If you suffer from sleep deprivation, you need to solve this problem because a lack of sleep has its ill bearing on your health. You should seek the help of sleep aids but adopt them in a proper sequence.

Don’t jump in first directly for a prescription sleeping pill. They do have undesirable side effects.
There should be a proper sequence of getting help with your sleep.

  • You should first and foremost try the natural and home remedies
  • If that does not help, you go for the effective natural and over the counter (OTC) sleep aids.
  • Lastly, seek your doctor’s help to get a prescription for an effective sleeping pill.

What is a sleep aid?

A sleep aid is any type of help or measure you adopt to get good sleep. It involves falling asleep with ease and staying asleep for the required hours. People, who suffer from sleep disorders such as insomnia, take the help of such aids.
It may be a natural sleep aid or it may be in the form of medication. Some of these aids are available over the counter (OTC) and some are sleeping pills available with a prescription only.
Many pharma companies have a variety of sleeping aids to help you. But, it is always advisable to try natural therapies first because sleep aids – non-prescription and prescription – do help to induce sleep but the next-day freshness of good sleep is not there.
However, if you regularly have trouble getting sleep, then it’s a red flag that something is wrong and you need to be investigated. It could be your late-night lifestyle or a medical or psychological cause.
In such cases, the sleeping pill will put you to sleep, masking the real cause of your sleeplessness and probably making it worse. Add to it the addictive nature of the sleeping pill, which again has its problems.

First, try the natural remedies for sleep

Some causes of insomnia do require treatment and such causes should be ruled out first and treated if present. Seek sleep aids if natural remedies have not helped.
Improving lifestyle habits
Making your bedroom environment sleep-friendly
Eating the right foods that encourage good sleep
Relaxation therapy
Behavioral cognitive therapy

Go for the OTC natural sleep medicines, if

  • If your insomnia has not improved after trying the above-mentioned self-help home therapies
  • If your insomnia still disturbs your next day working
  • If health complications develop due to lack of sleep
  • And if you experience sleeplessness every night, which is becoming worse

Over the counter and natural sleep aids

There are natural and over the counter sleep aids that induce sleep and need no prescription for their purchase. The only disadvantage is that these OTC medicines are not under the ambit of food and drug administration regulations and, therefore, the safety and effectiveness of a particular brand cannot be judged.

One way to ensure quality of such an OTC sleep aid product is to buy such products of an established company or brand.

OTC sleep aids are okay to take occasionally but their effectiveness becomes less when you take them very often.

Secondly, they do induce sleep but the quality of sleep is compromised and you feel groggy and unwell the next morning when you wake up.

They do help in putting you to sleep but much remains to be known about their safety and effectiveness.

Alcohol – not a good option

Alcohol is not a medicine and is often used as self-treatment to get sleep. However, though alcohol induces sleep, it disturbs the quality of sleep and can often result in insomnia in the long run.

Long term drinking of alcohol decreases the natural duration of the 3rd and 4th stages of NREM sleep, which contains the stage of deep sleep, and also disturbs the REM sleep. You frequently get up in the middle of the night due to a headache or to pass urine or dehydration or excessive sweating.

In a person who has been drinking alcohol over time, alcohol causes inhibition of glutamine, a natural body stimulant. This induces sleep. During alcohol withdrawal in a chronic alcoholic, the body tries to make up by secreting more glutamine, which prevents sleep. This can cause insomnia accompanied by increased REM sleep with vivid dreams.

Alcohol is definitely not an option to help you sleep. It does more harm than good.

Antihistamines

Antihistamines are medicines available (mostly tablets are used) without prescription or over the counter and usually taken as anti-allergy pills to treat allergy, hay fever, and the common cold.

Antihistamines block the action of histamine, a chemical messenger of the brain, which promotes wakefulness. By this action, antihistamines promote sleep. Though they produce drowsiness, you should not take them if you have chronic insomnia. Antihistamines are more sedating than some hypnotics.

Examples of antihistamines

These include diphenhydramine (Benadryl) and doxylamine (Unisom). Diphenhydramine is the only antihistamine that is considered safe by the Food and Drug Administration.

Melatonin

Melatonin is a natural sleep aid. It is a naturally occurring hormone in the body, which is secreted by the pineal gland of the brain. It is the “hormone of darkness” as it secreted during the dark hours of the day and maintains the circadian rhythm of the body.

The circadian rhythm is the internal biological clock of the body, which induces sleep during night and wakefulness during the day.

Melatonin is also made synthetically in the laboratory and is used as pills or lozenges. It is taken to adjust the biological clock of the body whenever it has been disturbed such as due to jet lag or changing working shifts.

You should take melatonin 2 to 4 hours before bedtime to induce sleep. Besides putting you to sleep, it increases your sleep hours. Most sleep experts do not advise the use of melatonin for more than two weeks. Any longer need of use requires that your insomnia be investigated for a cause.

Valerian – herbal sleeping pill

Valerian is an herbal sleeping pill and a natural sleep aid. Valerian is a perennially growing plant found in Europe and some parts of Asia and introduced in Northern America.

This herbal supplement is prepared from the root of the plant. It is available as tablets, capsules, tea, and tincture. The use of valerian to make you sleep is not backed by much scientific evidence, but it has proved effective in some cases.

Valerian has a sedative action on the brain and the nervous system. It is used to treat sleep disorders and more commonly to cure insomnia. It is also given for anxiety and emotional stress.

Sleeping pills, prescription sleep aids & medications

There are various types of prescription sleeping pills or sleep aids to treat short-term as well as chronic insomnia and help you sleep. They are called sedative hypnotics and these medications generally act on the brain receptors and slow down the nervous system. Some help you to fall asleep while others also help you to stay asleep.

Some of them have the disadvantage of becoming habit-forming (dependence). Their proper use as advised in doses and duration is important as else improper use can make your sleeping disorder worse in the long run.

Prescription sleeping aids are used only after lifestyle and behavioral changes have failed to cure your insomnia symptoms and only after your doctor’s advice. They have their share of disadvantages and it is necessary to weigh the advantages against the risks.

Ideally, they are most advantageous when you use them sparingly for a short period such as during a jet-lag, adjusting to shift changes and recovering from a medical procedure or surgery.

If you need to use them long-term, make sure you use them on a SOS basis only.

Benzodiazepines

Benzodiazepines are the oldest and most commonly prescribed sleeping pills. They are the strongest of the sleeping pills and the most likely to cause dependence if taken over a prolonged period. Diazepam (eg, Valium and Calmpose) is a benzodiazepine and these drugs help to induce sleep and cause less awakening at night.

How They Act | Mode of Action

Gama-aminobutyric acid (GABA) is a brain chemical – an amino acid- that blocks the transmission of signals between the brain cells, thereby decreasing the excitability of the neurons and calming nervous activity. Benzodiazepines enhance the effect of GABA, which results in a sedative and hypnotic effect.

Examples of benzodiazepines include diazepam (Valium), estazolam (ProSom), flurazepam (Dalmane), quazepam (Doral), temazepam (Restoril), and triazolam (Halcion).

Nowadays nonbenzodiazepines are used more because of the drawbacks of using benzodiazepines, which include physical and mental dependence, development of tolerance, hangover effects and loss of sleep quality.

NonBenzodiazepines

Non-benzodiazepine hypnotic sedative drugs are a newer type of hypnotics, introduced about 10 to 12 years back and which are prescribed for mild to moderate insomnia.

They act by slowing down the brain activity thereby promoting sleep. Though their mode of action is similar to benzodiazepines, they are more specific for making you fall asleep.

These sleeping pills do cause dependency but to a lesser extent than benzodiazepines and do not cause hangover effect and have no adverse effect on sleep apnea.

Examples of Non-Benzodiazepines

• zalepon (Sonata),

• zolpidem (Ambien, ZolpiMist), and

• eszopiclone (Lunesta),

Drawbacks and Side Effects of Non-Benzodiazepines Sleeping Pills

Side effects of these drugs are much less than the benzodiazepines

• Headache and nausea.

• Dizziness

• Next day morning grogginess and drowsiness

• Drug tolerance resulting in lesser efficacy of the drug when taken over time.

• Rebound insomnia when the drug is stopped.

• Rarely the person may develop complex sleep-related behaviors such as sleepwalking and sleep-driving.

Ramelteon (Rozerem)

Ramelton (Rozerem) is a melatonin receptor agonist hypnotic sleeping pill. It is the latest sleep medication to induce sleep and works similarly to melatonin. Though it has side effects, its risk of dependency is less. It is more effective in inducing sleep and not so effective in staying asleep.

Side effects

• Dizziness

• It may worsen symptoms of depression, if present.

• It is contraindicated in persons with liver damage.

It is taken 30 minutes before bedtime.

Antidepressants

Antidepressants are usually prescribed as sleeping aids in cases where insomnia and psychiatric problems co-exist. All antidepressants do not work in the same way and some may even worsen the quality of sleep. The most commonly used antidepressant is trazodone.

Sedating tricyclic antidepressants like amitriptyline, nortriptyline, doxepine and clomipramine improve sleep quality while stimulating tricyclics trimipramine, desipramine and protriptyline make it worse.

Of the SSRIs, only escitalopram improved sleep while fluoxetine, paroxetine, citalopram, venlafaxine, and duloxetine damaged sleep.

These antidepressants act by increasing the levels of naturally occurring substances, which maintain mental balance.

The FDA of the United States has not approved antidepressants for the treatment of insomnia, nor are they effective in treating your sleeplessness. However, Doctors do prescribe them on occasions for their sedating effects.

Side effects include a high risk of suicidal thoughts and worsening of the existing depression.

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