Understanding the Side Effects of Sleeping Pills

Medically Reviewed by Jabeen Begum, MD on June 19, 2024
Written by Debra Fulghum Bruce, PhD, Marijke Vroomen Durning, RN
11 min read

More than one-third of Americans experience insomnia and don’t get enough sleep. Perhaps you're one of them. If so, you may be considering taking a sleeping pill.

A sleeping pill can help your sleep problems for the short term. But it's important to know how to use them, the side effects, and how to avoid misusing them.

Most sleeping pills are classified as sedative hypnotics. That's a specific class of drugs used to help you fall asleep or stay asleep. Sedative hypnotics include benzodiazepines, barbiturates, and various hypnotics.

Benzodiazepines such as Ativan, Librium, Valium, and Xanax are anti-anxiety medications. They also increase drowsiness and help you sleep. While these drugs may be useful for the short term, all benzodiazepines are potentially addictive and can cause problems with memory and attention. They are usually not recommended for long-term treatment of sleeping problems.

Barbiturates, another group of drugs in this sedative-hypnotic class, depress your central nervous system, which sedates you. Short- or long-acting barbiturates are prescribed as sedatives or sleeping pills. But more often, these drugs are only used as anesthesia during surgery or other medical procedures. If you take too much -- overdose -- it can be fatal.

Newer medications help you fall asleep faster. Some of these sleep-inducing drugs include Ambien, Lunesta, and Sonata. They are somewhat less likely than benzodiazepines to be habit-forming, which means your body gets used to having them to fall asleep and you may have problems in the long-term dozing off without them. But there is still a chance that they can cause physical dependence over time. 

Another sleep aid, called Rozerem, acts differently from other sleep medicines. It affects a brain hormone called melatonin, and it's not addictive. Belsomra and Quviviq are unique sleep aids that affect a brain chemical called orexin. They can be habit-forming. Another sleep medicine that is not addictive, Silenor, is a low-dose form of the antidepressant doxepin.

Over-the-counter sleeping pills

You can find many over-the-counter (OTC) products that claim to help you fall asleep faster. They include:

Antihistamines: Diphenhydramine (Benadryl), usually given for allergies, can help you feel drowsy enough to sleep. Other OTC products, like Nytol, Sominex, and Unisom, are sold as sleep aids, but they contain antihistamines.

Melatonin: Melatonin is a hormone that helps tell your body when it’s time to wake up and when to sleep. Taking melatonin could help you regulate your sleep, especially if the insomnia is caused by jet lag or shift work.

Valerian: Some people use the supplement valerian to help manage their insomnia, but studies are divided as to whether it really works.

Like most medications, sleeping pills have side effects. You won't know, though, whether you will have side effects with a particular sleeping pill until you try it.

Your doctor may be able to tell you about some side effects if you have asthma or other health conditions. Sleeping pills can interfere with normal breathing and can be dangerous in people who have certain chronic lung problems such as asthma, emphysema, or forms of chronic obstructive pulmonary disease (COPD).

Common side effects of prescription sleeping pills such as Ambien, Halcion, Lunesta, Rozerem, and Sonata include:

  • Burning or tingling in the hands, arms, feet, or legs
  • Changes in appetite
  • Constipation
  • Diarrhea
  • Balance problems
  • Dizziness
  • Daytime drowsiness
  • Dry mouth or throat
  • Gas
  • Headache
  • Heartburn
  • Mental slowing or problems with attention or memory
  • Stomach pain or tenderness
  • Uncontrollable shaking of a part of the body
  • Unusual dreams
  • Weakness

Not everyone can safely take sleeping pills. They could affect other medications or cause serious side effects. If you think you need a sleeping aid, speak with your doctor first to make sure that a sleeping pill is safe for you, even if it’s available OTC.

Children

Just like adults, some children may have trouble falling or staying asleep. If this happens, it’s important to work with your child’s doctor to find out why this is happening. Sleeping pills aren’t usually recommended for children.

There are no FDA-approved sleeping pills for children under 16. Also, these drugs have been developed and tested on adults only, so doctors don’t know the right dosages to give to children.

Older adults

If you’re 65 or older, experts suggest that you avoid all sleep aids. This includes over-the-counter drugs and the newer “Z” drugs like eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien).

Compared to younger people, older adults have a greater chance of health problems on sleep meds. When you’re older, sleeping pills tend to stay in your system longer. Drowsiness can last into the day after you’ve taken them. Confusion and memory problems are also a known side effect. For older adults, this could result in falls, broken hips, and car accidents.

Other symptoms of some over-the-counter sleep medications can be especially hard for older adults to handle. Your mouth may be dry. You may also be constipated and find it hard to pee.

Before you decide to take sleeping pills, talk to your doctor. They may recommend a medical exam to help you figure out the cause of your sleep problems, like depression, anxiety, or a sleep disorder.  Your doctor will also suggest ways to treat sleeplessness without drugs.

Other people who shouldn’t take sleeping pills

If you are pregnant or breastfeeding, you shouldn’t take any OTC sleeping aids. If you have severe insomnia, your doctor might prescribe a sleeping pill to be used for a short time.

You also should only use sleeping pills with your doctor’s recommendation or prescription if you have:

  • Kidney disease
  • Low blood pressure
  • Abnormal heart rhythms
  • Seizures

Sleeping pills also might interact with medications you take for other health conditions, so be sure your doctor knows all medications you take, even those prescribed by other doctors. Also check with your pharmacist before using an OTC product or supplement, as these can also interact badly with prescription medications.

Some sleeping pills have potentially harmful side effects, including parasomnias. Parasomnias are movements, behaviors, and actions over which you have no control, like sleepwalking. During a parasomnia, you are asleep and unaware of what is happening.

Parasomnias with sleeping pills are complex sleep behaviors and may include sleep eating, making phone calls, or having sex while in a sleep state. Sleep driving, which is driving while not fully awake, is another serious sleeping pill side effect. Though rare, parasomnias are difficult to detect once the medication takes effect.

Daytime sleepiness, dizziness, or confusion can be another complication related to sleeping pills. Feeling this way can make it dangerous to drive to work or operate machinery, because your reaction time may be too slow. It can also make it hard for any other task that needs your full attention.

Rebound insomnia can happen if you suddenly stop taking sleeping pills. To reduce this risk, doctors usually recommend that you slowly lower your dose and wean yourself off gradually. If you want to or must stop taking the sleeping pills, speak with your doctor about how to do it.

Product labels for sedative-hypnotic medicines include language about the potential risks of taking a sleeping pill. Because complex sleep behaviors are more likely to occur if you increase the dosage of a sleeping pill, take only what your doctor prescribes.

Can you overdose on sleeping pills?

Anyone can overdose on sleeping pills. Teens and young adults seem to be at highest risk, especially if they take benzodiazepines. The risk is also high for anyone who mixes sleeping pills with opioids, other sedatives, or alcohol.  

You can have an allergic reaction to any medicine, including sleeping pills This could be related to either the active ingredient of the medicine itself or to any of its inactive ingredients (such as dyes, binders, or coatings). If you have an allergic reaction to a specific sleeping pill, you should avoid it. It's important to talk to your doctor at the first sign of these symptoms:

  • Blurred vision or any other problems with your sight
  • Chest pain
  • Difficulty breathing or swallowing
  • Feeling that your throat is closing
  • Hives
  • Hoarseness
  • Itching
  • Nausea
  • Pounding heartbeat
  • Rash
  • Shortness of breath
  • Swelling of the eyes, face, lips, tongue, or throat
  • Vomiting

If you are having any problems breathing or chest pain, you should get emergency medical care. 

The general rule of thumb is you should only take your sleeping pill when you know that you will be in bed for at least 7 to 8 hours. 

Don’t take the sleeping pill before you’ve finished your activities for the day. Learning the best times for you to take your sleeping pill may take some trial and error, and you may need to adjust your activities to fit it in. If you take the sleeping pill too early, you won’t be able to stay up as long as you’d like and you might wake up too early. If you take it too late, it may not be working when you need it and your sleepiness may last past your wake-up time.

It's usually recommended that you take the sleeping pill right before your desired bedtime. Read your doctor's instructions on the sleeping pill prescription label. The instructions have specific information regarding your medication. 

Some people have no trouble falling asleep but they can’t stay asleep, so they look for a sleeping pill that is short acting (not 7 to 8 hours). There is one drug that is FDA approved for this, called Intermezzo. You can take this medication if you have at least 4 hours left of sleep time.

Sleeping pills can interact with many types of OTC and prescription drugs, particularly those that affect your central nervous system. If you need a sleeping pill and take other medications, make sure your doctor knows what you are taking, even if prescribed by another health care professional. If you plan on trying an OTC sleeping aid, ask your pharmacist if it is safe to do so with medications (including other OTC supplements) you already take. 

Sleeping pills and medications

The drugs with the highest risk of interacting with sleeping pills, possibly causing depressed (slow) breathing and even death, include:

  • Opioids, including street drugs
  • Antidepressants
  • Antihistamines

Sleeping pills and alcohol

Even the smallest amount of alcohol can interact with sleeping pill. The alcohol enhances or increases the sedation. Combining the two can cause:

  • Dizziness
  • Fainting
  • Depressed breathing
  • Unconsciousness

Sleeping pills and grapefruit

If you enjoy having some grapefruit or grapefruit juice, you should know that they can have a negative effect on some medications, including some types of sleeping pills, like Halcion. The enzymes in the grapefruit slow down how your body metabolizes (breaks down) the medication, making the drug stronger and last longer in your body. This can be particularly dangerous if you are operating machinery or doing anything that needs you to be very alert in the morning after taking the sleeping pill.

If you do enjoy grapefruit, ask your pharmacist if it’s safe to consume it with your sleeping pill.

Over-the-counter sleep aids come with a warning not to take them for more than a specific length of time. This is for a couple of reasons. If your insomnia goes beyond that time, you may need to see a doctor to find out if there is a specific cause for the lack of sleep. The other is because of the risk of the medication becoming habit forming. Psychological dependence on the medicine may keep you from falling asleep if you don’t take it.

For short-term insomnia, your doctor may prescribe sleeping pills for several weeks. Yet after regular use for a longer period, some sleeping pills such as benzodiazepines or benzodiazepine agonists such as eszopiclone or zolpidem may stop working as you build a tolerance to the medication. 

Without the sleeping pill, you might find it difficult to sleep. In fact, most sleeping pills are habit forming. Only Rozerem and Silenor aren’t.

Some studies show that long-term use of sleeping pills actually interferes with sleep. The best way to avoid developing a physical or emotional dependence on sleeping pills is to follow your doctor's instructions and wean off  the drug when recommended.

Before starting to take sleeping pills, you may want to try some of these tips that could help you get your much needed rest.

Avoid 

  • Alcohol, which can cause restless sleep and frequent waking. Avoid drinking alcohol within 3 hours of when you want to go to sleep
  • Caffeine for at least 6 hours before bed
  • Large meals before bed, which can cause indigestion
  • Drinking water or other fluids close to bedtime, which can cause you to wake up during the night to pee
  • Smoking, because nicotine is a stimulant
  • Electronic devices for at least a half hour before bed
  • Exercising too close to bedtime

Try

  • Sipping warm milk, chamomile tea, or tart cherry juice before bed
  • Regular exercise, earlier in the day
  • Keeping your bedroom cool and dark
  • Meditating or listening to relaxing music before bed
  • Making a sleep schedule or routine, so your body gets used to when you want it to sleep

It’s not unusual to have a bad night’s sleep or even a few of them. But when it starts to affect your life, you might choose to try a sleeping pill. There are several OTC sleeping aids that you could choose from, but if you take any other medications, including supplements, you need to speak with your pharmacist to see if there are any interactions that could cause problems. Many sleeping pills, especially prescription ones, are habit forming. If you do start taking one, don’t take it longer than your doctor says to. And if you must stop, do so gradually, so you don’t experience rebound insomnia.

Is it bad to take sleeping pills every night?

If your doctor prescribes a sleeping pill every night, you should take it as directed. However, if you take OTC sleeping aids and find you need to take one every night, you should speak with your doctor because they aren’t meant to be taken for long periods.

What are the rare side effects of sleeping pills?

Some people develop parasomnias, unusual behaviors like walking, driving, or eating in their sleep. It is rare though.

How long do sleeping tablet side effects last?

Generally, the side effects of a sleeping pill should wear off when you stop taking it.

How long does it take for a sleeping pill to wear off?

The effects of a sleeping pill usually wear off by morning. This is why it’s recommended that you only take a sleeping pill if you know you can stay in bed for at least 7 or 8 hours.