Hypnotics for Sleep Drug Class Side Effects Uses List Warnings

Hypnotics (for Sleep) Medications

Hypnotics are drugs used to help people fall asleep. There are many types of hypnotic drugs, and doctors recommend and prescribe them based on the type of sleep problem you have. Lifestyle and sleep habit changes are also effective for treating certain types of sleep problems.

If you have chronic insomnia or problems sleeping, contact your doctor or other health care professional. Doctors specializing in sleep problems (sleep medicine) can help you determine the cause of your insomnia and treat it.
Hypnotic drugs are also called sleep aids, sleeping pills, or soporifics.

Types of hypnotics (hypnotic drugs)

The FDA has approved five types of hypnotic medications for the treatment of sleep problems:

Benzodiazepines
Nonbenzodiazepine receptor agonists
Melatonin receptor agonists
Orexin receptor agonist
Antidepressants

These medications are all effective for treating sleep problems, but they work differently. Some sleep medicines only last a few hours (short-acting medications), while others last longer in the body (long-acting medications). Doctors and other health care professionals choose sleep medications based on the type of sleep problem you have. For example, people who have trouble falling asleep will benefit from a short-acting sleep medicine. People who have trouble staying asleep will benefit more from long-acting sleep drugs.

What are hypotics used to treat?

Doctors prescribe hypnotics to treat insomnia, which is a sleep problem that may involve difficulty falling or staying asleep. Inadequate sleep affects mood, energy levels, health, and work performance.

Common causes of insomnia are stress, traumatic events, depression, anxiety, and medications. If you know the cause of your insomnia and treat it, it may reduce the need for sleep medications to aid or induce sleep.

QUESTION

Hypnotic side effects

Side effects of hypnotics depend on the type of hypnotic used.

Common side effects of some hypnotics include:

Headache
Nausea
Short-term forgetfulness
Rebound insomnia
Dry mouth
Hallucinations
Dizziness
Drowsiness
Withdrawal symptoms (anxiety or insomnia)
Unpleasant taste
Confusion
Dependence

Other side effects of hypnotics may include:

Dizziness
Cough
Abnormal dreams
Diarrhea
Upper respiratory infections
Stomach upset
Loss of coordination
Sleepiness
Hair loss
Dry skin
Loss of appetite
Nausea
Fatigue

Possible serious side effects may include:

Sleep paralysis
Behavioral changes
Abnormal thinking
Suicidal thinking
Worsening of depression
Sleep driving and other complex behaviors
Anemia
Hives
Exfoliatedermatitis

What drugs or supplements interact with hypnotics?

Combining sleep medications or using other medications that also cause drowsiness will lead to severe drowsiness.
Stimulants such as amphetamines or coffee may reduce the effect of sleep medicines.

List and examples of brand and generic names of hypnotic drugs

There are over 40 different sedative/hypnotic drugs available. Talk to your doctor, pharmacist, or other health care professional for any additional information about the generic forms available.

Melatonin receptor agonists

ramelteon (Rozerem)
prexin receptor antagonist
suvorexant (Belsomra)

Benzodiazepines

estazolam (Prosom)
flurazepam (Dalmane)
quazepam (Doral)
temazepam (Restoril)
triazolam (Halcion)

Non-benzodiazepine receptor agonists

eszopiclone (Lunesta)
zaleplon (Sonata)
zolpidem (Ambien, Ambien CR, Intermezzo, Zolpimist, Edluar)

Antidepressants

doxepin (Selinor)
mirtazapine (Remeron)
trazodone (Oleptra)

The dose of these drugs varies. Talk to your doctor about the exact dose you need to fall asleep.

OTC (over-the-counter) hypnotics

Diphenhydramine (for example, Benadryl) and doxylamine (for example, Unisom) are over-the-counter (OTC) drugs that can help people fall asleep. These drugs are antihistamines that cause drowsiness and sedation. Only use these medications for a few days. Talk with your doctor or other health care professional if you have insomnia for more than a couple of weeks.

You should read the instructions and warnings before taking OTC sleep medicine because they can have serious adverse effects if not used properly. They also may interfere with the action of other drugs.

Side effects reported by people taking diphenhydramine or doxylamine include:

Natural, herbal hypnotics and hypnotic supplements

Synthetic melatonin capsules, pills, or tablets may help people fall asleep. Melatonin is most often used for treating jet lag. Melatonin takes a few days, up to a few weeks to work when used for treating sleep problems.
Valerian is another supplement available to treat insomnia.

Talk with your doctor or pharmacist before taking herbal, natural, or other supplemental products for insomnia.

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Can I drink alcohol if I’m taking a hypnotic drug?

Do not drink alcohol before or after taking a sleep medication because drinking alcohol while using a sleep medication or sedative may lead to severe drowsiness.

Are hypnotics addictive?

Benzodiazepines are addictive hypnotics and are federally controlled substances. People can develop physical dependence after several days of taking them, and the risk is higher during long-term use.

Doctors should take care when prescribing benzodiazepine drugs to people with a history of drug abuse or alcoholism because they are more likely to become addicted to benzodiazepines.

Are these drugs safe to take if I am pregnant or breastfeeding?

Researchers have not studied the effects of most hypnotics on pregnant women. Therefore, they should not be used if you are pregnant unless it is absolutely necessary. Pregnant women who have sleep problems should try improving their sleep hygiene, relaxation, and ways to reduce stress.
Benzodiazepine use is harmful to the fetus when taken by pregnant women during their first trimester, so you should avoid them if you are pregnant.
Diphenhydramine may have a low risk of causing harm during pregnancy.

If you are pregnant, discuss the use of these drugs with your doctor.

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Summary

Hypnotics are sleep medications used to treat different types of insomnia. There are a variety of hypnotic drugs, and they are grouped into five types. Benzodiazepines, nonbenzodiazepines, selective melatonin agonists (these three drug types are classified as sedatives), antidepressants, and an orexin receptor agonist. Some hypnotics can be addictive and may cause withdrawal symptoms if discontinued abruptly.

Drowsiness
Hallucinations
Headache
Dry mouth
Nausea
Rebound insomnia
Diarrhea
Cough
Hair loss
Dry skin
Upset stomach
Abnormal dreams
Fatigue
Abnormal thinking
Suicidal thinking
Sleep paralysis
Anemia
Sleep driving and other complex behavior
Exfoliatedermatitis

Do not drink alcohol while taking hypnotic drugs. Stimulants like caffeine or amphetamines reduce the effect of insomnia medications.

Your doctor or other health care professional will recommend the type of hypnotic drug for you depending on the type of sleep problem you have, your current lifestyle habits, other medications you are taking, and any other medical problems you may have.

FDA. "Sleep Disorder (Sedative-Hypnotic) Drug Information." Updated: Jun 13, 2017.

Chawala, J, MD. "Insomnia Medication." Medscape. Updated: Aug 01, 2016.