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Sleeping pills treat insomnia by making you feel drowsy and relaxed. Sleep aids, including natural ones like melatonin, can cause side effects. You may feel confused or sleepy during the day. Some people walk or eat in their sleep (parasomnia). Other nondrug therapies like cognitive behavioral therapy (CBT) may be better at improving your sleep.
As the name suggests, sleeping pills can help you get some sleep. If you have a sleep disorder like insomnia, you may take these medications to help you fall asleep. Sleeping medicines can also help you stay asleep if you’re prone to waking up in the middle of the night. Sleeping pills go by many names, including:
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An estimated 1 in 7 people in the U.S. have long-term insomnia. Sleep difficulties become more common as you age. Approximately 1 in 3 people age 65 and older take some type of sleep medicine.
Sleeping pills are available over the counter (OTC), as natural supplements or by prescription.
Anyone age 18 and older can buy OTC sleep medications at the drugstore or other retail locations. You don’t need a healthcare provider to write you a prescription for an OTC medication. OTC sleep aids often contain an antihistamine. This drug treats allergies, but it can also make you drowsy.
Some people take natural remedies like melatonin or valerian supplements to help them sleep. Melatonin is a hormone your body naturally produces that promotes sleep. Valerian is an herb that supposedly aids relaxation and sleep.
Although OTC sleep aids and supplements are easily accessible, you should check with your healthcare provider before taking them. Drugs in over-the-counter sleep aids (including supplements) can interfere with other medications or make health conditions worse.
Prescription sleeping pills are stronger than over-the-counter ones. You need a prescription from a healthcare provider to get these pills. Providers don’t typically recommend using prescription sleeping pills long term because they’re not a cure for insomnia and there’s a risk of dependence and addiction. They may help in some cases, but providers will usually only prescribe them for short-term relief.
Types of prescription sleeping pills include:
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Each type of sleeping pill works differently. Some sleep aids cause drowsiness, while others silence the area of your brain that keeps you alert.
Most OTC sleeping pills contain antihistamines. Antihistamines work by blocking histamines, which are substances in your body that cause alertness. Common ingredients in antihistamines include diphenhydramine and doxylamine.
How natural sleep aids work depends on the type of supplement. Melatonin is a hormone that promotes sleep, due to its ability to influence when you fall asleep and wake up. Valerian has a natural calming effect on your nervous system and helps to promote a better night’s sleep.
Prescription sleep medications work in different ways. Benzodiazepines, for instance, work by stimulating a chemical in your brain called GABA, which leads to sedation, muscle relaxation and reduced anxiety. Z-drugs work by slowing the activity in your brain.
Approximately 8 out of 10 people experience a hangover effect the day after taking sleep medicine. They feel drowsy, have muddled thinking and experience dizziness or balance problems. These daytime effects can negatively impact your ability to drive, work, go to school and complete daily tasks. This is why it’s important to use caution when taking a sleep medicine.
Over-the-counter and prescription sleeping pills (and supplements) can cause these side effects:
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When you take sleeping medicines night after night, your body may start to depend on them. When you stop the medicine, your insomnia may come back worse than before. This effect is called rebound insomnia.
If you’ve used sleep aids for a long time, talk to your healthcare provider about how to stop safely. It may take months to stop taking the pills.
You also shouldn’t mix sleep aids with other sedatives or alcohol. There’s a possibility of overdosing.
Some prescription sleep medicines may bring on parasomnia. This disruptive sleep disorder can cause dangerous behaviors while you’re still mostly asleep. People who take Z-drugs may sleepwalk or eat, take medications, talk or even drive, all while unaware that they’re doing these things. You may appear to be awake, but your brain isn’t fully alert. Most people don’t remember doing these things after they wake up.
Sedatives can also worsen snoring and sleep apnea, a potentially life-threatening condition.
Benzodiazepines can be addictive and lead to a substance use disorder. To lower this risk, healthcare providers only prescribe these sleeping pills for short-term use. You’re more likely to get a prescription for Z-drugs instead.
Any medication you take while pregnant or breastfeeding (chestfeeding) passes to the fetus or baby. Check with your healthcare provider before taking any over-the-counter sleeping pills or supplements. For extreme insomnia, a provider may prescribe a short-term sleep aid.
Some parents give over-the-counter antihistamine medications to children to help them sleep. These medicines aren’t approved for sleep purposes. There’s a risk of overdosing your child.
Talk to your pediatrician or pediatric sleep specialist before giving OTC medications or supplements to your child.
Currently, there aren’t any prescription sleep medicines available for children. Changing a child’s sleep behaviors is often the best way to improve sleep.
People age 65 and older should typically try nondrug treatments first because there may be safer ways to improve sleep. Sleeping pills have special risks for older adults. The drugs can stay in your body longer and cause side effects like confusion, memory issues and balance problems that can increase your risk of falls and hip fractures.
If sleep issues are affecting your quality of life and nothing else has helped, talk to a healthcare provider. They may recommend trying an over-the-counter sleep aid like Benadryl Allergy®, Advil PM® or Tylenol PM®. Take these at a low dose for a short time and keep in touch with your provider about any side effects.
Sleep issues are a common issue for people with heart disease. According to one study, as many as 44% of heart patients have trouble sleeping. There are many different reasons, from shortness of breath to difficulty getting comfortable after heart surgery. Another study showed that up to 50% of heart surgery patients had trouble sleeping up to six months after their procedure.
Most healthcare providers recommend trying other methods to improve your sleep before sleeping pills. The long-term risks often outweigh the benefits of taking sleep aids. Your provider may recommend you change your sleeping environment or try cognitive behavioral therapy (CBT) first. If you’re still experiencing sleep issues, talk to your provider about sleeping pills before you start taking them.
Sleep issues can happen for many reasons, and people with cancer often have an increased risk for them. Like people with heart disease, your provider may recommend trying alternative methods to get a better night’s sleep before trying sleeping pills.
They may recommend keeping a sleep diary, in which you track your sleep by writing down the time and patterns of your sleep. You may try changing your sleep environment or talking to your provider about your current medications. They may also recommend cognitive behavioral therapy. If your sleep problems continue, your provider may prescribe a Z-drug.
Studies show that sleeping pills aren’t that helpful in promoting a good night’s rest. Most people who take sleep aids fall asleep about eight to 20 minutes faster than those without medicine. On average, you might get an additional 35 minutes of shuteye.
Generally, sleep aids should be for short-term use. They may be most helpful if a stressful life event, like a divorce or death in the family, is keeping you awake.
Cognitive behavioral therapy (CBT) is an effective tool for improving sleep and curing insomnia. Behavioral changes often improve sleep without the need for medications. Talk to your healthcare provider about this option.
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You should contact your healthcare provider if you’re taking sleeping pills and experience:
A sleeping pill overdose can occur if you take more than the recommended amount of medication or combine sleeping pills with alcohol or other medications. Most people who overdose will experience only mild side effects, like dizziness and nausea. But a sleeping pill overdose can be deadly. According to the National Institute on Drug Abuse (U.S.), there were about 12,500 drug overdose deaths involving benzodiazepines in 2021.
If you’re thinking about hurting yourself or struggling with thoughts of suicide, call or text 988 to reach the 988 Suicide & Crisis Lifeline. This service provides 24-hour, confidential support to anyone in the United States experiencing emotional distress or a suicidal crisis.
Staring at the clock or tossing and turning is no way to spend your nights. Still, you should talk to a healthcare provider before trying an over-the-counter sleep aid. Often, nondrug treatments and behavioral changes are all you need for improved sleep. But a provider may recommend a prescription sleeping pill in some cases. They can figure out what’s causing your insomnia and suggest the best plan to help you rest easier.
Last reviewed on 06/22/2024.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy