It is a well-known fact that sleep is essential for our bodies. However, not everyone understands the full importance of this body function. Furthermore, just because you are asleep does not mean you are fulfilling the needs of your body with regard to this function. Whilst all the stages of sleep are important, deep sleep is the most essential. It is the third stage of non-rapid eye movement sleep (REM sleep) and is the interim, which ensures you feel refreshed after you have awoken.
The average adult achieves one to two hours of deep sleep per night. With a sleep disorder, like insomnia, it may not only be difficult to reach this stage of sleep but any stage of sleep for that matter.
If you are not sleeping for at least 7 to 9 hours a night, you are not receiving the amount of rest you require to perform at optimum functioning. Sleeping tablets such as zopiclone and zolpidem can assist in helping you get this much-needed time of slumber. They are formulated to help you fall asleep quicker, keep you sleeping for longer periods or both. These pills are used for sedation, hence their classifications as sedatives and hypnotics.
The mechanism of action of a sleep aid depends on the type of pharmaceutical it is. Medications are classified based on what they do, but often they can be used for purposes other than which they are primarily approved for. For example, antidepressant tablets are produced for the treatment of depression and anxiety. However, their effects can also manage of sleep disorders, especially those associated with depression and anxiety.
Common sleeping tablets, such as benzodiazepines and Z-drugs (non-benzodiazepines), work by affecting the neurotransmitter, gamma-aminobutyric acid (GABA). The inhibitory effects of GABA slow down brain activity to induce sedation. These sleeping pills activate the GABA receptors to bring about these therapeutic effects.
Gabapentinoids are classified as such because they are structural analogues of GABA. They do not work on the receptors of the inhibitory neurotransmitter, but rather function by affecting the concentration of it. Higher levels of GABA means more of the neurotransmitter and hence, more of the inhibitory effects. Other medications can include those directly affecting the sleep-wake cycles and are known as sleep-wake cycle modifiers.
Sleeping tablets help achieve sound sleep through different mechanisms and their effects are dependent on which category of medications one uses. The main categories are as follows:
Sedatives: medications which decrease brain activity and help you feel relaxed. By creating a state of calm, the individual will find it easier to sleep.
Hypnotics: medicines which bring about drowsiness and assists with sleep induction and maintenance. They facilitate sleep that closely resembles natural sleep based on electroencephalographic or EEG characteristics (a monitoring system that records the electrical activity of the brain).
In general, the main function of sleeping tablets is to promote or extend the natural body function of sleep. They can be used for the maintenance of sleep or for sleep deprivation due to a disorder like obstructive-sleep apnoea and narcolepsy, or other events such as a stressful situation.
We explore this with the following three questions:
Based on the brand and type of medication you are using, the sleep aid should be taken as directed by the manufacturer. This information is apparent on the bottle or dispenser, but can also be found within the packaging information or electronically via the manufacturer website. Most sleeping tablets are for oral consumption. They can be taken wholly as a tablet or capsule and with a glass of water.
As the intended purpose of sleeping tablets is directed towards nighttime, these medicines are generally administered before bed. They can also be used if you require sleep during the day for reasons such as shift work or others. A more precise treatment schedule can be designed according to the onset of action of the medication. Some can work within minutes of administration and are most appropriately taken when you are already in bed. Others can require a longer time to take effect and may be administered an hour before retiring to bed.
The purpose of drinking water with sleeping tablets is to not only help you properly move the medicine through your system, so that the active ingredient may be absorbed by the bloodstream - but to also minimise the possibility and severity of side effects.
The difference of administration times is due to the varying formulations of sleep aids. Some can be fast-acting and release their ingredients quickly to help promote sleep. Others can be slow-acting and provide a maintained release of the active ingredient so as to keep you sleeping for longer.
The overall safety (side effects, risks, dependence, tolerance etc.) of a reputable sleep medication is assessed by agencies such as the Food and Drug Administration (FDA), which is a part of the Department of Health and Human Services. This approval means that a particular pharmaceutical is deemed safe for consumption.
The discrepancies of the safety of pharmaceuticals lie in one's response to the ingredients in the medication and how they are used. Side effects are a possibility of every type of medicine and the possibility thereof is based on one's body chemistry. Dependence and tolerance often occur when the medication is not used as directed or if it is used for treatment periods longer than those recommended.
Sleep deprivation seems to be far more dangerous than sleeping tablets (when used as advised). The effects of sleep deprivation can interfere with the mental, physical and emotional health of an individual. Research also links a lack of sleep (mostly chronic) with the advent of neurological diseases.
The Marche Polytechnic University of Italy showed chronic sleep deprivation can increase the risk of neurodegenerative diseases, like dementia. Additionally, a Canadian Association for Neuroscience study revealed that 80% of those with REM sleep behaviour disorder were connected to latter stages of neurogenerative disorders.
According to a 2020 statistical report on sleep and its effects on the general population, 4.7% of people have admitted to nodding off or falling asleep whilst driving in the month prior to the analysis. Implications like these, and others, may have consequences which can kill or seriously injure individuals and others.
Updated: 29th January 2021
Review Due: January 2022