Which is the most powerful sleeping pill

Sleeping pills (Hypnotics, Sleep pills, Sleeping pills)

Sleeping pills can make it easier to fall asleep and stay asleep. However, they do not eliminate the cause of the insomnia.

Short version:

  • Sleeping pills promote falling asleep and staying asleep and can enable a good night's sleep in the event of insomnia.
  • However, it should always be noted that these preparations do not eliminate the underlying causes and that it can quickly lead to a habituation effect.
  • The sleeping pills are divided into strong or prescription-only and medium to weak, non-prescription preparations.

Strong sleeping pills

They effectively lead to calming down and the onset of sleep. Due to their rapid onset of action, they often take away the fear of not being able to sleep properly. However, with prolonged use, they lead to physical changes and thus to possible physical dependence.

The fear of not being able to fall asleep without these drugs can also cause psychological dependence. Because of their side effects, strong sleeping pills should only be used under medical supervision.

They are divided into the following groups:

Benzodiazepines

Benzodiazepines such as nitrazepan are among the most common strong sleeping pills and are characterized by five properties that are different for the individual active ingredients.

In addition to their sleep-promoting properties, they also have an effect

  • Anxiety and convulsion relief
  • Calming and relaxing muscles

This also explains their wide application in the individual medical fields (psychiatry, internal medicine, etc.).

Those benzodiazepines that are used as sleep aids predominantly have a sleep-promoting effect, but also contain the other properties that often occur as side effects.

Benzodiazepines must not be stopped suddenly, as they otherwise lead to increased sleep disorders, anxiety and restlessness. In older patients, benzodiazepines often have a paradoxical effect and lead to restlessness, confusion, drowsiness and memory impairment.

Due to the rapid development of addiction, they should only be used for a short period of time and special attention should be paid to treating the cause (e.g. depression, stressful situation, etc.).

Non-benzodiazepines

This is not a single group of substances. These preparations contain substances that are similar to benzodiazepines in their sleep-promoting effects - e.g. zopiclone or zolpidem. The anxiety-relieving, antispasmodic and muscle-relaxing effect is there, but less pronounced. The risk of addiction has not yet been adequately clarified.

Antidepressants for sleep disorders

Certain antidepressants, such as mirtazapine, are also increasingly being used in low doses. Another commonly used drug is trazodone. In recent years, the neuroleptic, quetiapine, has also been used more frequently in low doses. There is no risk of physical dependence on the latter drugs, but they should only be used after careful consideration and gradually discontinued.

Weak sleeping pills

This group includes substances whose effects - but also side effects - are significantly lower. There is no danger of physical dependence here. The risk of psychological dependence is significantly reduced. But it is also true for these preparations that they do not start at the root of the problem and should therefore only be used for a short time and as a support.

They are classified as follows:

Antihistamines used as sleep aids

Antihistamines are mostly used against allergies, but they have a sleep-inducing side effect that is used as a weak sleep aid.

Melatonin helps you fall asleep

Given over several weeks, this endogenous sleep hormone melatonin can help support the natural biorhythm and sleep / wake rhythm.

Herbal sleep aids

Herbal preparations have become established here that are extracted from plants such as valerian, hops, lemon balm and passion flower. They also have a sleep-inducing effect, but are not suitable for sleeping through the night. One problem in the manufacture of herbal medicines is the standardization of the ingredients, so that the preparations available on the market are often of different quality.

Tips for using sleeping pills

  • Sleeping pills should only be used for a short time and should be used as a supportive measure in combating the causes. It is an advantage to set a time limit before you start taking it, which should not be more than 3-4 weeks away and should not be exceeded under any circumstances.
  • After a suitable sleep quality has been achieved, the drug is gradually discontinued - not immediately, but gradually.
  • Before taking a sleeping pill, you should have a detailed discussion with a doctor you trust.
  • Sleeping pills should never be taken in conjunction with alcohol.
  • An appropriate, sleep-promoting lifestyle (e.g. little alcohol, nicotine, caffeine, sufficient regeneration and exercise, reduction of stress factors) should always accompany the use of sleeping pills

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Authors:
Dr. Erich Mayer-Fally (first author), OA.Univ.Prof. Dr. Wolfgang Lalouschek (2015 update)

Status of medical information:

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ICD-10: G47