Sleeping Pill Use Disorder

Medically reviewed by:
Dr. Kimberly Langdon, M.D.

What is Sleeping Pill Addiction?

Sleeping pills, formally called “sedative-hypnotics,” are a class of psychoactive drugs used to treat insomnia and other sleep disorders. People who become dependent on sleeping pills or use them in ways not prescribed by a doctor have what is sleeping pill addiction.

Prescribed use of sleeping pills is fair common across the population. About 4% of adults over the age of 20 use them, with more women (5.0%) tending to use them than men (3.1%). Usage also increases gradually with age and with education. About 11% of pills prescribed for sleeping disorders are benzodiazepines, the first class of sleeping pills available commercially.

It is important that prescription sleep medication is managed by a physician. Some of these drugs, like Ambien, are inappropriate for patients with a history of liver disease, because they inhibit the cytochrome P450 metabolic system, which may increase exposure to the drug. Frequent and long-term use of some sleeping pills may not be appropriate for elderly metabolisms, as well, and some show links with eventual dementia.

Types of Sleeping Pills

Generally speaking, sleep-aids depress the central nervous system. That helps reduce the time it takes to fall asleep. Sleep aids typically act within a couple of hours, and most of them leave the system in 12 or 13 hours.

Commonly prescribed sedatives for aid in sleeping include:

• Butabarbital
• Chloral hydrate
• Estazolam
• Eszopiclone
• Flurazepam
• Ramelteon
• Temazepam
• Triazolam
• Zaleplon
• Zolpidem

There are over-the-counter sleep aids, melatonin, various antihistamines, and valerian. Melatonin is a hormone derived from tryptophan, an amino acid, and secreted by the pineal gland. Melatonin helps regulate circadian sleep rhythms. Some antihistamines, like diphenhydramine (Benadryl), which is commonly used for hay fever, help make people sleepy and ready for bed. Valerian, a flower known to parts of Europe and Asia, has various biochemical properties. In naturopathic medicine, valerian is a routine treatment for insomnia.

The most commonly abused prescription sleeping pills are benzodiazepines, barbiturates, and Ambien. Both of these medications are CNS depressants that work by slowing brain activity and cause drowsiness. These drugs are also useful in anxiety, panic and GADs.

Prescription sleeping pills come in pill, capsule, or liquid form, which a person takes by mouth.

Commonly prescribed sleeping pills are:

• Ambien or zolpidem
• Belsomra or suvorexant
• Benzodiazepines
• Lunesta or eszopiclone
• Rozerem or ramelton
• Sonata or zaleplon
• Trazadone- an antidepressant with sedating qualities

What are the Side Effects of Sleeping Pill Addiction?

The most common signs and symptoms of abuse of sleeping pills include:

• Drowsiness
• Dizziness
• Amnesia
• Impaired consciousness
• Sleepiness during the daytime
• Visual hallucinations
• Slurred speech
• Difficulty in concentration
• Dry mouth
• Low blood pressure
• Headaches

Those who begin taking prescription sleeping pills become uncoordinated and become sleepy until their body adjusts. Other effects of sleeping pill misuse included slurred speech, difficulty concentration, dry mouth, hypotension, and headaches.

Complex sleep behaviors occur when you are not fully awake, such as sleepwalking, sleep cooking, and sleep-driving with no recollection of the event. There have been numerous reports of people shooting themselves, being burned, and accidentally overdosing.

When taken regularly (even at prescribed doses) sedatives can cause physical and psychological dependence.

Abrupt discontinuation or even decrease in dose can cause withdrawal symptoms, sometimes severe. The symptoms of withdrawal syndrome can include any of these:

• Muscle cramps
• Vomiting
• Sweating
• Tremors
• Convulsions
• Anxiety
• Insomnia
• Seizures
• High blood pressure
• Cravings
• Hallucinations

What are the Signs of a Sleeping Pill Overdose?

Sedatives function by dampening the central nervous system’s control over bodily functions, so a sleeping pill overdose can impede a person’s involuntary functions, like breathing and cardiac action. The effect can appear much like heavy alcohol intoxication. Sleeping pill overdose has been known to kill people.

During a sleeping pill overdose, respiration and vital signs are monitored, and supportive treatment is provided when necessary.  The sedative effects can be reduced. Treatment teams are also alert to the possibility of more than one drug having been taken.

Sleeping pill overdose symptoms can include any of these:

• Slurring speech
• Unsteadiness
• Slowed breathing
• Dizziness or fainting
• Vomiting
• Clouded thinking
• Slowed heart rate
• Cold skin, especially in the extremities
• Bluish lips or fingertips
• Shock
• Coma
• Death

Treatment Options for Sleeping Pill Use Disorder

Success rates in treatment overall are highest in inpatient settings. Those who are addicted to sleeping pills should undergo detoxification that is medically supervised, as dosage should be gradually tapered, and carefully monitored.

Counseling should be conducted, either in an inpatient or an outpatient setting. Cognitive behavioral therapy is a standard psychotherapeutic approach, focusing on distorted thinking and resultant behavior.