Long ago the initial belief about sleep was that during this process, the body and brain were dormant. It is now known that this is, in fact, quite the opposite. During the stages of sleep, the brain and body are thought to be actively engaged in activities which are linked to daily life.
A sleep cycle is not the same for everyone. Some may find they experience the stages differently and for varying durations. However, the stages are the same for every individual with regard to the cycling of REM (rapid-eye movement) and non-REM sleep.
It was thought that REM sleep was important for memory and learning, but recent studies link these processes to the non-REM phase of sleep. Non-REM sleep has four stages:
Deep sleep is the stage of sleep which enables you to awaken refreshed. Most people with sleep difficulties find it difficult to sleep long enough, and uninterrupted, to reach the and fourth stages of sleep which makes them feel as though they are not well enough rested when they awake. Others may find difficulties with the earlier stages of sleep by which they cannot feel asleep unassisted.
Sleeping tablets can increase the total time spent asleep which allows one to reach the stages of deep sleep and thus, feel adequately rested. In addition, these therapeutics may help one with sleep induction.
Sleeping tablets work by affecting the central nervous system (CNS). A depression of the CNS brings about a feeling of calmness (and sedation) which relaxes the muscles and allows for proper sleep hygiene.
Medications, especially those designed to be used as sleep aids, typically have a short onset of action. This means they can take anywhere from minutes to an hour to induce their sedative and hypnotic effects. One of the most common sleeping tablets, zopiclone, for instance takes an hour to work.
Those which are used off-label as sleeping pills can take slightly longer. Pregabalin is a medication approved by the Food and Drug Administration (FDA) for use as a neuropathic analgesic and anti-epileptic. A non-FDA approved use involves administration of this therapeutic for sleep disturbances. The effects of this medicine, for approved or non-approved uses, often take a week or longer to be seen and for improvements to be noticeable. Off-label usage is still highly recommended by medical experts and patients alike, due to observed results.
The time it takes for a sedative to take action depends on the pharmacological profile of the medication.
You can take two sleeping tablets at once, provided that you remain within the recommended dosage guidelines for that specific medication. For example, if the advised dosage of a sleep aid is 15 mg at night, you can take two 7.5 mg tablets before you go to sleep.
However, it is not advisable to take two sleeping tablets when they are of greater potency, meaning once the recommended dosage is exceeded. This means that the relative strength of the medicine is higher as it contains more of the active ingredient. Therapeutics with too much of an active ingredient can lead to unpleasant side effects and risks.
Temazepam, for example, is a sleep medicine which comes in different formulations ranging from 7.5 mg to 30 mg. When administered for insomnia, the initial recommended dosage is 15 mg. This dose may be achieved by using two tablets (7.5 mg) prior to retiring to bed.
Non-benzodiazepine medications such as zopiclone and zolpidem are specifically designed to provide up to 8 hours of uninterrupted sleep and users should never take two of this particular kind of sleeping tablet.
Most medications are packed with information leaflets which indicate that the therapeutic should not be used in conjunction with alcohol. This is no different for sleeping tablets. The reason for this warning comes from the fact that both these substances can function as CNS depressants. A heightened effect of CNS depression can be fatal to one's health because it is possible to stop breathing when you use the sleeping pill concomitantly with alcohol.
Some sleep medicine specialists call this effect 'a multiplicative effect'. These specialists often suggest that when you mix these substances it is likely that the advised dosage has been tripled, if not quadrupled. It has also been said that alcohol creates a foundation for bad sleep as it causes you to stay the in the stage of light sleep rather than achieving a proper sleep cycle.
You may drink alcohol after administration of a sleep aid but the time taken for the effects of the medication to wear off is different for everyone. Normally, it is best to wait an average of six hours before you have alcohol. Each person's metabolism is unique and so the period between taking a sleeping pill and drinking alcohol may vary for everyone.
There are a multitude of reasons for experiencing sleeping problems when pregnant. This can include fluctuating hormones, nausea and heartburn.
The safety and efficacy of medications during pregnancy is generally not well-established. There are some medications though which can be thought of as useful. Sleeping tablets, in particular, may be helpful in situations where sleep disturbances have negative implications on the health of the expecting mother and the developing baby. This is of significance in cases where the benefits of the medicine outweigh the risks.
Benzodiazepine sleeping pills such as nitrazepam are often not recommended during pregnancy. However, controversy surrounds the use of these medications during gestation. Some believe it is not safe and can be harmful to the growing baby whilst others believe that the risk is insignificant. Data relating to the risk of malformations (particularly cleft lip or cleft palate) is estimated to be around 0.7%.
Initial reports suggest that benzodiazepines are associated with an increased risk of malformations, such as cleft lip or cleft palate. It has been recently revealed that there is no link between the use of this therapeutic and pregnancy. Furthermore, this risk is confined to the initial trimester of pregnancy, when lip and palate formation occurs; suggesting that these sleep aids may be useful for the latter stages of pregnancy.
Updated: 29th January 2021
Review Due: January 2022