31 Jan 2020

Are sleep medicines safe? Are they addictive?

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Medicines for sleep or ‘sleeping pills’ are viewed by different people in different ways. For a lot of people, sleeping pills mean tablets that are addictive and damage one’s organs such as kidney and liver. For others, taking them is a habit even though it may be harmful. Still others discount the presence of any harmful effects and use it. Yet another group of people might feel it as safe as long as it is prescribed and supervised by a qualified expert. So what is the reality? We shall discuss this today.

While the term ‘sleeping pill’ is often used to refer to any medicine that can put one to sleep, they are chemically very different and have different properties. The first thing to understand here is that medicines that induce sleep often have additional properties, which may be beneficial, or viewed as side effects. Depending upon these properties, certain medications may be primarily used for sleep while others, although inducing sleep, have primary effects that are used for some other purpose. Another way of looking at these medicines is to divide them in to two groups – addictive or habit-forming, and, non-addictive or non habit-forming.

Many classes of medicines can be classified under the heading of sleeping pills that are addictive. Usually, these medicines have additional actions like anti-anxiety and muscle relaxant effects. Some of the newer ones have an almost exclusive sleep effect. The duration of effect of these medicines varies from couple of hours to an entire day or even longer, facilitating selection based on the exact need. The older medicines were very dangerous in overdose, but the newer ones are far less so. But they are all addictive, some more and some less. This means that the following things are likely to happen on regular use: need to increase the dose periodically because of inadequate effect at the previous dose (tolerance); anxiety, sleeplessness and seizures (fits) on abrupt stoppage (withdrawal symptoms). Daytime sedation may lead to dulling of intellectual functioning, errors at work, accidents and falls, with their attendant implications. Because of this risk, these medicines should not ordinarily be used unless benefits clearly outweigh the risks. When they do need to be used, they are not recommended for more than 4-6 weeks.

Many medicines can be used for the purposes of inducing/ improving sleep and are not addictive. These medicines include certain antidepressants, antipsychotics and miscellaneous agents such as anti-histaminics (often used in the treatment of allergy/ common cold). They are often used in much lower doses than in cases of treatment of depression/ psychosis and must be used with caution, under the supervision of a qualified psychiatrist. They can also have certain side effects which can be minimized/ abolished with an expert prescription and supervision. Their biggest advantage is that they are not addictive and their additional antidepressant properties can be a boon, as sleep disturbances are often associated with stress.

So going back to the original question? Are medicines for sleep addictive? Some are, some are not. Are they safe? If they are properly prescribed and monitored, they are safe, but it is best to avoid the addictive ones as far as possible.

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