What are sleeping pills used for?

Sleeping pills are medicines designed to help you fall asleep or stay asleep. They are sometimes used to help treat insomnia. Sleeping pills can have serious side effects. If you are having sleep problems, it's a good idea to talk to your doctor or pharmacist.

Sleeping pills can be helpful if you are going through a difficult time and temporarily finding it hard to sleep. Together with sleep hygiene tips, they can help you get your sleep back on track.

However, if you have longstanding insomnia, sleeping pills are usually not a good option. It's important to remember that sleeping pills might help you sleep, but they do not treat the cause of your insomnia.

What are the different types of sleeping pills?

There are several different types of medicines used for sleep. Some medicines are intended to be used for sleep. Others can make you feel sleepy as a side effect, although they are not sleeping pills. Some herbal medicines are used as sleeping pills, but their safety and effectiveness may not be scientifically proven.

Remember that not all medicines are safe for everyone. Check with your doctor or pharmacist before trying any medicines for sleep. This is especially important if you:

• are over 65 years of age
• have any other health conditions – especially lung disease, chronic kidney disease, liver disease or obstructive sleep apnoea
• drink alcohol on a regular basis
• take other medicines
• are pregnant or plan to become pregnant
• are breastfeeding

Prescription medicines

Benzodiazepines, such as temazepam, are the most common type of prescription sleeping pills. They slow down your brain and body function, making you feel relaxed and helping you fall asleep and stay asleep. They are recommended only for short-term use, usually for less than 4 weeks.

Other common prescription sleeping pills include zopiclone and zolpidem. Their effect on your body is similar to benzodiazepines. They are also recommended only for short-term use.

Suvorexant is a newer medicine that blocks chemicals in your brain that keep you awake. It can be useful if you wake up during the night and struggle to go back to sleep. Suvorexant can be used for longer periods of time than other prescription sleeping pills.

Over the counter medicines

Melatonin is a natural hormone that helps control your sleep and waking pattern. Melatonin may improve your sleep quality and morning alertness. Pharmacists can provide it to people over 55 years of age with poor sleep.

Occasionally melatonin may be used for children who have long-term sleep problems. Talk to your doctor if you think your child may need melatonin.

Some antihistamines, such as doxylamine or promethazine, are sometimes taken without medical advice to help relieve insomnia. They are not sleeping pills – they are anti-allergy medicines which have a side effect of making you feel drowsy. They should not be used to help you sleep.

It's important to be aware that antihistamine medicines can cause serious harm to young children. They should never be given to children under 2 years of age. Some antihistamines should not be used in children under 6 years of age – follow the directions on the pack and talk to your doctor or pharmacist if you are not sure.

Herbal and traditional medicines

Herbal medicines are sometimes used to treat insomnia. Not all of these medicines have been proven to help you fall asleep. The most frequently studied medicines include:

• chamomile
• passionflower
• St John's wort
• valerian and hops combination

Chinese herbal medicine may be effective for sleep. Talk to a Chinese medicine practitioner to find out what might help you. Chinese medicine practitioners are regulated in Australia by the Australian Health Practitioner Regulation Agency (AHPRA). You can check if your practitioner is registered on the AHPRA website.

Do some medicines have a side effect of sleepiness?

Some medicines, not specifically designed as sleeping pills, can make you feel drowsy – for example, some antihistamines. This is an unwanted side-effect and they are not intended to be used as sleeping tablets.

Some medicines prescribed for mental health conditions can make you feel drowsy as a side effect. If you take medicines for your mental health, such as antidepressants or antipsychotic medicines, ask your doctor or pharmacist if they are likely to make you feel drowsy. It's important to take your medicine as instructed by your doctor and not to use it for sleep.

What are the risks of taking sleeping pills?

One main risk of sleeping pills is that you can become dependent on them. This means they become less effective over time. You will need to use higher doses to fall asleep and you will find it harder to sleep well without them. You may also begin to feel unwell or experience worse insomnia when you try to stop.

Sleeping pills can also make you unsteady, dizzy and forgetful. They can make it hard for you to concentrate. You might feel groggy or tired the next day. These side effects may increase your risk of having accidents and falls, especially if you are older.

Some types of sleeping pills can cause you sleepwalk or even drive while you are asleep. This is more likely if you take other medicines or drink alcohol.

How do I use sleeping pills safely?

Speak to a doctor or pharmacist if you have trouble sleeping. Don't start taking pills or other substances to help with sleep before you speak with your doctor, as they may have other suggestions to help you manage your insomnia.

If your doctor has prescribed sleeping pills, here are some tips on how to use them safely:

• Check with your doctor or pharmacist if you can take your sleeping pills with your other prescription and non-prescription medicines. This includes herbal and traditional medicines.
• Take the sleeping pills as prescribed.
• Ask your doctor how long you need to take them and how to stop safely.
• Don't mix sleeping pills with alcohol.
• Don't take someone else's sleeping pills or share yours with anybody.

Sleeping tablets generally start working within 20 to 30 minutes after you take them. It is important that you get into bed after taking any sleeping tablets. There is a risk of feeling unsteady once the tablets start working.

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How can I sleep well without taking medicines?

The first step to sleeping well is to practice good sleep hygiene. This means creating a good sleep environment, maintaining a consistent sleep schedule and controlling factors like noise and temperature. Good sleep hygiene also includes avoiding stimulating activities close to bedtime, limiting your caffeine and alcohol intake, and doing relaxing activities before going to bed.

You can also improve your sleep without medicines with the help of cognitive behaviour therapy (CBT), a type of psychological therapy. CBT is the recommended treatment for insomnia.

CBT can help if you have difficulty falling asleep or struggle to stay asleep for the whole night. It can help to change behaviours and thoughts that disrupt sleeping.

Therapy usually involves the following techniques:

• Mindful breathing helps you to stay calm and be in the present moment, by focusing on your breathing rather than on your thoughts.
• Visual imagery helps you to create pictures in your mind that make you feel calm.
• Muscle relaxation makes you aware of any muscle tension.
• Stress reduction techniques help you handle stress and make you feel less stressed over time.
• Sleep restriction means spending less time in bed overall, so that you are asleep for most of the time you spend in bed.
• Stimulus control means you use your bed only for sleeping and get up if you can't fall asleep within 15 to 20 minutes. It also means you don't sleep anywhere else besides your bed. This is to train your brain to associate your bedroom with sleep.

Talk to your doctor to find out more about treatments for your insomnia that don't involve medicines. Your doctor can also recommend a therapist trained in CBT.

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Resources and support

• If you take benzodiazepines, Reconnexion supports you to better understand your medicine and helps you manage withdrawal, poor sleep and anxiety. Phone 1300 273 266.
• The Sleep Health Foundation has a range of sleep factsheets, including helpful tips for children, teenagers and older adults with sleep difficulties.
• If you have questions about your medicines, or need general information about side effects, you can call Medicines Line on 1300 633 424.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.