According to a 2020 study, 8.4% of adults in the US use prescription sleep medication to help with insomnia and sleep problems.[1] While these drugs are widely used, they can have side effects and risks to be aware of.
There are sedative dangers and sleep medication risks with virtually all sleep medications, but some have greater risks than others. Learn more about dangerous sleeping pills and precautions to take.
Key Points
- Many sleeping pills can be used to treat different types of insomnia and sleep disorders.
- Though sleeping pills can be effective for treating short-term insomnia, they all carry risks and side effects.
- All sleeping pills have a risk of dependence and addiction, especially with long-term use or abuse.
What Is Insomnia?
Insomnia is characterized by difficulty sleeping at least three days a week for at least three months. This can mean trouble falling asleep, staying asleep, or waking too early and not being able to go back to sleep.
There are many potential causes of insomnia, including depression, anxiety, mental health conditions, pain conditions, and medications.[2] Poor sleep hygiene habits, such as eating not long before bed or spending time on your phone just before falling asleep, can affect insomnia.
What Are Sleeping Pills?
Depending on the cause and symptoms, several drugs may be prescribed to treat insomnia. Some are used to help you fall asleep, while others are designed to help you sleep fully and restfully.
Many sleeping pills are classified as sedative-hypnotics, which include benzodiazepines, barbiturates, and other hypnotics. Benzos are anti-anxiety medications, but they increase drowsiness and help you sleep. Barbiturates depress the central nervous system, which has a sedative effect.
Newer medications, such as Ambien, Lunesta, and Sonata, have been developed specifically to help with sleep. Another drug that has been used more recently, Rozerem, has a different mechanism and affects melatonin in the brain, the hormone that influences sleep-wake cycles.
Zolpidem
Zolpidem, commonly known as Ambien, Edluar, or Zolpimist, is a sedative-hypnotic medication used for the short-term treatment of insomnia. It belongs to a class of drugs known as non-benzodiazepine sleep aids and enhances the effects of the neurotransmitter gamma-aminobutyric acid (GABA), which induces sleep.
While zolpidem can be used safely for short-term treatment of insomnia, it does have some side effects like drowsiness, dizziness, headache, nausea, and memory problems.[3] Some people have complex sleep behaviors that can be dangerous, such as sleepwalking or sleep driving.
Zolpidem also has the potential for dependence and abuse, particularly with long-term use. In some cases, zolpidem may impair functioning the next day, leading to a “hangover” feeling.
Zaleplon
Zalepion, commonly known as Sonata, is another non-benzodiazepine sleep aid that’s used to treat insomnia. It has a short half-life, making it effective for people who need help falling asleep but not staying asleep.
Like Ambien, zalepion is intended for the short-term treatment of insomnia – particularly for falling asleep. It can cause drowsiness, dizziness, headache, and nausea, though its short half-life is less likely to cause next-day drowsiness. Though rare, zalepion can cause complex sleep behaviors.[4]
There’s a potential for dependence on zalepion. If you stop taking it, you may experience withdrawal symptoms, including rebound insomnia.
Triazolam
Triazolam, commonly known as Halcion, is a benzodiazepine used for short-term management of insomnia. Its quick onset and short duration of action can help with falling asleep but may not be ideal for maintaining sleep.
There are some serious side effects with triazolam, including drowsiness, dizziness, memory impairment, and the potential for coordination problems.[5] In some people, triazolam can cause behavioral changes like aggression or hallucinations.
Like other benzos, triazolam has a high potential for dependence, tolerance, and withdrawal symptoms. If you take benzos for a long period, there’s a risk of serious withdrawal symptoms, including seizures and rebound insomnia.
Temazepam
Temazepam, commonly known as Restoril, is a benzodiazepine commonly prescribed for short-term treatment of insomnia. It helps with both falling asleep and staying asleep. It’s generally preferred over other benzos for chronic, prolonged insomnia.
Several side effects with Restoril exist, including drowsiness, dizziness, headache, and coordination problems.[6] Some people may experience memory issues and mood swings.
Like other benzos, there’s a risk of dependence and tolerance with the long-term use of temazepam. Stopping temazepam suddenly causes a risk of withdrawal symptoms and rebound insomnia if used for extended periods.
Suvorexant
Suvorexant, sold under Belsomra, is an orexin receptor antagonist used to treat insomnia. It works by blocking the action of orexin, a neurotransmitter that promotes wakefulness and helps you to fall asleep and stay asleep.
Belsomra has some side effects, including drowsiness, headache, dizziness, and dry mouth.[7] It may also cause abnormal dreams, sleepwalking, and next-day drowsiness. Some people experience complex sleep behaviors with suvorexant, and there’s also a risk of dependence.
Ramelteon
Ramelteon, commonly known as Rozerem, is a melatonin receptor agonist that mimics the action of melatonin, a hormone that regulates sleep-wake cycles. It’s used to treat difficulty falling asleep, particularly with chronic insomnia.
Ramelteon has several common side effects, including drowsiness, dizziness, and fatigue.[8] Less commonly, it can cause nausea and headaches. While ramelteon is generally considered to have a lower risk of dependence compared to other sleep aids. However, it can be habit-forming.
Daridorexant
A newer orexin receptor antagonist, daridorexant, sold under the brand Quviviq, works similarly to suvorexant. It’s designed to help with sleep onset and maintenance by inhibiting orexin neurotransmitters.
Daridorexant’s side effects are similar to other insomnia drugs and include fatigue, dizziness, headache, drowsiness, unusually deep sleep, and hallucinations.[9] Some people may experience sleep paralysis on daridorexant. There is a risk of dependence with long-term use.
Because daridorexant is newer to the market, its long-term risks are still being evaluated.
Doxepin
Doxepin, commonly known as Silenor, Zonalon, or Prudoxin, is a tricyclic antidepressant with sedative properties used in low doses to treat insomnia. It is particularly useful for improving sleep maintenance rather than inducing sleep onset.
Side effects are common with doxepin, including drowsiness, dry mouth, constipation, and blurred vision.[10] It can also cause weight gain and urinary retention. Some people may experience next-day drowsiness, especially if it’s not taken as prescribed. There’s also a risk of dependence and anticholinergic effects, such as behavioral changes, confusion, delirium, and hallucinations.
Eszopiclone
Eszopiclone, commonly known as Lunesta, is a non-benzodiazepine sleep aid used to treat insomnia. Similar to zolpidem, it helps with sleep onset and maintenance by enhancing the activity of GABA.
Lunesta has several common side effects, including drowsiness, dizziness, headache, and unpleasant taste.[11] It can also cause dry mouth and gastrointestinal issues. Some people experience complex sleep behaviors and next-day impairment. Lunesta has a risk of dependence and withdrawal symptoms like rebound insomnia.
Lemborexant
Lemborexant, sold under Dayvigo, is another orexin receptor antagonist like suvorexant and dandorexant. It helps with falling asleep and staying asleep by blocking orexin signaling.
Like other sleep medications, lemborexant has side effects like headache, drowsiness, and dizziness.[12] It may also cause dry mouth and abnormal dreams. Like other orexin receptor antagonists, it may cause next-day drowsiness and impaired motor skills. It has a risk of dependence, particularly with prolonged use or abuse.
What’s the Most Dangerous Sleeping Pill?
Newer sleeping pills are generally safer than their barbiturate predecessors, but they aren’t without risks. All sleeping pills have a risk of dependence, and overdose, especially when used at high doses, for longer periods than intended, or combined with other drugs. Combining sleeping pills – or any depressant – with other depressants like alcohol or opioids significantly increases the risk of overdose and other adverse effects.
The signs of a sedative overdose are specific to the drug but generally include slurred speech, problems breathing, dizziness or fainting, vomiting, slowed heartbeat, cold skin, bluish tinge to lips, fingers, and skin, unconsciousness, shock, and coma. Sleeping pill overdoses can be fatal without intervention, so it’s crucial to seek emergency medical attention if you suspect an overdose.
Getting Help for Sleeping Pill Addiction
Though sleeping pills can be successful in treating short-term insomnia, it’s possible to become addicted to them. For some, they become unable to sleep without the help of a pill, and as their tolerance increases, they may need to take larger dosages to get the same results. For others, sleeping pill addiction occurs when they abuse sleeping pills or mix them with other drugs to get unique effects.
Even if you’re not psychologically addicted to sleeping pills, which is a compulsive need to use sleeping pills, and unsuccessful attempts to quit or reduce usage, you can become dependent on them. This is different from addiction, but you can still experience withdrawal if you try to stop – sometimes with dangerous complications.
The first step in overcoming sleeping pill addiction is often detox. Withdrawal can have dangerous complications, especially with benzos, so medical detox is recommended to provide medical supervision and alleviate symptoms.
With physical dependence, detox may be enough to stop taking sleeping pills. However, with a sleeping pill addiction, an inpatient or outpatient addiction treatment program may be necessary to address the causes of addiction and treat the underlying factors of insomnia. On the other hand, individualized treatment may include behavioral therapies and classic therapies like individual and group counseling.
Take Precautions with Sleeping Pills
Insomnia is a common and disruptive problem that can negatively impact your life and health. Sleeping pills can be effective in treating short-term insomnia, but they have side effects and risks to be aware of.