Sleep is as essential to life as nutrition and physical safety. When our sleep suffers, so does every part of our life, from work to relationships.
About one third of adults struggle with insomnia — and many of these turn to sleeping pills to try to get their lives back on track. As many as four percent of adults use prescription sleeping pills like Ambien or Lunesta.
Unfortunately, anyone who takes medication for insomnia can develop an addiction. Many people take sleeping pills for years – over time, a person will develop tolerance to the drug, creating a need to take larger doses to get some sleep. Withdrawal symptoms like rebound insomnia, anxiety, tremors and seizures can occur in this type of addiction.
Are Sleeping Pills Addictive?
Insomnia is one of the most common complaints heard in the primary care office. In most cases, a person with insomnia is prescribed a prescription sleep aid. Benzodiazepines are commonly prescribed for difficulty sleeping. These drugs can be addictive if a person takes them in high doses or for an extended period. Benzodiazepine sleeping pills should be taken at the lowest effective dose for the shortest amount of time.
Commonly prescribed benzodiazepines for sleep include:
· Lorazepam (Ativan)
· Clonazepam (Klonopin)
· Temazepam (Restoril)
· Diazepam (Valium)
· Alprazolam (Xanax)
You’ve probably heard of some popular sleeping pills like Ambien and Lunesta. These types of sleeping pills are called non-benzodiazepine sleeping pills. They work similarly to benzodiazepines, but have fewer side effects and are less likely to cause addiction.
The most common non-benzodiazepine sleeping pills are:
· (Zolpidem) Ambien
· (Zaleplon) Sonata
· (Eszopiclone) Lunesta
Signs and Symptoms of Sleeping Pill Addiction
When you wake up groggy and flinch at the idea of your long day ahead, you know you didn’t get the best night’s sleep. It’s hard to know whether you feel that way because you didn’t get enough sleep or if you’re feeling the effects of a sleeping pill hangover. So how can you tell if you are becoming addicted to sleeping pills or just not getting enough sleep?
Some signs and symptoms that you might be addicted to sleeping pills include:
· Intense fatigue throughout the day
· Sleeping through your alarm
· Trouble remembering minor details of your day
· Angry outbursts for no reason
· Declining performance at work and home
· Frequent illnesses
· Inability to sleep without medication
· Trying to stop taking sleeping pills without success
· Taking sleeping pills despite the negative consequences they cause
Are Sleeping Pills Dangerous?
The primary danger of sleeping pills is the potential for overdose. Benzodiazepines caused nearly 12,000 overdose deaths in 2017, making them the most dangerous type of sleeping pill. It’s not uncommon for people to mix these sleeping pills with drugs or alcohol; a choice that can be fatal. Non-benzodiazepine sleeping pills like Ambien are less addictive than other sleeping pills, but a person can still become addicted. The use of alcohol with these drugs is especially problematic and can cause cardiac and breathing problems. When a person is addicted to these sleeping pills, they can experience tremors, panic attacks and even seizures if they stop taking the drug.
Dependence on sleeping pills is linked with dangerous sleep behaviors like sleepwalking, sleep driving, sleep eating and sexual behavior. The effects of sleeping pills can last up to eight hours after you wake up, causing driving impairment the morning after you use them.
Are Sleeping Pills Effective?
Ask a person with insomnia about their relationship with sleeping pills, and they might tell you they’d be lost without them. Yet, while many people rely on sleeping pills, science tends to disagree that people who use them get more sleep.
No one would argue that an extra fifteen minutes of sleep is nice. Yet, do most people who use sleeping pills know that evidence suggests an extra fifteen minutes is all you’ll get? If a sleeping pill only gets you a few minutes more sleep, then why are people so satisfied with their sleeping
pill habit? Sleeping pills soothe the same part of the brain that regulates anxiety, so a person who takes one worries less and generally feels happier.
While sleeping pills have their dangers, it’s also dangerous to go without sleep. Sleep deprivation is linked to preventable but life-threatening health conditions including diabetes, heart disease, obesity and depression. Lack of sleep can also put you in dangerous situations while driving or working.
Natural Alternatives to Sleeping Pills
Rightfully so, many people seek to find a balance between getting enough sleep to function and avoiding addictive sleeping pills. Luckily, there are some natural alternatives to sleeping pills that may be just as effective.
Diet Changes for Insomnia
It’s not the first thing most people think about when trying to treat insomnia, but diet changes can help a person get to sleep and stay asleep. As with everything, each person’s body is different and what works for one person may not work for another.
High glycemic index foods like white rice, pasta, bread and potatoes can help a person feel calm and sleepy if eaten less than an hour before bedtime. High carbohydrate diets in general can help people get to sleep faster, while high protein diets are believed to improve the quality of sleep. Diets high in fat are believed to reduce the total amount of time a person sleeps. Reduction in calories, as with dieting, can negatively impact a person’s quality of sleep.
Some hormones found in foods can promote sleep. Tryptophan can be found in both turkey and pumpkin seeds and can help a person fall asleep and stay asleep. Grapes, cherries, tomatoes, mushrooms and pistachios are some foods that are high in melatonin, a hormone that can help a person fall asleep faster.
Sleep Hygiene for Insomnia
Changing your sleep hygiene, or sleep routines, can help you create a peaceful environment for sleep without the use of sleeping pills. Keeping the time you go to sleep and wake up each day consistent will help regulate the body clock in a way that helps it rely on its own mechanisms to sleep and wake.
If you have trouble sleeping once you are in bed, don’t stay there. Rise from bed and do something relaxing, like reading a book or petting your dog until you feel sleepy again. If you head to bed and still aren’t able to sleep, continue this routine until you are able to fall asleep.
Alcohol and caffeine both work against your best efforts to sleep. Although some people believe alcohol helps them feel sleepy, it’s best to avoid it because it negatively impacts quality of sleep.
Make your bedroom as pleasant as possible, with soft, clean sheets and fluffy pillows and blankets. Cover any blaring lights from alarm clocks, fans or other electronic devices. Don’t watch screens in your bed or for an hour before bedtime. Use a white noise machine or app to distract from other noises outside or around the house. Some people find wearing an eye mask or ear plugs helpful at minimizing distractions.
Cognitive Behavioral Therapy (CBT) for Insomnia
Cognitive behavioral therapy (CBT) is a highly studied form of therapy that is often recommended for treatment of insomnia. During a CBT session, a therapist can help you identify why you have trouble falling asleep or staying asleep. The therapist will help you identify patterns of behavior and thinking that get in the way of a good night’s sleep. You will learn tools to reroute the thoughts and behaviors into positive actions that can help you sleep better. CBT may be cost prohibitive for some people who live with insomnia, but there are also web and smartphone-based apps that use CBT to tackle insomnia.
Exercise Therapy for Insomnia
Exercise is probably the easiest, most accessible, most affordable and most natural way to treat insomnia. People who have a moderate to high level physical activity each day are 56% less likely to have insomnia. In fact, when a person exercises daily, sleep improvements are like those felt by sleeping pills.
There are a few factors at play that make exercise so beneficial to sleep. One is that raising your body temperature is a trigger for your wake and sleep cycles. Increasing your core temperature with exercise tells your body that it’s wake. Later your body will cool down, letting your system know it’s time for sleep.
Melatonin for Improved Sleep
Melatonin is a hormone produced in the human brain, but it can also be taken as a supplement. It can be purchased over the counter and is one of the most commonly used natural sleep aids. This hormone helps regulate biological rhythms that tell the body when it’s time to sleep and wake. Melatonin has been well-studied in cases of jet lag and shift work and evidence suggests it reduces time to fall asleep.
Valerian for Improved Sleep
Valerian root is derived from a flowering plant. It is perhaps one of the most studied natural sleep aids because it has been used in Europe for decades. Valerian is becoming increasingly popular because it can be purchased over the counter, is inexpensive and has no ascertainable side effects. In people who use valerian root for insomnia, up to 80 percent say their sleep quality is improved. Valerian root has shown to be especially effective in women with menopause related insomnia.
Tryptophan for Improved Sleep
Tryptophan is an amino acid that communicates with the human brain to moderate sleep cycles. Tryptophan is necessary for the creation of serotonin, “the happiness chemical,” that in turn produces melatonin. Tryptophan can be taken as a supplement to improve insomnia, but it’s also found in some food sources like eggs, turkey, chicken, milk, cod and salmon.
L-Theanine for Sleep
L-Theanine, is another amino acid that can improve sleep. It was first discovered in green tea, and has noted relaxation properties. It isn’t believed to have any side effects and contains properties that are thought to be beneficial to long term health and brain development.
Finding the Insomnia Solution without Sleeping Pills
In our fast-paced culture based on productivity, going without sleep is often a badge of honor. However, the consequences of sleep deprivation are risky and can negatively impact long-term health, as well as immediate physical and mental health.
Protecting sleep is a form of self-care that enables a person to better serve their work, community and family. Yet, finding the balance between getting some sleep and avoiding sleeping pills can be tricky for people who are under a lot of stress.
No one wants to live with insomnia, but taking sleeping pills may be riskier than sleep deprivation if you have a personal or family history of drug dependence. Many people cycle through a number of lifestyle changes and sleep supplements before finding the right combination that improves length of and quality of sleep. If you’re unable to find the right combination on your own, working with a nutritionist, therapist or personal trainer are some alternatives to taking sleeping pills that are backed by science.
Small changes every night to your sleep routine can help you achieve restful sleep without the overwhelming feelings of changing everything at once.
Author: Dr. Sarah Toler. Dr. Sarah Toler is a Certified Nurse Midwife and Doctor of Nursing Practice in Los Angeles. She is a graduate of Baylor University Louise Herrington School of Nursing and completed her nurse midwife residency at Parkland Memorial Hospital in Dallas, Texas. Dr. Toler specializes in women’s mental health, particularly perinatal and postpartum mood disorders including depression, anxiety, and obsessive-compulsive disorder. She works as a medical reviewer and writer for Addictions.com on her spare time, often writing about substance use disorders, and their connection to mental health.