Sleeping pills may help with insomnia, but some can cause next-day drowsiness, impaired alertness, dependence, falls, and other serious side effects. Learn about the potential risks and safer ways to manage sleep problems.
WARNING! These Pills May Increase Health Risks — What You Should Know About Sleeping Pills
When sleepless nights become a regular problem, reaching for a sleeping pill can seem like an easy solution. These medicines can help some people fall asleep or stay asleep, but they are not completely risk-free.
Depending on the medication, dose, duration of use, age, and other medicines being taken, sleeping pills can cause significant side effects. The U.S. Food and Drug Administration (FDA) warns that certain prescription insomnia medicines can cause serious sleep-related behaviors, while benzodiazepines carry risks of misuse, addiction, physical dependence, and potentially dangerous withdrawal.
What are sleeping pills?
“Sleeping pills” is a broad term covering several types of medicines used to treat insomnia. These include prescription medicines such as zolpidem, zaleplon and eszopiclone, as well as certain benzodiazepines and some over-the-counter products.
They don’t all have the same risks, so it’s important not to assume that every sleep medicine affects the body in exactly the same way.
1. Next-day drowsiness can be a serious problem
One of the most important concerns is that a person may still have the effects of a sleeping medicine the following morning.
Some medicines can impair:
- Alertness
- Reaction time
- Concentration
- Coordination
- Driving ability
- Ability to operate machinery
The FDA specifically warns that people taking insomnia medicines can experience next-morning impairment even when they feel fully awake.
For this reason, don’t drive or perform activities requiring complete alertness if your medicine leaves you drowsy or impaired.
2. Some medicines can cause unusual sleep behaviors
Certain prescription sleep medicines, particularly the “Z-drugs” zolpidem, zaleplon and eszopiclone, have been associated with rare but serious complex sleep behaviors.
A person may perform activities while not fully awake, such as:
- Sleepwalking
- Eating
- Preparing food
- Leaving the house
- Making phone calls
- Driving
In some reported cases, these behaviors have resulted in serious injuries or death.
If you experience a complex sleep behavior after taking one of these medicines, the FDA advises stopping the medicine and contacting your healthcare professional immediately.
3. Dependence can develop with some sleeping medicines
Some sleeping medications, particularly benzodiazepines, can cause physical dependence when taken regularly.
The FDA warns that benzodiazepines can carry risks of misuse, addiction, physical dependence and withdrawal. Suddenly stopping a benzodiazepine after regular use can cause serious withdrawal reactions, including seizures.
That doesn’t mean everyone who takes these medicines will become addicted. However, they should be used exactly as prescribed and shouldn’t be stopped abruptly without medical guidance when regular use has occurred.
4. Falls and accidents are another concern
Drowsiness, dizziness and impaired coordination can make walking, climbing stairs or driving less safe. Sleeping medicines can therefore contribute to accidents and falls, particularly in people who are more sensitive to sedating medications.
Older adults can be particularly vulnerable to medication-related dizziness, confusion and falls, so medication choices and doses should be carefully reviewed by a healthcare professional.
5. Mixing sleeping pills with alcohol can be dangerous
Alcohol can increase the sedating effects of many sleep medicines.
The FDA specifically advises people taking prescription Z-drugs not to drink alcohol before or while taking them because the combination can increase side effects.
Sleeping medicines should also not be combined with other sedating medicines unless a healthcare professional has specifically advised that combination.
6. Over-the-counter doesn’t always mean risk-free
Some sleep products are available without a prescription, but that doesn’t automatically make them harmless.
The FDA notes that over-the-counter insomnia medicines can also cause next-morning impairment.
Always check the label and ask a pharmacist or doctor if you’re unsure whether a product is appropriate for you—especially if you already take other medicines.
When should you talk to a doctor?
Speak with a healthcare professional if:
- You regularly need sleeping pills to fall asleep.
- Your insomnia continues despite treatment.
- You feel confused, dizzy or unusually sleepy during the day.
- You have fallen after taking a sleep medicine.
- You experience unusual behaviors while asleep.
- You have difficulty stopping a medicine you’ve been taking regularly.
- You take several medicines that may cause drowsiness.
Persistent insomnia can sometimes be related to another underlying problem, so simply increasing or continuing sleep medication may not address the real cause.
Safer sleep strategies may help
Medication isn’t always the only option. Depending on the cause of insomnia, improving sleep habits and using behavioral approaches can be important parts of treatment. The National Heart, Lung, and Blood Institute notes that approaches such as stimulus-control therapy can help establish healthier sleep patterns.
Helpful habits may include keeping a consistent sleep schedule, reducing caffeine later in the day, limiting stimulating activities before bedtime, and keeping the bedroom comfortable and dark.
The bottom line
Sleeping pills can be useful for some people, but they should not be treated like ordinary supplements. Some can cause next-day impairment, falls, unusual sleep behaviors, dependence or other serious reactions.
If you’re currently taking a sleeping medicine, don’t change the dose or suddenly stop a regularly used prescription medication on your own. Talk with your doctor or pharmacist about the safest approach for your particular medicine and situation.
A good night’s sleep matters—but so does getting there safely.