Insomnia Medications: Uses and Side Effects
The act of sleeping is something that’s vital for the human body. During sleep, different processes occur that influence people’s physical and mental balance. Unfortunately, there are many illnesses and conditions that are capable of altering this process and causing insomnia, which makes it necessary to use medication to treat it.
Insomnia is a disorder characterized by the inability to fall asleep or stay asleep. It can make daily activities difficult due to the daytime and nighttime symptoms it creates. On many occasions, it’s a symptom of other psychiatric conditions such as anxiety and depression.
This sleep disorder is linked to psychological factors, so lifestyle changes must be made first. If these changes fail, the specialist may order some medications to treat insomnia, however, these drugs have some side effects.
What are the common medications for insomnia?
The number of people taking sleep medication around the world is staggering. Studies show that the consumption of these compounds has increased in countries such as Spain by up to 34%. Therefore, it’s imperative to get to know and identify which drugs are used to treat this disorder.
These are included within a group of psychotropic drugs known as hypnotics. The main function of these drugs is to depress the activity of the central nervous system (CNS) in order to get a good night’s sleep. These drugs include the following:
Benzodiazepines and analogs
These medications are the treatment of choice for multiple sleep disorders. They increase the depressant effect of gamma-aminobutyric acid (GABA) in the body. These compounds bind to the GABA receptor enhancement site, increasing the influx of chloride ions into the cell.
Among the benzodiazepines and their most used analogues, the following stand out:
- Lormetazepam
- Zolpidem
- Alprazolam
- Lorazepam
Non-benzodiazepine or barbiturate drugs
This group of drugs is made up of compounds with a structure different from that of benzodiazepines and barbiturates. The main components of this group are antidepressants with a sedative effect and antihistamines, as they achieve the same sedative effect.
Among the drugs belonging to this group of drugs, the following stand out:
- Paraldehyde
- Chloral hydrate
- Chlorvinol
- Diphenhydramine
Barbiturates
Despite their great sedative effect, these drugs aren’t currently used to treat insomnia. This is due to the large number of side effects that they produce in people who consume them, including cardiorespiratory depression and kidney damage.
Uses of insomnia medications
All hypnotic drugs are used in the treatment of chronic insomnia, which must occur at least 3 nights a week for a period greater than 3 months. These medications can also be used in the treatment of acute insomnia, however, in these cases, they should be the last option.
Psychotropic drugs, in general, are used in the treatment of many different diseases, and so the sedative effect of hypnotics is useful in the control of other pathologies. In this sense, these drugs are also useful in the treatment of diseases such as anxiety and depression.
It should be remembered that other compounds have a sedative effect as well, however, they were synthesized to treat different pathologies. An example of this are antihistamines, which are the first-choice treatment for multiple allergic processes.
Another case that’s very similar to antihistamines are neuroleptics. This group of drugs was created in order to treat different types of psychosis. However, they also depress the CNS, so they can induce sleep and relieve symptoms of insomnia.
What are its effects on the body?
As mentioned before, medications to treat insomnia are responsible for decreasing the activity of the central nervous system. This decrease in activity is what will make it possible to conciliate and maintain sleep in people with the disorder.
As with all commercialized drugs, hypnotics also have side effects. The main effect they can have is drowsiness due to a prolonged depression of brain activity.
On the other hand, some studies show that the body can develop tolerance and dependence on these drugs when we take them for long periods. Tolerance occurs when it’s necessary to increase the dose in order to achieve the desired effect as a result of different changes in the cells.
Dependence is the inability to stop taking a substance. When the administration of these drugs is stopped abruptly, it’s possible to develop withdrawal syndrome. In this sense, it’s vitally important to follow the intake and suspension instructions provided by the specialist.
Benzodiazepines and their analogs are the first choice
The use of medications to treat insomnia should only be started when all other available treatments have failed. The consumption of these compounds must be carried out under strict medical supervision due to the effects that they can unleash in the body.
Despite the large number of hypnotics available, benzodiazepines and their analogs remain the first-choice treatment. This is due to their high effectiveness and their low capacity to trigger tolerance and dependency processes.
- Sarrais F, de Castro Manglano P. El insomnio. Anales Sis San Navarra. 2007; 30( Suppl 1 ): 121-134.
- Vicente Sánchez M, Macías Saint-Gerons D, Fuente Honrubia C, González Bermejo D et al. Evolución del uso de medicamentos ansiolíticos e hipnóticos en España durante el período 2000-2011. Rev. Esp. Salud Publica. 2013; 87(3): 247-255.
- Estivill E, Roure N, Albares J, Martínez C, Pascual M, Segarra F. Tratamiento farmacológico del insomnio: ventajas e inconvenientes. Cómo sustituir la medicación hipnótica. Vigilia-Sueño. 2007; 18(S1): 2-8.
- Way WL, Trevor AJ. Sedative–hypnotics. Anesthesiology. 1971 Feb;34(2):170-82.
- Vermeeren A. Residual effects of hypnotics: epidemiology and clinical implications. CNS Drugs. 2004;18(5):297-328.
- Asnis GM, Thomas M, Henderson MA. Pharmacotherapy Treatment Options for Insomnia: A Primer for Clinicians. Int J Mol Sci. 2015 Dec 30;17(1):50.