Dorothy FarrarHypnotics (sleeping pills)
Hypnotics (sleeping pills) are intended to promote the sleep process. They can be based on synthetically produced or naturally occurring active ingredients. A sleeping pill is used to treat insomnia. Depending on the starting substance, the transition to sedatives or narcotics can be fluid.
What are sleeping pills?
Due to their sleep-promoting effect, sleeping pills change the sleep profile. The medicines can be helpful for both insomnia and problems sleeping through the night . Depending on the phase in which the insomnia occurs, drugs with a short or longer duration of action can be used.
The sleep-inducing agents can be administered in the form of tablets, capsules or juice. Higher dose hypnotics or hypnotics given intravenously can also be used for short-term sedation. Anesthetists also use sleeping pills to induce anesthesia.
Effect and medical application
The different groups of active ingredients have different effects and start at different times. Benzodiazepines mainly affect sleep stages II, III and IV. While sleep stages II and II are lengthened, benzodiazepines shorten the fourth sleep stage.
The REM phase, on the other hand, remains unaffected. Benzodiazepines also have a calming, anxiolytic and antispasmodic effect. Non-benzodiazepine agonists also have a muscle-relaxing and antispasmodic effect in addition to the sleep-inducing effect.
Sleep architecture is hardly affected by these drugs. Barbiturates are particularly potent sleeping pills that not only have a sleep-promoting effect, but also a sleep-enhancing effect. They suppress REM sleep, disrupting sleep recovery. Due to the severe side effects, barbiturates are rarely used as sleeping pills today. An exception are sleep disorders, which cannot be adequately alleviated with other sleeping pills. Many antihistamines also have a sedative effect in addition to their antiallergic effect.
shapes and groups
The benzodiazepines form a large group of hypnotics. This group includes individual substances such as clobazam, diazepam, flurazepam or lorazepam. Well-known preparations are Gityl®, Normoc®, Sigacalm® and Oxa-CT®. The drugs zopiclone, zaleplon and zolpidem represent the substance group of non-benzodiazepine agonists. They bind to similar receptors as benzodiazepines, but are structurally different. These medicines are also called Z-remedies because their names all begin with the letter Z. Trade names of non-benzodiazepine agonists are Imovane®, Zopiclodura®, Zopitin®, Ximovan®, Mondeal®, Stilnox®, Zoldem® and Dorlotil®.
Barbituric acid derivatives, also known as barbiturates, are now only used as sleep aids in very severe cases. Medical use is limited to the active ingredients phenobarbital and thiopental. Phenobarbital is available under the trade names Aphenylbarbit®, Luminaletten® and Luminal®. Pentothal® and Trapanal® are drugs that contain thiopental as an active ingredient.
First-generation antihistamines, ie antihistamines of the ethanolamine and ethylenediamine type, also have a sedating effect. These include the active ingredients diphenhydramine, doxylamine, meclozine and promethazine. Well-known commercial preparations from this group are Dibondrin®, Benocten®, Moradorm®, Sediat®, Vivinox Sleep®, Dorm®, Atosil®, Closin®, Proneurin®, Prothazin® and Farganesse®.
dosage
The dosage of the sleeping pills depends on the type and intensity of the sleep disorders and on the respective preparation. Since many sleeping pills have side effects and are also subject to prescription, the doctor determines the appropriate dose.
Herbal, natural and pharmaceutical alternatives
Various medicinal plants have a calming and sleep-inducing effect. The hop cones of the climbing plant hops contain bitter substances and essential oils that have a calming effect and also improve sleep. The combination of hops and valerian has proven to be particularly effective . However, the effect of both medicinal plants is rather mild.
An immediate improvement in sleep should not be expected. Rather, an effect is only noticeable after about two to four weeks. Nervous problems falling asleep can be treated with lemon balm . In addition to lemon balm, the essential oil obtained from the leaves of the plant is also suitable for this. Lemon balm goes well with lavender . Lavender also has a relaxing and sleep-inducing effect.
Interactions and side effects
Hypnotics can have a variety of side effects. For example, benzodiazepines commonly cause daytime sleepiness, drowsiness , and dizziness . Especially at the beginning of the therapy, reduced alertness, muscle weakness , unsteadiness in movement, bladder dysfunction and gastrointestinal complaints can also occur. Anorexia and menstrual disorders have also been observed as side effects.
Because of their severe side effects, barbiturates are only rarely used as sleeping pills. In particular, the high potential for dependency should be considered when administering it. The withdrawal symptoms when weaning are similar to the withdrawal symptoms of alcohol withdrawal (delirium tremens). Since barbiturates have a very narrow therapeutic range, there is always a risk of overdose with the risk of central respiratory paralysis.
Non-benzodiazepine agonists have dry mouth , headache , daytime sleepiness, and weakness as possible side effects. Anterograde amnesia also develops in some patients . This means they have memory lapses after taking medication. If the drugs are administered over several weeks, withdrawal symptoms must also be expected.
In particular, sleeping pills with zopiclone have a high physical and psychological addiction potential. Therefore, these sleep-inducing drugs should not be taken for more than a few days. People who already have an addictive disorder should only take non-benzodiazepine agonists in exceptional cases.
Side effects such as dry mouth, loss of libido, urination disorders and constipation can occur when taking antihistamines. A chronic stuffy nose can also occur as a result of ingestion. Hallucinations and confusion may also occur in rare cases of overdose. There is also a risk of an increase in intraocular pressure. In the worst case, glaucoma can lead to blindness.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.