Sleeping pills

What are sleeping pills?

Hypnotics, sedatives, sleep aids, tranquilisers

Sleeping pills are used, as the name suggests, to help people sleep. This can mean helping people get to sleep or stay asleep. There are different types of sleeping pills that can be prescribed including:

Other drugs can also be used to aid sleep such as antihistamines and antidepressants. Sleeping pills are not effective long term but can be prescribed short term to help someone sleep.

Benzodiazepines

Benzodiazepines can be prescribed to treat anxiety or sleep problems such as insomnia and have almost entirely replaced barbiturates. They work by increasing the levels of a brain neurotransmitter called GABA (gamma-aminobutyric acid) which has a calming effect on the brain. 

Effects

Benzodiazepines relieve anxiety and tension and can make people feel more calm and relaxed. Effects begin around 30 minutes after taking and can last for up to 6 hours.

They are classed as depressants and slow down people’s reactions, making them feel drowsy, lethargic and forgetful. They can also lead to problems concentrating, headaches, vertigo making the user more at risk of an accident. Benzodiazepines can also cause a loss of libido.

Tolerance to benzodiazepines can develop quickly if a person takes them regularly. They will get the full effect of the drug for only for the first few weeks. This can lead to a dependence.

Withdrawal can result in symptoms such as intense anxiety, nausea, insomnia, irritability, dizziness and headaches. Sudden withdrawal from high doses is not recommended and can be very dangerous and result in confusion, hallucinations and convulsions. Many people find it very difficult to give up benzodiazepines and may need a gradually reduced dosage to do so. Symptoms can last from a few weeks to a year.

On their own there’s low fatality from OD but combined with other central nervous system depressants like alcohol or opioids, the risk is greatly increased.

Examples of Benzodiazepines used for sleep include: lormetazepam, loprazolam, nitrazepam, temazepam.

Read more about Benzodiazepines.

Z-drugs

Z-drugs act in a very similar way to benzodiazepines and can be used to treat insomnia. While similar they have fewer adverse side effects and are often prescribed first. 

Effects

Z-drugs have a calming effect on various functions of the brain resulting in sedation, reduced anxiety and muscle relaxation.

Users may experience drowsiness, light-headedness, forgetfulness and confusion. They may have an increased risk of accidents including car accidents.

Like benzodiazepines, tolerance can be gained quickly and users can become dependent. Users can experience withdrawal-related anxiety during the day.  

The Z drugs currently licensed for prescription in the UK are zolpidem and zopiclone.

Barbiturates

Barbiturates are synthetic drugs which used to be regularly prescribed for anxiety, depression and insomnia. They have now almost entirely been replaced by benzodiazepines and nonbenzodiazepines (“Z-drugs”). This was partly due to their ability to cause dependence and also because of the small difference between a normal dose and an overdose.

Effects

Barbiturates are sedative drugs which slow down the central nervous system in a similar way to alcohol. A small dose will make people feel relaxed, sociable and good humoured. With larger doses hostility and anxiety are common effects and slurred speech, loss of coordination and difficulty staying awake may follow. Falling over and accidents become more likely.

There is a high risk of overdose because the lethal dose is quite close to the ‘normal’ dose level. The risk is greater if barbiturate use is combined with use of other downer drugs like alcohol, heroin or tranquillisers.

Read more about Barbiturates.

Recreational use

Sleeping pills can be misused and taken recreationally for their relaxing effect. They can also have  hallucinatory effects if the user fights the urge to sleep after taking.

Prevalence

According to Statista’s research (Leading 10 dispensed hypnotics and anxiolytics in England in 2020), Zopiclone was the most common anxiolytic to be prescribed in 2020 with nearly 5.1 million items prescribed. Temazepam was 5th on the list and had nearly 810,000 items prescribed and nitrazepam was 7th with over 380,000.

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