs

Z-drugs are sedative-hypnotics named after the Z that begin most of their names. This class of medications is primarily used for sleep. They work similarly to benzodiazepines and, like benzos, are Schedule IV controlled substances. Z-drugs include:

• Zolpidem (Ambien)
• Zaleplon (Sonata)
• Eszopiclone (Lunesta)

Over-the-Counter Sleep Aids

Many different over-the-counter sleep aids exist and include both over-the-counter supplements and herbal remedies. Some of the most common over-the-counter sleep agents are:

• Diphenhydramine (Benadryl), an antihistamine
• Doxylamine, an antihistamine
• Melatonin, a hormone
• Valerian, an herbal supplement

Effects of Sleeping Pills

Sleeping pills slow down the body’s central nervous system functioning. Depending on the class of sleeping pills, they can accomplish this in several different ways. Benzodiazepines, Z-drugs and valerian mainly work by enhancing the activity of gamma-aminobutyric acid (GABA) in the brain. GABA is the brain’s calming neurotransmitter. Sedation is one of the major side effects of drugs like benzos that enhance GABA. 

In contrast, most over-the-counter sleeping pills work on other brain pathways that increase sedation:

• Melatonin modulates the sleep-wake cycles by binding to melatonin receptors in the brain’s suprachiasmatic nucleus. 
• Doxylamine and diphenhydramine promote sleep by blocking H1 histamine receptors in the brain.

Sleeping Pill Addiction and Abuse

Because many sleeping pills are controlled substances, they can put a person at risk of abuse, addiction and dependence. They can be misused for various reasons, including chemical coping: a person may feel as if their insomnia is only controlled when taking a sleeping pill. Unfortunately, this can make it difficult for a person to stop taking the medications, as they may feel they won’t get adequate rest without the sleeping pill.

Statistics

Sleeping pill abuse is common. Overall, about 30 million people have taken a benzo. However, much fewer, about 6 million, people in the U.S. have abused a benzo or sedative like a Z-drug. Among those prescribed benzos, about 17% have misused them, and less than 2% have a substance use disorder linked to this abuse.

Commonly Abused Sleeping Pills

Data is sparse about the most commonly abused sleeping pills. However, some are prescribed more often than others, which may make their abuse more likely. The most commonly prescribed sleeping pills as of 2019 were:

• Alprazolam, with more than 17 million prescriptions
• Clonazepam, with more than 15 million prescriptions
• Zolpidem, with more than 15 million prescriptions
• Lorazepam, with more than 10 million prescriptions

How Quickly Can You Get Addicted To Sleeping Pills?

To avoid addiction, sleeping pills should be taken at the lowest possible dose for the shortest possible duration. Addiction can develop quickly, and sleeping pill use is only recommended for a few weeks maximum at a time to avoid becoming dependent on the substances.

Signs of Sleeping Pill Addiction

Often, a person will start showing signs of addiction when they begin to struggle with a substance like sleeping pills. These include:

• Taking more sleeping pills or for a longer time than intended
• Unsuccessfully trying to cut down or control sleeping pill use
• Spending a lot of time obtaining, taking or recovering from sleeping pills
• Craving sleeping pills
• Problems maintaining obligations at home, school and work because of sleeping pills
• Interpersonal problems caused by sleeping pill use
• Reducing other activities due to sleeping pill use
• Using sleeping pills even when it is dangerous to do so, like before operating a motor vehicle
• Taking sleeping pills even though you know doing so is causing problems in your life
• Needing more or higher sleeping pill doses to achieve the same effects as before
• Having withdrawal symptoms when you try to cut back or stop taking sleeping pills

Symptoms of Sleeping Pill Addiction 

A person who struggles with sleeping pill addiction can have a variety of side effects. While some side effects are more common in the short term, others can be consequences in the long term. Some short-term side effects of sleeping pill use include:

• Daytime sleepiness
• Complex sleep-related behaviors, like sleepwalking, sleep eating or sleep driving
• Behavioral changes
• Memory loss

Studies have shown that long-term sleeping pill use can have health consequences. This is particularly true for benzodiazepines, which are linked to cognitive impairment, motor vehicle crashes and hip fractures. Common antihistamines used for sleep, like diphenhydramine, are also linked to dementia when used long-term.

Sleeping Pills and Polysubstance Abuse

When someone abuses sleeping pills, they often mix the medication with other substances. Sometimes, this is to enhance the sleeping pill’s effects, while other times, it is done to get high. Abusing more than one substance at a time is called polysubstance abuse. Polysubstance abuse increases the risk of complications like overdose and can make becoming sober more complex and difficult.

Mixing Sleeping Pills With Alcohol

Mixing sleeping pills and alcohol is dangerous and should be avoided because both substances are central nervous system depressants and can have additive effects. Combining them can enhance many side effects of sleeping pills, including problems with judgment, thinking and motor skills. In addition, mixing sleeping pills and alcohol can increase the addictive risk of sleeping pills.

Mixing Sleeping Pills With Painkillers

Mixing sleeping pills and painkillers is dangerous and can lead to overdose. The FDA requires a Black Box Warning on both prescription sleeping pills and opioid painkillers for this reason. In 2020 alone, 16% of opioid overdose deaths also involved a sleeping pill, specifically a benzo.

Mixing Sleeping Pills With Antidepressants

Sleeping pills and antidepressants should be taken together very carefully and only while under a doctor’s care. Sleeping pills and antidepressants are both psychoactive medications, meaning they impact the brain’s neurotransmitters. However, they often impact different neurotransmitters, with sleeping pills generally acting as central nervous system depressants and antidepressants often increasing the brain’s level of chemicals like serotonin.

Taking more than one psychoactive medication at a time is complex. You should carefully discuss the risks and benefits of taking sleeping pills with your doctor if you also take an antidepressant.

Mixing Sleeping Pills With Benzodiazepines

Because sleeping pills are generally central nervous system depressants, mixing them with other depressants like benzodiazepines can be dangerous and have additive effects. This may lead to overdose, which can be deadly. In addition, many sleeping pills are either benzos or chemically related to benzos and work in similar ways, like Z drugs. Combining different benzos can be very dangerous and can cause an overdose.

Sleeping Pill Overdose

A sleeping pill overdose is possible and can be deadly, especially when multiple substances are used. Common symptoms of a sleeping pill overdose include extreme drowsiness; the person may not be able to wake up in some cases.

Combining the sleeping pill with other substances, like opioids, increases the danger of overdose. The specific overdose symptoms will vary depending on the substances used, but slowed breathing is a common sign, which can be fatal.

Treatment For Sleeping Pill Addiction at The Recovery Village Columbus

Stopping sleeping pills on your own can be very difficult. Fortunately, help is available. The Recovery Village Columbus offers a full continuum of treatment programs to help wean you off sleeping pills and stay off them for good while developing healthy sleep habits that do not require medication. 

In medical detox, we will help ease you off sleeping pills in a supervised setting. Once your body is cleansed of the sleeping pills, we can help you progress to rehab, where you can learn healthy sleep and coping habits for living a sleeping pill-free life.

Get Help Today

Our caring experts at The Recovery Village Columbus know how hard it is to quit sleeping pills. That’s why we are here for you every step of your recovery journey from sleeping pill addiction. Don’t wait: contact us today to see how we can help