The Side Effects of Sleeping Pills and How They Affect Our Sleep Cycle

The importance of a good night’s rest cannot be overstated. Poor sleep is linked to all-cause mortality, which means getting too little or too much sleep are “significant predictors of death,” according to a 2010 meta-analysis study. But good sleep is increasingly a privilege, as stress, workloads, and the trappings of a modern lifestyle squeeze out valuable shut-eye.

Naturally, there are medications that aim to fix this problem. Home remedies like extracts of valerian root, a pinkish-white flower, have existed in North America since the mid-19th century. Contemporary drugs like Ambien, an insomnia drug, or melatonin, a sleep-related hormone the body naturally produces, make up an industry generating $70 billion per year. But whether they actually help is a different question.

Here’s how sleeping pills actually work, the potential risk of side effects, and how they affect our circadian rhythm and sleep cycle.

All sleeping pills work essentially the same way, by boosting production of a neurotransmitter known as GABA. GABA helps to quiet down the activity of neurons in our brains, and it’s an important part of our sleep cycles. 

Almost every drug that makes you drowsy, including barbiturates, benzos, valerian root, and even alcohol, utilizes this chemical. 

Though losing sleep can be unhealthy, some prescription sleep aids also come with rare but serious side effects, such as sleepwalking, driving asleep, rebound insomnia, or sleep aid dependency.

Some sleeping pills could cause sleepwalking as a potential side effect. In late April, the Food and Drug Administration put a black box warning — the agency’s most severe label — on three of the most popular insomnia drugs: eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien). The FDA logged 66 incidents of semi-conscious behavior after taking the drugs, such as sleepwalking or driving asleep, that resulted in serious injury or death.

To make matters worse, when you stop taking some sleeping pills, they can cause “rebound insomnia” which makes it even more difficult to fall asleep. These so-called Z drugs don’t work much better than a placebo, according to a 2012 meta-analysis of about 4,400 patients across 13 studies.

Another possible side effect of sleeping pills is building a dependency to sleep aids. As Walker explains in his book, the brain responds to drugs by trying to become less sensitive and alters its balance of receptors, creating a type of dependency. “This is also known as drug tolerance,” he writes. 

For this reason, Cash says discontinuing sleeping meds requires slowly tapering down the dose, rather than stopping immediately, and should be supervised by a doctor. “Generally it is recommended that sleep medications be adopted only for the short-term, for four consecutive weeks of use or less,” she says.

Not getting the right amount of sleep can be detrimental to one’s health. But while drugs for sleep may help in a pinch, their side effects may not be worth it. Overall, there really are no long-term substitutes for the real thing: deep, restful slumber.

Read More: The Importance of Sleep for Your Body

Sleeping pills might not be the best path to a healthier relationship with sleep. Low levels of GABA have also been linked to insomnia and anxiety. As neuroscientist and “sleep diplomat” Matthew Walker explains in his 2017 bestseller Why We Sleep: “Sleeping pills do not provide natural sleep, can damage health, and increase the risk of life-threatening diseases.”

While taking drugs like Ambien may help you become unconscious, sedation is not the same as sleep. These hypnotic drugs can actually restrict the deeper brain waves produced during REM sleep, leading to grogginess and forgetfulness the following morning. Feeling sluggish the next day might lead people to consume more caffeine, making sleep difficult and perpetuating the cycle. 

Read More: The Importance of Sleep for Your Body

Other people opt for a different route with melatonin supplements. Melatonin is a hormone produced by our bodies that tells our brains it’s time to sleep. Melatonin signals our brains that it’s dark out, and to prepare for sleep. Melatonin supplements have become popular among those looking for a good night’s rest. 

Melatonin supplements may not actually induce better sleep, though, and the effects are modest at best. Some commercially-available supplements have issues with quality control as well.

The natural production of melatonin is part of our circadian rhythms, internal cycles of alertness and drowsiness that operate on a roughly 24-hour timetable.

Read More: Do Melatonin Diffusers Help You Sleep Better

 Sleeping pills and melatonin supplements disrupt the body’s natural sleep-wake cycle, affecting circadian rhythms. When circadian rhythms are disrupted, studies show that it can have a range of negative effects on physical and mental health. Your body aims to follow a routine that fits with daytime, nighttime, meal times, and when you're active. When these routines don't line up, it can make it tough to fall asleep, and your sleep quality might suffer.

 Circadian rhythms have a significant impact on mental health, with mood disorders often linked to disruptions in these internal biological clocks. Factors like night-shift work or exposure to artificial light at night can worsen mood disorders, emphasizing the bidirectional relationship between circadian rhythms and mental well-being.

 Circadian rhythms could also lead to cancer if disrupted. Liz Cash, an assistant professor at the University of Louisville, studies circadian rhythms in people with cancer. She says patients with disrupted rhythms have worse overall survival rates than patients who maintain more regular cycles.

“When individuals experience disruptions in these rhythms over the long-term (many years), this can lead to changes in physical health and contribute to the development of disorders like obesity, diabetes and cancer,” Cash says.

Circadian rhythms are so important that the disruptions caused by working a late-night shift makes certain jobs likely carcinogens, according to the World Health Organization.

Read More: How Your Circadian Rhythms Control Your Every Waking — and Sleeping — Moment

Always speak to a medical provider before starting any medication. If you feel that you or someone you know may be having issues with sleep medication, call 988, the Suicide and Crisis Lifeline. 

Yes, taking too many sleeping pills can lead to an overdose. Always consult a medical provider before starting any sleep medication and never take more than prescribed. 

Taking sleeping pills can have adverse side effects such as dizziness, memory loss, drowsiness, and a reliance on them. If you take them for prolonged periods of time, it can lead to intensified side effects along with high blood pressure, depression, and irregular heartbeat. 

Sleeping pills should only be taken if you can get a full seven to eight hours of sleep. According to the Cleveland Clinic, sleeping pills may help you fall asleep faster, but overall, you may only get an additional 35 minutes of sleep. Sleeping pills are generally used for short-term situations. Consult a medical professional if you’re having chronic issues sleeping. 

Sleeping pills take about 30 minutes to kick in. It’s best to take them about a half hour before you go to bed. 

Yes, especially if taken for more than two weeks. If you start to notice these symptoms in yourself or a loved one, contact a medical professional right away:

• Detachment

• Isolation 

• Mood swings

• Sleeping pill cravings

• Withdrawal symptoms

• Lack of interest 

• Needing a larger sleeping pill dose

Read More: Why Do We Sleep?

This article was originally published on Aug. 20, 2019 and has since been updated with new information from the Discover staff.