Some current medications can cause you to sleep too deeply. Experts say milder pills and sleep therapy might be better options.
What’s a good night’s sleep worth?
For people with insomnia or other sleep problems, getting eight hours of sleep is precious. There’s no shortage of drugs on the market aimed at helping people sleep better.
But what if some of these medications worked too well?
It’s been understood for decades that sleep medications can cause such deep sleep that not even a loud fire alarm can wake someone from their slumber.
But now a newer class of drugs may be able to provide restfulness without dulling the brain’s ability to respond to stimuli.
Researchers from Japan’s Kagoshima University recently investigated the effects of a new class of “hypnotic” drugs, finding promise in their tests on lab mice.
The study was published in the journal Frontiers in Behavioral Neuroscience.
This new class of drugs, known as dual orexin receptor antagonists (DORAs), provide a more targeted approach to combating sleeplessness.
Prescription medications tend to work by dulling more of the brain, including the crucial pathways that determine what kind of external stimuli is worth responding to. These drugs can also have the knock-out effect of “sleep drunkenness” extending into the waking hours.
While the Japanese research is still in its early stages, it provides promising information on the potential of DORAs that could eventually give doctors more tools for treating insomnia.
One expert interviewed by Healthline says that medications will always have a place in sleep medicine, but he stresses that sleeping pills are a short-term solution in many cases.
In addition to research showing that sleep medications can dull a person’s ability to respond to an emergency alarm, there’s a host of other side effects as well.
Dr. Ryan Donald, clinical assistant professor of sleep medicine at The Ohio State University Wexner Medical Clinic, told Healthline that the dulling effects of some drugs can lead to injuries for people who get up in the night to use the restroom, or even for people driving the next morning.
One popular sleep aid, zolpidem (Ambien), was in the headlines last year after comedian Roseanne Barr blamed the drug for a racist tirade on Twitter.
While the drug doesn’t explain the racist tweets, it has been associated with odd conduct.
“These medications can be associated with strange behaviors at night,” Donald said. “It’s not uncommon for people to develop what we call parasomnias, or abnormal behaviors that they might not be aware of.”
Donald says that he doesn’t prescribe a lot of sleeping pills in his practice.
“Most sleep doctors I’ve met and trained with don’t use them very much, but there are definitely situations where they’re helpful,” he told Healthline.
One of these situations is for treating acute insomnia, which is less than three months in duration, Donald said. Oftentimes, a sleep aid is prescribed for a couple of weeks to help get people with acute insomnia over the hump.
“For chronic insomnia, sleep medications aren’t that helpful,” he said. “It depends on the drug, but a lot of medications tend to become less effective with time.”
Another factor to consider is that many people with sleep problems aren’t necessarily taking the right kind of medication for their condition.
“With sleep aids, people often use what they’re most comfortable with,” Donald said. “Oftentimes, people use things like antihistamines, where the primary purpose is not to help them fall asleep, and these medications come with their own list of side effects to worry about. If you do use a sleeping pill, they should target sleep-related issues more specifically.”
For those with chronic insomnia, Donald says the best course is to engage in cognitive behavioral therapy for insomnia (CBTI), which has longer-lasting benefits than medication alone.
“Often with pills, once a person is taken off them, they can rebound and fall back into the situation they were in before,” Donald said.
“CBTI has more lasting value. The biggest limitation is access. It can be hard to find a good therapist who’s trained in CBTI. This is why many doctors tend to lean more heavily on pills depending on the situation,” he said.
Medications have drawbacks and therapy can be tough to find — so what day-to-day steps can be taken to improve your sleep?
One primary driver of sleeplessness is stress. The dread of looking at the clock during the night and learning that the alarm will go off soon is a feeling familiar to many.
This problem is simple enough to remedy: Just put your clock in a position where you can’t see it.
Donald recommends a few steps to lessen sleep anxiety.
“It’s important to remember that not everybody has a good night’s sleep every night,” he said. “One of the tendencies of people with chronic insomnia is to catastrophize, so they tend to worry about not getting enough hours of sleep. As soon as people start getting anxious or worried about their sleep, it makes it harder to get to it.”
To combat this, Donald says it’s probably best to get up if you don’t fall asleep quickly or begin to feel stressed. Changing the scenery and engaging in slower activities such as reading in dim light is often enough to transition the brain from stressing about sleep to actually getting sleepy.
Other steps include avoiding stimulants such as alcohol, caffeine, and nicotine before bed, along with avoiding distracting electronic devices like smartphones.
A final step, often unpopular with people who like sleeping in on the weekend, involves setting a regular schedule along with prioritizing comfort. Your bedroom should be dark, quiet, and cool for the best sleep.
“Consistency in your sleep schedule is key,” Donald said. “Set your wake time to be the same every day whether it’s a weekend or weekday. Sleeping late generally isn’t the best idea when it comes to maintaining a healthy sleep schedule.”
Sleep aids could soon be more targeted with fewer unnecessary sedative effects.
Researchers in Japan are looking at “hypnotic” sleep medications that may help people with insomnia get better sleep without knocking them out cold.
However, for people with chronic sleep disorders, sleeping pills aren’t a magic bullet.
Improving sleep hygiene and engaging in sleep therapy are the best practice, experts say.