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Medication for insomnia5/8/2023 ![]() ![]() Other medicinesĬhlormethiazole, chloral, and barbiturates are old-fashioned sleeping tablets. In the UK it is not currently licensed for this. In some countries melatonin is used to help with sleep problems related to jet lag. If helpful, it can be used for a maximum of ten weeks in total. The recommended duration of treatment is for three weeks to start with. A melatonin supplement is sometimes advised in older people (more than 55 years of age) with sleep disorders such as long-term insomnia. It is involved in helping to regulate the daily cycles (circadian rhythms) of various functions in the body. The level of melatonin in the body varies throughout the day. Melatonin is a naturally occurring hormone made by the body. Melatonin is, strictly speaking, not a 'sleeping tablet'. For these reasons, current UK guidelines do not advise the use of antihistamines to be used solely as a sleeping tablet. They may also cause rebound insomnia if you take them for a long time. Also, they may cause a 'hangover' effect and some drowsiness in the morning. Antihistamines are not as powerful as benzodiazepines or Z drugs at causing sleep. An antihistamine is the active ingredient of some sleeping tablets that you can buy from pharmacies, without a prescription. This 'side-effect' is useful in some people who have difficulty sleeping because of their allergy. However, drowsiness is a side-effect of some antihistamines - for example, promethazine. These medicines are commonly used to treat allergic reactions such as hay fever. However, they act in a similar way (they have a similar effect to benzodiazepines on the brain cells). Strictly speaking, they are not benzodiazepines. Other related drugs called zaleplon (no longer available in the UK), zolpidem and zopiclone are also sleeping tablets. Benzodiazepines include temazepam, loprazolam, lormetazepam, and nitrazepam. Are there different types of sleeping tablet? Benzodiazepines and Z drugsīenzodiazepines and Z drugs are sometimes used as sleeping tablets. It is also thought that there is an additional placebo affect, which means that just by taking the tablets, you may feel more relaxed and positive about getting to sleep, and therefore more likely to get a better night's sleep. There are different types of sleeping pills that work in different ways, but all generally affect the brain in some way to promote sleep. Sleeping tablets work either by a general affect on the brain to promote drowsiness or by directly binding with receptors in the brain to cause sleepiness or relaxation. If you just take the tablets for a week or two, you will not become dependent on them. Doctors advise that you take no more than two weeks of sleeping tablets at a time. Or if you have jet lag and are struggling with re-setting your internal time clock. A short course of sleeping tablets (for a week or two) may help you cope better in the daytime. For example, if you have had a sudden shock or bereavement, sleeping can be a problem. In short courses for time-limited problems, they are safe to use. In some cases, however, sleeping tablets may be very helpful. Some types of people seem more likely than others to become addicted to substances. Tolerance, dependence and addiction are different things. ![]() This can happen even after you have slowly withdrawn from it so that you are no longer dependent. If you are addicted to a medication, you have uncontrollable cravings for it and feel a need to take it. Some people who are dependent on benzodiazepines or Z drugs may become addicted to them. ![]() If you have taken a benzodiazepine or Z drug regularly for more than two to four weeks, you will need to come off it gradually, to avoid withdrawal symptoms. Withdrawal symptoms include mental health problems such as anxiety, shaking, or just feeling awful. This means that withdrawal symptoms occur if the tablets are stopped suddenly. Some people become dependent on benzodiazepines or Z drugs. It can take as little time as just a few days for tolerance to develop. In time, the higher dose does not work and you need an even higher dose, and so on. You then need a higher dose for it to work. This means that, in time, the usual dose has no effect. If you take sleeping medicine such as benzodiazepines and Z drug sleeping tablets to treat insomnia each night, your body becomes used to them. (This has not been proven yet.) Tolerance ![]() One study suggests that people who use sleeping tablets for a long time are more likely to develop dementia. (Older people who take sleeping tablets have an increased risk of breaking their hip, as the result of a fall.) Risks Some people have fallen down stairs due to the drowsiness caused by sleeping tablets. You may fall over and injure yourself if you feel sleepy. These can occur - for example, if you have to get up in the middle of the night to go to the toilet. Clumsiness, drowsiness, and confusion in the night (if you get up) ![]()
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