There is three basic types of sleep disorders: those that cause insomnia, those that cause fatigue during the day, and those that make it difficult to sleep through the night. About 80 percent of the population struggle with the most commonly diagnosed sleep disorder, transient insomnia and an estimated 15 percent adults in the United States has been diagnosed with chronic insomnia. Approximately 30-50% of individuals rely on sleep aides to doze off at night however many individuals overuse and abuse seep aides and studies have shown that sleep aides can result in addiction. In 2012, 21 percent of individuals abusing sleeping pills had suicidal thoughts related to their drug use. There were over 30,000 emergency room visits due to nonmedical use of the common sleeping pill zolpidem (Ambien) and in 2013, nine million Americans regularly used sleeping pills to help them sleep during the night. Sleeping pills are generally taken and prescribed for short-term use however many people become addicted over the long-term and feel that they cannot sleep without them. As with any addiction, impulsive behaviors and poor decisions can occur leading to unhealthy lifestyle choices that can result in broken relationships, the loss of a job, breaking the law or financial hardships.
Classes of sleeping pills
Sleeping pills fall into a category of drugs known as sedative-hypnotics, which includes benzodiazepines and barbiturates. Common benzodiazepines that are prescribed for sleep include alprazolam (Xanax), diazepam (Valium), lorazepam (Ativan), and quazepam (Doral). There are also non-benzodiazepine hypnotics that are commonly referred to as “z-drugs” since they induce sleep. These include zolpidem (Ambien), zaleplon (Sonata), and eszopiclone (Lunesta). Over the counter sleep aides include diphenhydramine (Benadryl) and acetaminophen/diphenhydramine (Tylenol PM) and are commonly abused since they are easily accessible compared to prescription sleep aides.
Side effects associated with sleep aids
Sleeping pills should only be taken for short-term use but unfortunately due to their high addictive potential, many individuals use them over a longer term resulting in side effects, which include the following:
- Dreamless sleep
- Lack of coordination
- Poor memory
Overtime the brain and the body builds a tolerance to sleep aids meaning that a higher dose is needed in order to produce the same effects. This makes it much harder to discontinue their use however recovery is possible. One of the major reasons why individuals relapse in recovery is due to rebound insomnia, which occurs after the cessation of sleeping pills. This occurs because the body and brain are so hooked on sleeping pills and when they are no longer in the blood, it makes it harder for individuals to naturally fall asleep.
Sleeping pills and co-occurring disorders
Individuals who abuse sleeping pills are known to have a greater incidence of depression and/or anxiety disorder and they self-medicate with sleep aides in order to induce faster sleep to alleviate their stress. Additionally many individuals with alcohol addiction will mix sleeping pills while drinking which can be a lethal combination. As with any other co-occurring addiction, it is important to treat each condition as a separate condition but simultaneously in order to prevent relapse.
Treatment for sleeping pill addiction
Treatment for sleeping pill addiction involves treating the underlying sleep disorder, if one is present, as well as recognizing the underlying triggers. Depending on the specific sleeping aid, medication can be administered to help tolerate the withdrawal side effects. Benzodiazepines must be tapered off slowly in order to prevent seizures and therefore professional addiction treatment is necessary. Psychotherapy including cognitive behavioral therapy and dialectal behavioral therapy are also used to help develop positive coping skills and relapse prevention skills.