Sleeping Pills: Abuse, Addiction & Risks

What Are Sleeping Pills?

Sleeping pills are over-the-counter (OTC) or prescription medications that treat patients with insomnia. By definition, insomnia is a sleep disorder that makes it challenging to fall asleep and stay asleep. Other symptoms of insomnia include:

• Waking up too early and not being able to fall back asleep
• Memory issues, trouble concentrating, and making mistakes often
• Extremely low energy levels
• Mood swings
• Low work performance
• Poor quality of life
• Not feeling well-rested after sleeping
• Depression and anxiety
• Irritability and worrying about sleep

Many of these medications promote and prolong sleep, which means people will not wake up randomly throughout the night. Sleep pills are also referred to as sedatives because they have calming effects and can make you drowsy.

In the U.S., about 4 percent of adults 20 and older used prescription sleeping aids in the last month. Women also take sleeping pills more often than men. 

Centers for Disease Control and Prevention (CDC)

Types of Sleeping Pills

There are many different types of prescription sleeping pills available, depending on individual needs and reasons for taking the drug. However, the three most common types of pills include Ambien (zolpidem), Sonata (zaleplon), and Lunesta (eszopiclone).

Some medications only help you fall asleep, while others help you fall asleep and stay asleep throughout the night. Additionally, certain sleeping pills are also at risk for dependence, but others are not addictive.

For example, commonly prescribed sleeping pills that can lead to dependence, but also help you fall asleep and stay asleep, include:

• Estazolam
• Eszopiclone (Lunesta)
• Temazepam (Restoril)
• Zolpidem extended-release
• Suvorexant (Belsomra)

Medications that help you fall asleep, but not stay asleep, and can lead to dependence include:

• Triazolam (Halcion)
• Zaleplon (Sonata)
• Zolpidem (Ambien CR)

Lastly, sleeping pills that help you fall asleep and stay asleep (but are not addictive) include:

• Doxepin (Silenor)
• Ramelteon (Rozerem)

Abuse & Addiction Symptoms

Sleeping pills are addictive and many of them lead to dependence. Although people do not crave the drug as intensely as a person addicted to opioids (e.g., heroin or fentanyl) does, they can become psychologically dependent over time. In other words, a person who routinely takes sleeping pills may believe they can’t sleep without them. This belief is true because their brain and body start to rely on the drug to sleep properly throughout the night.

It is often difficult to recognize sleeping pill abuse because they are taken before bed. However, if you or a loved one begins taking the medications after the prescription runs out, it is a strong indicator that abuse has formed.

Abuse

Other common signs of sleeping pill abuse include:

• Lightheadedness
• Dizziness
• Breathing difficulties
• Changes in your thought process
• Increased depression or anxiety
• Swelling and itching
• Strange dreams
• Slurred speech
• Drowsiness during the day
• Amnesia (memory loss)
• Irregular sleeping patterns
• Headaches or migraines
• Trouble balancing and problems with coordination
• Sleepwalking (benzodiazepine and non-benzodiazepine sleeping pills can cause this)
• Abnormal behaviors while using sleeping pills, including cooking food, driving, or having sex, have also been reported.

Signs of addiction are more severe than abusing sleeping pills. In particular, when a person becomes addicted, they constantly think about obtaining or taking more of the drug. This can negatively impact daily life and responsibilities, including work, social life, and finances.

Addiction

Symptoms of a sleeping pill addiction include:

• Taking another person’s prescription
• Relying on the medications to fall asleep
• Taking higher doses than prescribed to feel the same effects
• Running out of a prescription early
• Strong cravings
• Being secretive, feeling detached, and isolating oneself
• Trouble with finances
• Performing low at school or work
• Changes in priorities, such as revolving your day around obtaining more pills
• Relationship problems
• Going to the doctor often to obtain more than one prescription
• Extreme changes in mood
• Extreme drowsiness and memory problems

Risks, Dangers & Interactions

Sleeping pills are central nervous system (CNS) depressants, which means they decrease a user’s heart rate and breathing. As a result, respiratory problems and breathing difficulties can develop with excessive use. Loss of consciousness, brain damage, or death can also occur if your heart rate decreases low enough.

Mixing sleeping pills with opioids, such as heroin or fentanyl, or alcohol, is very dangerous and life-threatening. These drug interactions increase your chance of respiratory depression and can cause an overdose.

Lastly, some people take more sleeping pills than prescribed to achieve a “high” rather than fall asleep. Doing so is extremely dangerous and can also lead to an overdose.

Withdrawal Symptom

The most common withdrawal symptom of sleeping pills is “rebound insomnia.” By definition, rebound insomnia is when sleep becomes worse after stopping the use of certain sleep medications. In most cases, rebound insomnia is worse than the patient’s original insomnia before taking sleeping pills.

More specifically, rebound insomnia frequently occurs after someone withdrawals from nitrazepam, flunitrazepam, or triazolam, even if they only took it for a short period of time. Diazepam and flurazepam, however, do not cause rebound insomnia during withdrawal.

People will begin to develop withdrawal symptoms in about seven days after stopping use. Depending on your age, gender, dosage, and length of use, the symptoms can last for a few weeks. Besides rebound insomnia, withdrawal symptoms include:

Addiction Treatment Options

A sleeping pill addiction is a serious mental health issue, and there are several different treatments available to support your recovery. For example, treatment for benzodiazepine addictions usually includes four stages:

• Detox and withdrawal — before rehab begins, you will go through the medical detoxification and withdrawal process. Stopping use “cold-turkey” on your own is not recommended. Instead, having a medical professional monitor your withdrawal symptoms is more effective in achieving long-term sobriety.
• Inpatient treatment — this type of treatment is completed at a residential treatment center, where patients receive continuous psychological and medical observation. Inpatient facilities offer either 30-day, 60-day, or 90-day treatment programs. In some cases, treatment can last up to a year.
• Outpatient rehabilitation — this form of rehab does not include medical supervision in a residential setting. Rather than living at a facility, you only meet a few times each week to receive treatment and participate in therapy.
• Aftercare — beyond these treatment options, counseling and behavioral therapy also effectively treat benzodiazepine addictions. More specifically, cognitive-behavioral therapy (CBT) helps people manage triggers, stress, expectations, and behaviors related to sleeping pills after the withdrawal detox is complete. You may also benefit from group therapy, individual therapy, a sober living home, or 12-step education after rehab.

Tolerance and dependence increase significantly with continued use of sleeping pills. As a result, it is difficult to quit using without professional help. Find treatment today.