What are sleeping pills?

Sleeping pills are medicines that help you fall asleep or stay asleep. They are sometimes used to help treat insomnia. Sleeping pills can have serious side effects. Sleeping pills are best used with other methods to help you sleep.

Sleeping pills can help if you're going through a difficult time and temporarily find it hard to sleep. Together with sleep hygiene tips, they can help you get your sleep back on track.

However, if you have longstanding problems with sleep, taking pills long term is usually not the best option. Sleeping pills might help you sleep, but they do not treat the cause of your insomnia.

Some medicines are intended to be used for sleep. Others can make you feel sleepy as a side effect, but are not sleeping pills.

Visit pregnancy birth and baby to learn about sleep problems in children.

Do not give medicine to children without talking to your doctor or pharmacist first.

How do sleeping pills work?

Sleeping pills can help you to fall asleep or stay asleep. Benzodiazepines help you relax and fall asleep. Other types of sleeping pills stop a chemical in your brain that keeps you awake.

Melatonin affects your body's sleep and wake pattern.

The choice of treatment depends on if you have trouble going to sleep, or staying asleep.

What are the different types of sleeping pills?

There are different types of medicines that can be prescribed for problems with sleep. You can buy other medicines for short term sleep problems over the counter at the pharmacy. Some people take herbal medicines for sleep, but their safety and effectiveness may not be scientifically proven.

Remember that not all medicines are safe for everyone. Check with your doctor or pharmacist before trying any medicines for sleep. This is especially important if you:

• are over 65 years of age
• have any other health conditions – especially lung disease, chronic kidney disease, liver disease or obstructive sleep apnoea
• drink alcohol on a regular basis
• take other medicines
• are pregnant or plan to become pregnant
• are breastfeeding

To search medicines by active ingredient or brand name, use the healthdirect Medicines search feature.

Prescription medicines

Benzodiazepines, such as temazepam, are the most common type of prescription sleeping pills. They slow down your brain and body function, helping you feel relaxed and fall asleep, then stay asleep. They are recommended only for short-term use, usually for less than 4 weeks.

Other common prescription sleeping pills include the Z-drugs zopiclone and zolpidem. Their effect on your body is similar to benzodiazepines. They are also recommended only for short-term use.

Suvorexant and lemborexant are orexin antagonists that work by blocking a chemical in your brain that keeps you awake. These medicines can be useful if you wake up during the night and struggle to go back to sleep. They can be used for longer periods of time than other prescription sleeping pills.

Some medicines prescribed for mental health conditions or seizures can make you feel drowsy as a side effect. If you take medicines for your mental health, such as antidepressants or antipsychotic medicines, ask your doctor or pharmacist if they are likely to make you feel drowsy. It's important to take your medicine as instructed by your doctor and not to use it for sleep unless recommended.

Occasionally melatonin may be prescribed for children who have long-term sleep problems. Talk to your doctor if you think your child needs melatonin. Your doctor may refer them to a specialist.

Over the counter medicines

Melatonin is a natural hormone that helps control your sleep and waking pattern. Melatonin may improve your sleep quality and morning alertness. Pharmacists can provide it to people over 55 years of age with poor sleep or to adults who have jet lag.

Antihistamines

Some antihistamines, such as doxylamine or promethazine cause drowsiness. They are known as sedating or 'first-generation' antihistamines. They are sometimes taken without medical advice for insomnia. These antihistamines are not sleeping pills — they are anti-allergy medicines which have a side effect of making you feel drowsy. They should not be used to help you sleep.

It's important to be aware that sedating antihistamine medicines can cause serious harm to young children. They should never be given to children under 2 years of age. Some antihistamines should not be used in children under 6 years of age — follow the directions on the pack and talk to your doctor or pharmacist if you are not sure.

Never give sedating antihistamines to children under 2 years for any reason.
Do not give sedating antihistamines to children or teenagers to help with sleep. This can be harmful.

Herbal and traditional medicines

Herbal medicines are sometimes used to treat insomnia. Not all of these medicines have been proven to help you fall asleep. The most frequently studied include:

• chamomile
• passionflower
• St John's wort
• valerian and hops combination

Chinese herbal medicine may be effective for sleep. Talk to a Chinese medicine practitioner to find out what might help you. Chinese medicine practitioners are regulated in Australia by the Australian Health Practitioner Regulation Agency (AHPRA). You can check if your practitioner is registered on the AHPRA website.

What are the side effects or risks of taking sleeping pills?

One main risk of sleeping pills is that you can become dependent on them. This means they become less effective over time. You will need to use higher doses to fall asleep and you will find it harder to sleep well without them. You may also begin to feel unwell or experience worse insomnia when you try to stop.

Sleeping pills can also make you unsteady, dizzy and forgetful. They can make it hard for you to concentrate. You might feel groggy or tired the next day. These side effects may increase your risk of having accidents and falls, especially if you are older.

Some types of sleeping pills can cause you to sleepwalk or even drive while you are asleep. This is more likely if you take other medicines or drink alcohol.

You may also experience worse sleep or very vivid dreams when you stop taking medicines for sleep.

How do I use sleeping pills safely?

Most sleeping tablets start working within 20 to 30 minutes after you take them. Melatonin takes longer to work after taking it.

It's important that you get into bed after taking any sleeping tablets. There is a risk of feeling unsteady once the tablets start working.

Here are some more tips on how to use sleeping pills safely.

• Check with your doctor or pharmacist if you can take your sleeping pills with your other prescription and non-prescription medicines. This includes herbal and traditional medicines.
• Take the sleeping pills as prescribed.
• Ask your doctor how long you need to take them and how to stop safely.
• Don't mix sleeping pills with alcohol.
• Don't take someone else's sleeping pills or share yours with anybody.

When should I see my doctor?

Speak to a doctor or pharmacist if you or your child have trouble sleeping.

Talk with your doctor before you start taking pills or other substances to help with sleep. Your doctor may have other suggestions to help you manage your insomnia. For example, you could get help for stress or anxiety.

Your doctor can also help if you want to wean yourself off sleeping pills.

Are there any alternatives to taking sleeping medicines?

You may be able to improve your sleep without taking sleeping pills.

Sleep hygiene

The first step is to practice good sleep hygiene.

This means creating a good sleep environment, keeping a consistent sleep schedule and controlling things like noise and temperature.

Good sleep hygiene habits also include:

• avoiding stimulating activities or screen use close to bedtime
• limiting your caffeine and alcohol intake
• doing relaxing activities before going to bed

Psychological therapy

You can also improve your sleep without medicines with the help of cognitive behaviour therapy (CBT), a type of psychological therapy. CBT is the recommended treatment for insomnia. It can be used alone, or with medicines.

CBT can help if you have trouble falling asleep or staying asleep all night. It can help change habits and thoughts that make it hard to sleep.

Therapy usually involves seeing a psychologist to learn the following techniques:

• Mindful breathing — to help you to stay calm and be in the present moment, by focusing on your breathing rather than on your thoughts.
• Visual imagery — to help you to create pictures in your mind that make you feel calm.
• Muscle relaxation — makes you aware of any muscle tension.
• Stress reduction techniques — to help you handle stress and make you feel less stressed over time.
• Sleep restriction — means spending less time in bed overall, so that you are asleep for most of the time you spend in bed.
• Stimulus control — means you use your bed only for sleeping and get up if you can't fall asleep within 15 to 20 minutes. It also means you don't sleep anywhere else besides your bed. This is to train your brain to link your bedroom with sleep.

Talk to your doctor to find out more about treatments for your insomnia that don't involve medicines. Your doctor can also recommend a therapist trained in CBT.

Resources and support

• If you take benzodiazepines, Reconnexion supports you to better understand your medicine and helps you manage withdrawal, poor sleep and anxiety. Phone 1300 273 266.
• The Sleep Health Foundation has a range of sleep factsheets, including helpful tips for children, teenagers and older adults with sleep difficulties.
• The Royal Children's Hospital has information and a video about healthy sleep habits.
• Read more about the warnings for use of first-generation antihistamines.
• If you have questions about your medicines, or want to know about side effects, you can call Medicines Line on 1300 633 424.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.