December 2020 | Reviewed by: Seema Khosla MD and Andrea Matsumura MD
What are sleep medications?
Medications can be used to reduce some sleep-related problems. Each medication targets a specific part of the brain. It is the brain that controls when your body sleeps and when it is awake. This is a complex process that also involves your heart, lungs and muscles.
A medication can provide much needed relief for someone with a sleep problem. This can promote good health and an overall sense of well-being. But many medications have side effects to consider.
The same drug can affect people in different ways. A medication that helps someone else may not work for you. Your medical provider can determine if a medication is the best treatment for your sleep problem. Never take a medication, including an over-the-counter sleep aid, without first talking with your medical provider. Some medications are used only for rare sleep disorders and the use of these medications should be overseen by a sleep doctor.
Although most patients do well with medications, it is important to be aware of potential side effects and take the medications only as prescribed. For example, Some stimulant medications can impact your heart and may need to be monitored more carefully than other medications. Some can cause a change in your mood or cause a serious skin rash.
Some medications, including sleep aids, can cause dependence when you take them for a long time. You may have withdrawal if you suddenly stop using the drug. Your body also may develop a tolerance to the medication.
Many sleeping pills must be taken just before you go to bed. Make sure you know if you should take the medication with or without food. Most sleeping pills should be taken on an empty stomach.
Women who are pregnant or nursing may be limited in the options available due to concerns about the fetus or of the medication passing to the baby via breast milk.
WARNING: Complex sleep behaviors such as sleepwalking or sleep driving can occur with some sleep aids used for insomnia. Read this consumer update from the FDA to learn about these safety risks.
How are sleep medications used to treat disorders?
Sleeping pills are the most common sleep-related medication. They may be used as part of a treatment plan for insomnia. People with insomnia have trouble falling asleep and/or staying asleep. They may also wake up too early or feel unrefreshed after sleeping.
Instead of having trouble falling asleep, some people fall asleep too easily and are sleepy when they should be awake. Stimulants can increase your alertness and concentration. They often are used by people who have hypersomnia or narcolepsy. People with narcolepsy may take another medication if they also have cataplexy (muscle weakness triggered by a strong emotion such as laughing).
People who are unable to get enough sleep may also use stimulants (such as caffeine) when they need to be alert. This is often the case in people who have shift work disorder.
Excessive daytime sleepiness is a common symptom of sleep apnea. Treatment with CPAP, an oral appliance, or surgery may treat the problem and eliminate the sleepiness. If the sleepiness is not resolved, then a stimulant may be combined with one of the other treatments.
People with a movement disorder such as restless legs syndrome or periodic limb movements may require treatment with medication. Your sleep can be severely disrupted by these disorders.
Some sleep disorders such as REM sleep behavior disorder and confusional arousals can be disturbing and dangerous. Medications may be used to treat them. Sleep-related eating disorder is another sleep disorder that responds well to medication.
Taking a melatonin supplement at a specific time and dose as recommended by your sleep doctor may help some people who have a circadian rhythm disorder. Examples include jet lag and advanced sleep-wake phase. Melatonin is a natural hormone that helps the body maintain a regular sleep-wake cycle.
The use of medications for your treatment will depend on how severe your symptoms are, your other medical conditions, your other medications, and potential side effects. Your medical provider or sleep doctor will determine what is most appropriate for you.