It is estimated that more than a fifth of older adults use insomnia medications. These sleeping pills are usually available with prescriptions. The newer insomnia drugs have fewer side effects than the older benzodiazepine-based sedatives. Sleeping pills should be taken only before bedtime. Doctors recommend combining good sleeping practices with sleeping pills to improve sleep.
Drugs & Medications to Treat Insomnia
Benzodiazepine Hypnotics
Benzodiazepine hypnotics, the oldest drugs used for treating insomnia, are among the most effective insomnia medications. They work for a longer time, and are recommended for treating sleep-related problems such as night terrors and sleepwalking. By activating the gamma aminobutyric acid (GABA) receptors in the brain, benzodiazepine-based sedatives improve sleep.
Benzodiazepine hypnotics are divided into two categories – long acting benzodiazepines and medium to short acting benzodiazepines. The side effects of these sedatives vary from person to person. Their severity usually depends upon the age of the user, the dosage of the drug and duration of its use.
Side effects are more severe in elderly people, especially after taking the long acting benzodiazepines. These sleeping pills can cause severe allergic reactions, facial swelling, daytime drowsiness, respiratory distress, depression, memory loss and urinary incontinence. Overuse of these drugs can be fatal.
To prevent dependence on these sedatives, they are recommended only for short-term use. Withdrawal syndromes may occur when the drug is stopped after prolonged use. Insomnia may recur, a condition known as rebound insomnia, after stopping the drug. Risk of rebound insomnia is higher following short-term benzodiazepine use.
Zolpidem
Zolpidem is a non-benzodiazepine hypnotic. This common sedative helps a person to get a full night’s sleep for 7 to 8 hours. You may sleep for fewer hours by taking the original version of this insomnia drug.
To avoid waking up in the middle of the night, the new extended release version of the drug is recommended by doctors. Zolpidem is also available in the form of oral spray. It is used for treating short-term sleeping problems. Within 15 to 30 minutes after taking the sedative, a person falls asleep.
Eszopiclone
Eszopiclone is a non-benzodiazepine sedative that provides full night’s sleep. It helps to maintain sleep throughout the night. Unlike most sedatives, this insomnia medication does not cause daytime drowsiness. It is one of the few sleeping pills approved for prolonged use.
Ramelteon
Unlike most sedatives that work on the GABA receptors, ramelteon targets the melatonin receptors in the brain. It is one of the safest sedatives that work by modulating the sleep-wake cycle. Dependence on ramelteon has not been observed following long-term use.
Zaleplon
This sedative works for the shortest time. It helps a person to sleep for at least four hours. Since it remains active for a short time, zaleplon is not suitable for people who wake up frequently throughout the night. It is usually recommended for people who have difficulty in falling asleep.
Antidepressants
Insomnia related to depression is treated with antidepressants. Sedating antidepressants promote sleep by targeting the neurotransmitters that control mood. Dizziness and daytime sleepiness are common side effects of sedating antidepressants.
