What are Hypnotics?
Hypnotics are a class of drugs that are classified as “sleeping pills.” Hypnotics are drugs that are made to induce, improve, and extend sleep in people who have sleep problems. They are typically used to treat insomnia and other sleep disorders.
Hypnotics include medications from many different classes, including antipsychotics, benzodiazepine receptor agonists, antihistamines, orexin antagonists, and melatonin (or melatonin receptor agonists).
What are Hypnotics Used For?
Sedative hypnotics are a sleep medicine that is used for treatment of insomnia and to help people get a better night’s sleep. These drugs can be used to treat sleep conditions in people that wake in the middle of the night, or to help them go back to sleep with frequent wakeups.
Hypnotic medication can be helpful in assisting people in sleeping better overall or getting back to sleep if they wake frequently in the middle of the night. There are prescription medication options such as benzodiazepines, or other types of over-the-counter drugs that can help treat insomnia such as melatonin.
Types of Hypnotics
Benzodiazepines
Benzodiazepine hypnotics are a relatively safe and effective type of medicine used to aid sleep problems and treat insomnia. Benzodiazepine use can result in dependence or addiction to the drug in patients who use it. Examples of these benzodiazepine hypnotics include:
- Flurazepam (long acting)
- Lorazepam
- Alprazolam
- Flunitrazepam
- Triazolam
- Temazepam
- Quazepam (long- acting)
- Oxazepam
- Estazolam
- Prazepam
- Clonazepam (long acting)
Non-Benzodiazepines
Examples of hypnotic medications that are non-benzodiazepine hypnotics include:
- Lunesta (eszopiclone), often called “z drugs”
- Imidazopyridines: Ambien, Ambien CR, Intermezzo (zolpidem) (class of its own)
- Sonata (pyrazolopyrimidine) (class of its own)
- melatonin receptor stimulator: Rozerem (ramelteon)
- Precedex (dexmedetomidine hydrochloride)
- Notec (chloral hydrate)
Barbiturates
Barbiturates are another group of non-benzodiazepines. Barbiturates are sedative hypnotic drug medications prescribed by a doctor that are used for short-term treatment of insomnia in patients that suffer from sleep problems.
Antidepressants
Although use of antidepressants as hypnotics has become increasingly common, few studies have been conducted to specifically examine their effects on insomnia. They have unique effects on neurotransmission, but their hypnotic properties are most strongly related to antagonism of serotonin, histamine H1, and adrenergic receptors.
Serotonergic antidepressants can cause features of unexpected sleep stages that can be characterized by rapid eye movements during the stage of non-REM sleep. This can cause or exacerbate periodic limb movements or restless legs syndrome.
Over the Counter Sleep Aids
Examples of non-prescription hypnotic drugs include:
- Unisom Nighttime Sleep-Aid
- Dormin
- Nytol
- Simply Sleep
- Sominex
- Extra Strength Tylenol PM
- Diphenhydramine hydrochloride
- Excedrin P.M.
- Over the counter formulations of melatonin
Treatment of Insomnia
Insomnia is characterized by difficulties with falling asleep or maintaining sleep. Treatment for insomnia includes many hypnotic drugs that are needed to help a person go back to sleep or maintain healthy sleeping habits.
Insomnia is a sleep condition that affects many adults and causes them to have trouble getting to sleep, staying asleep throughout the night, and sleeping as long as you would prefer in the morning. It can have serious health effects, including a higher risk for auto accidents, widespread health effects from sleep deprivation and excessive daytime sleepiness.
Sleep problems can cause a lot of frustration for people that are trying to get a restful sleep, and it can cause other side effects and health problems if it is not properly addressed. It is important to get a good night’s sleep, and people who suffer from insomnia have other problems with concentration and managing their daily responsibilities.
Sedatives work by modifying certain neurotransmitters and receptor agonists in your central nervous system (CNS) to your brain. In this case, they relax your body by slowing down brain activity. When someone takes a sedative hypnotic drug, the effects cause a person to experience sleepiness or drowsiness that help to treat insomnia.
There are a variety of hypnotics that are prescribed by a doctor that are medications used for treating insomnia patients. The half-life, or how long the effects of the drug are active in the body is the main difference among the various types of hypnotics.
- The half-life determines the type and duration of hypnotic residual effects and the unwanted or adverse effects.
- When hypnotic drugs have a long half-life, the drug itself or chemicals it creates accumulate with nightly use. This accumulation may cause impairment of normal day to day functions involving motor skills and thoughts.
Side Effects of Hypnotics
Hypnotics may cause side effects or adverse effects to occur when people use them. The side effects of hypnotics can range from mild to severe in patients who use the medication.
Side effects of hypnotics include:
- Headache
- Nervousness
- Nausea
- Rapid heart rate
- Talkativeness
- Sleepiness
- Irritability
- Abnormal behaviors during sleep including sleep walking and other sleep related activities
- Confusion
- Dreaming/nightmares
- Euphoria
- Palpitations
- Relaxed feeling
- Chest pains
- Weakness
- Tremor
- Lack of concentration
- Depression
- Insomnia
Dangers of Hypnotics
It is important to be aware of the potential drug interactions that can occur when you are taking hypnotic medicines with other drugs. Benzodiazepines, when taken with other drugs such prescription pain medicines, alcohol or some over-the-counter cold and allergy medications, can have addictive depressant effects. These effects can lead to reduced respiration, slowed heart rate or even death.
Certain antifungals, such as Xolegel (ketoconazole), Sporanox (itraconazole), Diflucan (fluconazole), and Nizoral, may increase the levels in the blood and increase the effects of zolpidem by changing the activity of zolpidem in the liver. With this, it is crucial to adjust and monitor zolpidem doses when needed during antifungal use.
If you or someone you know have experienced any of the above side effects or adverse effects after Hypnotic use of these medications, please contact your doctor or the staff at AToN Center. The negative effect of these drugs can be severe if not treated properly.
Addiction to Hypnotics
When hypnotics are used as a sleep medicine and taken as directed by your doctor, there is usually no concern for dependence or addiction. When someone starts to take these hypnotic medications for a long period of time or for reasons other than for sleep, it may indicate there is a problem.
Dependence may occur with these cns drugs if they are used for reasons other than the advice of the doctor, for example to increase drowsiness but a sleep disorder is not present. Symptoms of addiction may include cravings for the drug, going out of your way to get it, taking the drug when it is not prescribed, or experiencing withdrawals upon discontinuing use.
Addiction in the United States
Addiction and drug dependence is a serious problem that affects many individuals every day. According to the National Survey on Drug Use and Health (NSDUH), approximately 19.7 million American adults (aged 12 and older) battled an addiction or substance use disorder in 2017.
Often, an addiction coincides with other mental illness called co-occurring mental health disorders that need to be addressed to fully treat and address the substance problem. People who experience these co-occurring disorders will need to treat them at the same time as their addiction.
Treatment at AToN Center
It can be a challenge for patients to find the right advice when it comes to addressing an addiction or substance abuse problem. No matter what type of addiction you suffer from, the staff at AToN Center can help you with the individualized treatment methods we offer.
Addiction can come in many forms, including to dependence to certain medications, such as hypnotics. Our highly trained, doctoral level physicians can offer treatment and advice to help with the problems that arise with substance abuse.
If you or someone you know is struggling with any type of abuse to drugs or alcohol, please contact our team for more information on our treatment programs.
