Sleep medications, including prescriptions, over-the-counter, and herbal supplements, can be useful for helping people with short-term insomnia or when their sleep patterns are disrupted by stress.
However, if you feel dependent on sleep medications to get to sleep at all or function normally during the day, it’s possible that a dependency or addiction has developed.
SOBA New Jersey provides assistance for adults dealing with substance use disorders involving prescription sleep medications, underlying mental health disorders that could be driving it, and the challenges associated with safely discontinuing their use.
Key Points
Prescription sleep medications can include benzodiazepines, non-benzodiazepine hypnotics, sedative-hypnotics, antihistamines, melatonin, and other sleep aids.
Common prescription sleep medications include zolpidem (Ambien), eszopiclone (Lunesta), zaleplon (Sonata), temazepam (Restoril), and triazolam.
Sleeping pill addiction may involve cravings, long-term use, higher doses, withdrawal symptoms, or continued use despite health issues and negative consequences.
Withdrawal symptoms can include rebound insomnia, anxiety, irritability, sweating, tremors, mood swings, and, in some cases, serious complications.
Treatment may include detox, tapering, cognitive behavioral therapy, inpatient or outpatient care, group therapy, mental health support, and aftercare.
What Are Sleeping Pills?
Sleeping pills are medications or sleep aids used to help people fall asleep, stay asleep, or manage short-term sleep problems. This can include prescription medications and over-the-counter (OTC) sleep aids.
Prescription sleeping pills may include:
Benzodiazepine sedative-hypnotics such as temazepam (Restoril) and triazolam (Halcion)
Non-benzodiazepine hypnotics (Z-drugs), such as zolpidem (Ambien), eszopiclone (Lunesta), and zaleplon (Sonata).
Over-the-counter sleep aids with antihistamines such as Benadryl
Melatonin, and other supplements commonly used for sleep support.
Some people may also misuse other benzodiazepines, such as alprazolam (Xanax), to help them sleep even when those medications are not prescribed for insomnia.
Many sleeping pills act as sedatives by slowing activity in the central nervous system. Some, including benzodiazepines and medications such as zolpidem, enhance the effects of GABA, a neurotransmitter that reduces brain-cell activity.[1] This can make the medication effective in the short term, but it can also increase the risk of tolerance, physical dependence, and misuse when taken longer than directed.
The label approved by the U.S. Food and Drug Administration (FDA) for Ambien states that zolpidem is indicated for short-term treatment of insomnia involving difficulty falling asleep.[2] This is important because sleeping pills are not usually meant to be a long-term solution without regular medical review.
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Sleeping pill addiction develops quietly, often without the person being aware that they are developing tolerance at all. Most often, it starts with a prescription from a healthcare provider.
Some people take their medication as prescribed, and only realize they have a problem when they try to stop and can’t. Someone else may start by taking the prescribed dose, then continue taking it over time, only to later find that the same dose no longer has any effect. This may lead them to take higher doses or take it more frequently to get the effect they want.
Others may take medication earlier in the evening, mix it with alcohol or opioids, take someone else’s prescription, take it during the day, or use it to cope with anxiety, depression, stress, or emotional pain.
However, dependency develops; once it does, it is very difficult to discontinue use without professional help. Some people continue using because they fear rebound insomnia, while others experience cravings or uncomfortable withdrawal symptoms when they try to stop.
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Someone who is addicted to prescription sleep medications may exhibit the following signs:
Taking higher dosages of prescription medications
Feeling anxious or irritable if they do not receive their medication on time
Continuing to use prescription sleep medications even when they cause significant side effects
Doctor shopping in order to get more medication
Mixing their prescription sleep medications with alcohol or illegal substances
Lying to family members about how much prescription sleep medication they use
Mood swings, poor coordination, and excessive sedation throughout the day
Sleeping pill addiction is not a weakness. It is a treatable substance use disorder that often develops alongside sleep disorders, stress, trauma, or mental health conditions.
Side Effects of Sleeping Pills
The side effects of sleeping pills vary depending on which type of medication, the dose taken, and if you are taking any other medication or substance with it.
Common side effects include:
Drowsiness
Dizziness
Dry mouth
Headaches
Slower reaction times
Difficulty remembering things
Poor coordination
Feeling groggy when you wake up the next day.
Some types of sleep medications can cause behaviors that are abnormal or dangerous. The Ambien label has a boxed warning concerning complex sleep behaviors such as sleepwalking, sleep driving, and performing other actions while still asleep. These incidents have resulted in injuries and deaths, and it’s recommended that patients discontinue using the medication if these behaviors occur.[3]
Long-term use can create additional problems. For example, patients who take prescription sleep aids can lose confidence in their body’s natural ability to fall asleep. They may also develop tolerance, and be encouraged to take more medication, combine medications, or switch to another substance when their normal dose stops working. In some cases, this can lead to escalating use, stronger cravings, and increased withdrawal risk.
Sleeping Pill Withdrawal and Detox
Prescription sleep aid withdrawal can be difficult, particularly for people who have been taking large doses for extended periods of time.
Withdrawal symptoms can include rebound insomnia, anxiety, irritability, sweating, tremors, nausea, mood swings, cravings, and difficulty concentrating. Rebound insomnia can feel especially discouraging because the original sleep problem that the medication was meant to treat may return more intensely for a period of time.
Withdrawal from sedatives, tranquilizers, and hypnotics can even be dangerous. NIDA warns that people addicted to central nervous system depressants should not try to stop on their own because withdrawal symptoms can be severe and, with some medications, potentially life-threatening.[4]
That is what medical detox is designed to address. Detox may help clients safely begin the recovery process. Depending on the medication, a healthcare provider may require a gradual reduction in dosage (tapering) before discontinuing a patient’s prescription sleep aid. This is especially true for benzodiazepines and certain sedative-hypnotic medications.
It can also support clients through withdrawal symptoms, sleep disruption, cravings, mental health symptoms, and safety concerns. However, detox only helps with physical dependence. It does not address the underlying causes for substance use, the sleep disorders the medication was initially prescribed to address, or any other co-occurring mental health disorder.
After the body begins to stabilize, therapy and ongoing care are important. The right treatment plan that involves therapy, medication management, and other supports can help address the reasons sleeping pill use became difficult to control in the first place.
Sleeping Pill Addiction Treatment
Addiction treatment programs for prescription sleep medication need to incorporate each client’s unique combination of medication history, sleep disorders and concerns, mental health status, degree of withdrawal risk, and desired recovery outcomes.
At SOBA, treatment may consist of detoxification, inpatient treatment, or outpatient treatment programs.
Treatment options often include:
01
Medical support and tapering
Medical personnel can determine if detox or tapering is necessary, provide support to minimize withdrawal complications, and help stabilize the client.
02
Cognitive behavioral therapy for insomnia (CBT-I)
CBT-I addresses specific issues related to sleep patterns, worry about falling asleep, and behaviors that maintain insomnia. The American College of Physicians recommends CBT-I as the first-line treatment for adults suffering from chronic insomnia disorder.[5]
03
Sleep hygiene support
Clients may also learn practical sleep hygiene strategies, such as maintaining a consistent sleep schedule, limiting caffeine or screen use before bed, creating a calming nighttime routine, and making the sleep environment more restful. These habits can help support healthier sleep as clients move away from relying on sleeping pills.
Treating Sleep and Mental Health Together
Many people start taking sleeping pills because they are exhausted and desperate for a decent night’s sleep. Many times, sleep issues stem from mental health disorders like anxiety, depression, traumatic issues, ongoing stress, pain, and other related issues.[6] Without addressing the underlying reasons why someone can’t sleep, it can feel impossible to stop using sleep medication.
This is why addiction treatment must focus on the client as a whole. A comprehensive assessment needs to evaluate sleep disorders, substance use disorder (including misuse of sleep medications), mental health symptoms, prescription drugs including antidepressant medications or opioid medications, and over-the-counter sleep aids.
Recovery often includes changing sleep habits, being able to manage and reduce fear surrounding insomnia, treating anxiety or depression, and teaching healthy methods to manage stress. Although stopping the use of sleeping pills is a key component of recovery, that is not the end goal. The ultimate goal is to enable each client to have confidence in their ability to fall asleep and get rest without misusing sleep medication.
Frequently Asked Questions About Addiction to Sleeping Pills
01
Can you become addicted to sleeping pills?
Yes. Some sleeping pills can lead to tolerance, physical dependence, cravings, and addiction, especially with long-term use, higher doses, or use outside of medical directions.
02
What are signs of sleeping pill addiction?
There are several behaviors that indicate possible sleeping pill addiction, including taking more than recommended, feeling like you cannot fall asleep without them, having cravings between doses, memory loss, daytime drowsiness, hiding your use of sleeping medication, and continuing to use the medication even though there have been negative consequences.
03
What are common sleeping pill withdrawal symptoms?
Withdrawal symptoms from sleeping pills can vary depending on which medication was used and the duration and dosage levels. However, common withdrawal symptoms may include rebound insomnia, anxiety, irritability, sweating, body tremors, nausea, mood swings, cravings, and difficulty concentrating.
04
Is it safe to stop sleeping pills suddenly?
Not always. Some sleeping pills, especially benzodiazepines and sedative-hypnotics, may require a gradual taper. Stopping suddenly can be dangerous for some people, so it is important to speak with a healthcare provider.
05
What treatment helps with sleeping pill addiction?
Treatment may include detox, tapering, CBT, CBT-I, individual therapy, group therapy, family support, outpatient treatment, inpatient care, support groups, and aftercare planning.
06
Can SOBA help with sleep problems and mental health?
Yes. SOBA helps clients address sleeping pill addiction, sleep concerns, substance use disorder, and co-occurring mental health conditions as part of a personalized treatment plan.
If you or someone you love is struggling with sleeping pills, SOBA New Jersey is here to help.
We work with adults suffering from sleeping pill misuse and related withdrawal symptoms, cravings, mental health issues, and prescription drug addiction.
Whether you are currently using Ambien, Lunesta, Sonata, Restoril, benzodiazepines, over-the-counter sleep aids, or some other type of sleep medication, our staff at SOBA can help you through your journey safely and successfully.
Reach out to SOBA New Jersey today to speak to an admissions specialist to learn more about your treatment options and start taking the first step.
[5] Qaseem, A., Kansagara, D., Forciea, M. A., Cooke, M., & Denberg, T. D. (2016). Management of chronic insomnia disorder in adults: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 165(2), 125–133. https://www.med.upenn.edu/cbti/assets/user-content/documents/ACP%20Insomnia.pdf
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