Why use sleeping pills?
The purpose of sleeping pills is to help you get to sleep and to help establish a natural sleep rhythm. Previous sleeping medication would leave those taking it feeling “knocked out” the following day and in more of a zombie state, creating another problem.
What types of sleeping medication are available?
The position has changed from the early 20th century when barbiturates were commonly prescribed. These were easy to overdose on and it was also easy to get a high level of dependence on the medication. In the 1960s, benzodiazepines were found to be a safer drug but, in the long term, benzodiazepines such as diazepam were also found to leave many people with a dependence on the drug. People taking them developed a tolerance which meant they needed to use more than originally prescribed for them to work as they did before. Then came Z drugs such as Zopiclone and Zolpidem which act on the brain’s receptors in the same way as benzodiazepines but have a slightly different chemical structure. They are medically preferred as they show fewer side effects (though many complain of being left with a dry mouth or metallic taste) but more importantly there is a lower risk of dependence.
There is now a new sleep medication that is starting to be prescribed for insomnia called Daridorexant or Quiviviq. This was approved for use in the UK in 2023. Whilst a Z drug will produce a calming effect in the brain, Quiviviq works in a very different way as it reduces levels of wakefulness. It has very few side effects and an extremely low risk of developing a dependence or addiction. Daridorexant or Quiviviq is a type of drug known as DORA. DORA is an acronym for a Dual Orexin Receptor Antagonist which basically acts by blocking the activity of a drug in the body called orexin (also known as hypocretin) which regulates wakefulness, appetite and arousal.
Safe use of Zopiclone and Zolpidem
Those undergoing a residential medically supervised alcohol detox will often be prescribed Zopiclone for a few days. With an alcohol addiction or dependency we tend to lose a natural sleep pattern as our drinking alcohol will mean that, rather than going naturally to sleep, we will pass out. Taking Zopiclone helps people to fall asleep, to stop waking during the night and to establish a better pattern of sleep. Z drugs work by affecting a calming chemical in the brain called gamma-aminobutyric acid (known as GABA) which helps to initiate a natural sleep pattern.
Addiction to Zopiclone or Zolpidem
Drugs such as Zopiclone and Zolpidem are only meant to be prescribed for a short period. There is an increasing and now significant number of people who are managing to get their prescriptions extended or have chosen to purchase the medication illegally off the internet. These people are developing an addiction or dependence due to their actions as they may feel that they cannot cope with daily life without Zopiclone. They have developed a psychological dependence. This has resulted in more people being admitted to residential addictions units seeking help for their sleeping medication dependency – a prescription drug misuse.
What to do if you have insomnia
All sleeping medication should only be used for short term effect to prevent physical and psychological dependence and addiction. If you are experiencing insomnia, consider CBT-I (Cognitive Behavioural Therapy for Insomnia) to understand what is behind your insomnia and to put your mind at ease. Other suggestions that have been made by people suffering from insomnia have been to plunge your feet into cold water and leave the legs and feet outside your bed covers! Alternatively, embrace it and use the time awake to get through some of the tasks you need to complete. Worrying about not sleeping can be more harmful to mental health than the lack of sleep itself.