Sleeping meds
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Overview of Sleeping Medications: Efficacy, Risks, and Innovations
Common Sleeping Pills and Natural Remedies
Sleeping pills are widely used to combat insomnia and other sleep disturbances. Common medications include benzodiazepines and non-benzodiazepine hypnotics (Z-drugs) such as zolpidem and eszopiclone, which act on benzodiazepine receptors to promote sleep4 8. Additionally, natural remedies like 5-hydroxytryptophan and valerian/hops fluid extracts are also used, although their efficacy may not be as well-documented as pharmaceutical options1 9.
Prevalence and Demographics of Sleep Medication Use
Sleep medications are a common treatment for insomnia, with significant usage differences observed between men and women. Data from the 2020 National Health Interview Survey (NHIS) indicate that a substantial percentage of adults use sleep medications regularly, highlighting the widespread nature of sleep difficulties2. This usage is driven by the association of insufficient sleep with various negative health outcomes, including type 2 diabetes, heart disease, obesity, depression, and increased injury risk2.
Risks and Side Effects of Traditional Sleep Medications
Traditional sleep medications, while effective, come with a range of side effects. Benzodiazepines and Z-drugs can cause dependence, daytime sedation, falls, and cognitive impairments4. These medications work by enhancing gamma-aminobutyric acid (GABA) signaling, which quiets brain activity but can lead to unwanted side effects due to GABA's role in various brain functions3. The FDA has added stronger warning labels to some of these medications to mitigate these risks3.
New Developments: Orexin Receptor Antagonists
A promising new class of sleep medications targets the orexin neurotransmitter, which regulates the sleep-wake cycle. Suvorexant, an orexin receptor antagonist, has shown efficacy in helping people fall asleep faster and stay asleep longer without serious side effects, as demonstrated in phase 3 clinical trials3. This targeted approach aims to promote sleep by mimicking natural brain processes, potentially offering a safer alternative to traditional sleep medications3.
Use of Sleep Medications in Special Populations
In nursing home residents, sleep disturbances are common, and the use of sleep-promoting medications is widespread. However, the environment and care routines in nursing homes often contribute to sleep issues. Nonpharmacological interventions are underutilized despite their effectiveness. When medications are used, short-term prescriptions of benzodiazepines and Z-drugs are common, but they come with risks such as daytime sedation and falls4.
Antidepressants and Sleep
Antidepressants can significantly alter sleep patterns, particularly affecting REM sleep. Some antidepressants, like SSRIs, can disturb sleep initially but may improve sleep over time. Others, like amitriptyline, are more sleep-promoting. The choice of antidepressant can be crucial for patients with concurrent sleep disorders, as some medications may exacerbate conditions like restless legs syndrome7.
Conclusion
Sleeping medications, both pharmaceutical and natural, play a crucial role in managing insomnia and other sleep disturbances. While traditional medications like benzodiazepines and Z-drugs are effective, they come with significant risks. New developments, such as orexin receptor antagonists, offer promising alternatives with potentially fewer side effects. Understanding the demographics of sleep medication use and the specific needs of populations like nursing home residents can help optimize treatment strategies. As research continues, the goal remains to find effective and safe solutions for improving sleep health.
Sources and full results
Most relevant research papers on this topic
Sleep Medicine
5-hydroxytryptophan is a natural product that has been used for centuries as an alternative treatment for insomnia.
Sleep Medication Use in Adults Aged 18 and Over: United States, 2020.
Men use sleep medications more frequently than women, with a prevalence of insomnia of 5% in men and 5% in women aged 18 and over in 2020.
New class of sleep drugs may offer a safer night's rest
Suvorexant, a new sleep medication, could promote faster and longer sleep without causing serious side effects, compared to traditional sleeping pills.
Use of Sleep-Promoting Medications in Nursing Home Residents
Sleep-promoting medications can be beneficial for nursing home residents, but long-term use is advised due to potential risks and side effects.
Literature Review
Highly CitedMedications and their effects on sleep.
Drugs can cause sleep disorders like hypersomnolence, insomnia, and abnormal sleep behaviors, which can be managed with proper sleep hygiene and medication selection.
Antidepressants and Sleep
Antidepressants alter sleep patterns, with some being sleep-promoting and others sleep-disturbing, but generally improve sleep in depressed patients after 3-4 weeks of treatment.
Highly CitedThe sleep–wake cycle and sleeping pills
Sleeping pills are not effective in preventing shiftwork or jet-lag symptoms, and their use is not recommended for cabin crews due to potential cognitive impairments and safety risks.
Sleep improving effects of a single dose administration of a valerian/hops fluid extract - a double blind, randomized, placebo-controlled sleep-EEG study in a parallel design using electrohypnograms.
A single dose of valerian/hops fluid extract effectively improves sleep quantity and quality in poor sleepers compared to placebo.
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