This week Marion Kerrlooks at sleeping medications
I occasionally have difficulty sleeping and was wondering about getting some sleeping tablets from my GP. Can you tell me how these medicines work?
We all experience nights when sleep does not come easy or when we wake up too early. Normally caused by a temporary worry or anxiety, it can also be from the discomfort of the symptoms of an acute illness. Once these resolve, a normal sleep pattern resumes. Persistent sleeplessness, however, can be the result of a long- term illness or from psychological problems, including depression and anxiety.
Sleeping tablets or hypnotics work by depressing the brain's function, interfering with the chemical activity in the nervous system, allowing the brain to switch off and slip into sleep. But normal sleep and medication-induced sleep are not of the same quality.
Put simply, normal sleep consists of phases of light sleep, deep sleep and dream sleep. In contrast, hypnotics suppress deep and dream sleep, resulting in less refreshing sleep.
What about side effects?
Hypnotics tend to work rapidly, producing drowsiness and sleep within an hour or two. However, these drugs can produce a "hangover" effect the next day, or cause daytime drowsiness, slowed reactions, and unsteadiness.
Sleeping tablets tend to become less effective the more often you take them. This can lead to an increase in the dose needed to achieve the same effect. In addition, some people can experience physical or psychological dependence on this type of medication when taken for more than a few weeks.
When sleeping tablets are suddenly stopped withdrawal symptoms may be experienced. These include disturbed sleep, nightmares, anxiety, hallucinations and convulsions. If sleeping tablets are prescribed they are best taken at the lowest possible dose, for the shortest amount of time and gradually reduced to avoid withdrawal symptoms.
Have you any suggestions for getting a good night's sleep without resorting to medication?
Most sleep problems resolve once the underlying cause has been identified and dealt with.
Simple remedies can help: a good pre-sleep routine including winding down an hour or more before going to bed; avoiding alcohol; a hot milky drink or warm bath before retiring; and not reading or watching TV while in bed.