Learn the risks of sleep aids

Some of these prescription medications are linked to daytime sleepiness, a risk of falls, and more.

Published: July, 2017

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Millions of Americans rely on prescription sleep medications, called sedative hypnotics, to fall asleep. While the drugs can help people get a decent night's rest, they are not designed for long-term use. "Each of the pills has its own risks," says sleep expert Dr. Lawrence Epstein, an instructor in medicine at Harvard Medical School.

Types of sleep aids

Sedative hypnotics fall into three categories.

Melatonin-receptor agonists such as ramelteon (Rozerem) leave the body quickly. They target melatonin receptors in the brain and are not thought to be habit-forming.

Benzodiazepines, such as lorazepam (Ativan) and temazepam (Restoril), target a brain chemical called gamma-aminobutyric acid (GABA) that reduces nerve activity and promotes sleep. Benzodiazepines can be habit-forming and may cause daytime sleepiness. The drugs are also associated with a potentially deadly side effect when taken with prescription painkillers, as we reported last month. "And there is concern that using benzodiazepines may contribute to the development of dementia. It's under investigation," says Dr. Epstein. He also notes the risk of falling if you wake up groggy when using these drugs.

Nonbenzodiazepines , such as zolpidem (Ambien) and eszopiclone (Lunesta) target GABA as well. However, they don't last as long in the body and have fewer side effects compared with benzodiazepines. But they still put you at risk for sleepwalking and daytime sleepiness.

Other complications

It's difficult to stop taking sleep aids. "People develop a dependence on them. When you take them away, they get a temporary withdrawal reaction and can't sleep. But they think it's because they need the drug to sleep," Dr. Epstein explains.

He advises that instead of abruptly stopping use of a sleep aid, you taper off the medication slowly. "Do it under a doctor's supervision, to monitor the withdrawal response."

Life without sleep aids

A well-studied therapy that can help you sleep is cognitive behavioral therapy for insomnia (CBT-i). It involves talk therapy to change unproductive thinking patterns, along with changes in sleep habits. CBT-i also uses relaxation therapy, stimulus control, and established sleep and wake patterns. A typical course of CBT-i lasts six to eight weeks.

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