Problems

Prescription sleep medications may be taken:

1. when sleep difficulties cause problems in carrying out daily activities
2. the cause of insomnia has been identified and found best treated with medication
3. the sleep problem is expected to be temporary and short-term
4. behavioral approaches did not help or the person is unwilling to try them
5. insomnia is expected because of a known medical or biological condition or an event
such as giving a speech or traveling across time zones

Prescription sleep medications that promote sleep are called hypnotics. Among the commonly prescribed     hypnotic drugs are a group known as benzodiazepines. This group of drugs act on areas in the brain believed to be involved in promoting sleep. Examples of benzodiazepine drugs commonly used are lorazepam (Ativan), diazepam (Valium) and midazolam (Dormicum). There are also non benzodiazepine hypnotics such as Zolpidem and Zopiclone. Other medications such as antidepressants and other agents have also been used to promote sleep. These are however usually prescribed by specialists only after the person has failed to respond to non medical treatment and first-line medications.

Using benzodiazepines at correct doses for a short period of time is effective. It can help a person to function well and improves quality of life. Side effects that can occur include feeling sleepy during the day or finding it difficult to carry out routine daytime tasks.

Some may find themselves waking up too early in the morning particularly after taking a benzodiazepine with a short duration of action. Rarely, a person taking a hypnotic may feel very agitated instead of calm and should stop taking this medication immediately and inform his doctor.

In most cases medication is used only until the immediate stressor is under control or lifestyle changes have had a chance to work. Addiction to benzodiazepine can occur, even with regular use for only two weeks, especially when doses higher than prescribed are taken. People who have problems with drug or alcohol abuse are more prone to become dependent on benzodiazepines.

It is generally considered acceptable to take hypnotic medications, especially when the person does well on the same dose and has no side effects. In fact, not taking it may cause more distress to the person.

Should your doctor prescribe you hypnotics, you should strictly follow the dosage prescribed by your doctor. Avoid alcohol as alcohol and hypnotics enhance each other’s effects. There may be a risk of unsteadiness and falls in the elderly who need to get up in the middle of the night.

Doses should therefore be lower for the elderly. Those who operate heavy machinery and drive need to be aware of the effects of the hypnotic on them as the risk of accidents may be increased. Many people taking hypnotics for more than 2 weeks need to understand that the medications should be gradually decreased rather than stopped all at once. Without gradual tapering, stopping abruptly may cause the insomnia to come back. You should work with your doctor to discontinue the hypnotic medication gradually.

OTC Prescription Sleep Medication

Sleep aids are available over the counter (OTC) because they have been found to be safe when used according to directions. Many such medications include antihistamines.
These substances are used for ‘runny” noses or allergy attacks and has sedating (calming) effects. However OTC drugs are subjected to less rigorous testing and may be less effective.

They also should not be taken with alcohol or other drugs with sedating effects. Older persons should be careful about these drugs as they stay in the body longer and can cause daytime sleepiness and unsteadiness. People with breathing problems, glaucoma, chronic bronchitis and difficulty urinating, or women who are pregnant or breastfeeding should avoid them.

Herbal products such as valerian root, or melatonin (an artificial or animal form of a substance produced by humans that is linked to sleep) are not required to undergo the same rigorous testing as prescription drugs. Their long-term impact, side effects and possible interaction with other drugs or medical conditions are often unknown.

It is advisable to discuss the use of OTC sleep aids with your doctor, especially if you are going to take them for a significant period of time. It is important to note that if you are taking sleep aids, whether prescribed by your doctor or bought OTC, you will also need to focus on improving your sleep practices.

Problems With Prescription Sleep Medication