Beware Side Effects of Sleep Aids

Two of the most popular supplements for sleep, melatonin and valerian, both taken at night, are also not recommended for long-term use. Melatonin is a hormone made by the body that helps regulate its internal clock, telling you when to go to bed and when to wake up, and melatonin supplements have been proposed as a sleep aid. But a comprehensive analysis of research studies, published in 2004, determined that short-term use doesn’t help with most sleep disorders. As for valerian, some studies show it may help halt insomnia with fewer side effects than most drugs, but more research is needed to determine long-term safety and effectiveness.

Two newer classes of prescription medications have come on the market in recent years. One class, called nonbenzodiazepines, includes medications such as eszopiclone (Lunesta), zaleplon (Sonata) and zolpidem (Ambien). They induce drowsiness by working on a particular receptor in the brain, called GABA, believed to be influential in sleep. Two years ago, the FDA approved ramelteon (Rozerem). It works differently than other prescription sleep medications, affecting the melatonin receptors in the brain, so it may work best for people who have trouble falling asleep. Rozerem is not believed to have the same potential for abuse and dependence as other sleep drugs and is approved for long-term use.

Although the newer medications may be somewhat safer, they aren’t risk-free. The FDA recently required all manufacturers of prescription sleeping pills to strengthen the warnings on their labels about potential risks, including severe allergic reactions, angioedema (severe facial swelling) and odd behaviors such as sleep-driving, making phone calls, and preparing and eating food (while asleep).

In addition to physical side effects, sleeping pills also can reap a psychological price. Users sometimes feel as though they’ve lost control over their sleep, says Smith. “You basically lose the belief that your body can function normally,” he says. “Then people end up taking it longer than they need it.”

Treat Underlying Conditions

Consider these possible treatments for the underlying conditions that can lead to sleeplessness:

Antidepressants. Although antidepressants are not sleep medications, regular doses may improve sleep both by elevating mood and reducing anxiety and by boosting levels of serotonin in the brain. In addition, some antidepressants (such as tricyclics) have sedating effects.

Anxiety treatments. Relaxation techniques and behavior modification can reduce anxiety, which can lead to better sleep.

Pain medications. Talk to your doctor about medications that can better manage your pain. Stronger drugs, such as opioids and narcotics, are designed for short-term use and can leave you feeling sleepy the next day. For some people with chronic pain, low-dose antidepressants can interrupt the pain cycle and help them sleep better. You may have to try several medications before you find one that resolves your issues with pain and sleep.