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The same medications that can help you get a good night’s rest can also potentially lead to sleeping pill addiction.1, 2 Several types of medication can help people manage sleeping problems, including prescription and over-the-counter (OTC) options.1, 3 Both prescription and OTC sleeping pills have potential for misuse.
Types of Sleeping Pills
There are several names commonly used for sleeping pills, including:1,3
- Sleep aids
- Sleep medicine
Different types of sleeping pills work through different processes. Sedatives induce drowsiness, while anxiolytics (i.e., antianxiety medications) work to calm the part of the brain the is responsible for alertness.
Types of sedatives, hypnotics, and anxiolytics include:1, 3
Benzodiazepines, often called “benzos,” are prescribed on-label for anxiety and clinical insomnia. Benzodiazepines work by increasing a type of neurotransmitter called GABA in the brain. GABA can have a calming effect. Benzodiazepines have a high potential for addiction and misuse.1
Common types of benzodiazepines include: 1
- Diazepam (Valium)
- Alprazolam (Xanax)
- Clonazepam (Klonopin)
- Lorazepam (Ativan)
- Triazolam (Halcion)
Barbiturates (Sedative Hypnotics)
Barbiturates belong in a class of drugs known as sedative-hypnotics. As the name indicates, barbiturates induce a sedative effect and are commonly prescribed for sleep disorders. These drugs also have a calming effect and may be given for anxiety. Like benzodiazepines, barbiturates also have a high potential for addiction and misuse.
Common types of Barbiturates include:1
- Amobarbital (Amytal)
- Phenobarbital (Luminal)
- Pentobarbital (Nembutal)
- Secobarbital sodium capsules (Seconal)
Z-Drugs (Benzodiazepine Derivatives)
Z-drugs are prescription medications approved for the treatment of insomnia. Z-drugs slow down the brain’s activity, helping a person relax and fall asleep. But, like many other types of prescription sleeping pills, Z-drugs are linked with potential harm. Z-drugs carry a Boxed Warning—a special warning label describing its potential risks—regarding people who should not use Z-drugs. The Boxed Warning indicates that Z-drugs are contraindicated in people who have experienced a condition called “complex sleep behaviors.”
Complex sleep behaviors include behaviors that occur when a person is not fully awake, such as:4
- Sleep driving
- Sleep cooking
- Taking other medications while not fully awake, which could lead to accidental overdose
Using Z-drugs can cause health problems.4 In rare instances, using these medications can carry the risk of serious side effects and life-threatening consequences. Z-drug class substances include medications such as: 4
- Eszopiclone (Lunesta)
- Zaleplon (Sonata)
- Zolpidem (Ambien, Ambien CR, Edluar, and Zolpimist)
Diphenhydramine is an OTC antihistamine that helps relieve allergy symptoms and cough; it also assists with sleep. Diphenhydramine works by inducing drowsiness and blocking histamine. Histamine plays a significant role in the development of allergy symptoms. While diphenhydramine can help treat symptoms, it does not treat the underlying cause of sleep problems, allergies, or other disorders.6
OTC medications containing diphenhydramine can help induce sleep, but they can lead to physical and mental health concerns when misused.
Benadryl Genahist, Sominex, and Unisom are common brand names for sleep aids that contain the active ingredient diphenhydramine.6
Signs and Symptoms of Sleeping Pill Addiction
Beyond health problems, misusing sleeping medications can lead to substance use disorders (SUDs)—the clinical diagnosis of an addiction to sleeping pills or any other addictive substance.2 Only a qualified treatment professional can offer a diagnosis of SUD or suggest an addiction treatment plan.
The American Psychiatric Association (APA) categorizes the signs and sleeping pill addiction symptoms based on the types of substances people misuse.2 Although the APA lists several types of sleeping pill addictions, some common traits apply to all sleeping pill addictions, including:2
- Using sleeping pills for purposes other than sleep assistance
- Taking sleeping pills in larger doses than you originally intended
- Using sleeping pills for longer than you expected to
- Spending lots of time trying to acquire or recover from the effects of sleeping pills
- Craving sleeping pills or feeling a strong urge to take these medications
- Struggling to meet responsibilities at home, work, or school because of repeated sleeping pill misuse
- Continuing to take sleeping pills despite the problems they cause in relationships with family, friends, or others
- Giving up valued life activities due to sleeping pill misuse
- Using sleeping pills in situations or ways that could lead to physical harm
- Continuing to take sleeping pills even when you know the medications could cause physical or mental health conditions
Signs and symptoms of sedative, hypnotic and anxiolytic intoxication, which may occur from the misuse of benzodiazepines and barbiturates, include:2
- Speech problems
- Loss of physical coordination
- Loss of balance
- Rapid eye movements
- Memory problems
- Difficulty maintaining attention
- Impaired consciousness
- Loss of consciousness, or coma
People may attempt to misuse diphenhydramine to become intoxicated, experience euphoria, boost their energy levels, or elevate their mood.5 Signs of intoxication may include: 2
- A change in mood
- An inability to think clearly
- Behavioral changes
- Changes in relationships
Tolerance, Withdrawal, and Overdose
Sleeping pill addiction can lead to a person becoming dependent on these medications.2 That means that people become used to these medications and need to use them to function normally, such as not being able to sleep for any length of time without using medication.2, 7 Dependence can develop into tolerance and withdrawal symptoms.2
Tolerance occurs when a person’s body and mind adapt to repeated sleeping pill use.2 When tolerance to sleeping pills develops, people become less sensitive to their effects. They may develop a need to use higher doses of sleeping medication to get the same impact that they achieved at lower doses. As tolerance increases, so too does the risk of overdose, particularly with drugs such as benzodiazepines.
Symptoms of withdrawal can occur when a person experiences sleeping pill addiction.2 Withdrawal is most likely to occurs when a person stops using sleeping pills after taking them in high doses for an extended period.
Some sleeping medications, especially benzodiazepines, can cause symptoms of tolerance, withdrawal, or dependence, even when taken as directed.2 Withdrawal symptoms from benzodiazepines can occur even after a relatively short period of use, which is why your prescribing doctor will likely decrease your dose gradually over a period of time before stopping it. The presence of these symptoms alone does not mean that a person has an addiction or SUD.
Symptoms of withdrawal from sleeping pills can cause significant problems.2 Withdrawal symptoms from sleeping pills may include:2
- Increased sweating
- Tremors in a person’s hands
- Sleeping problems
- Hallucinations (i.e., seeing, hearing, feeling sensations, or experiencing things that do not exist)
Some sleeping pills, such as barbiturates, work by depressing the nervous system (CNS) and brain; they can help you relax and sleep when taken as prescribed. But when a person takes too many sleeping pills, the impact on the brain and nervous system may cause you to stop breathing.6, 7
Symptoms of sleeping pill overdose may include:7, 11
- Heart problems
- Problems with urination
- Increased body temperature
- Psychosis, including hallucinations or detachment from reality
- Kidney failure
- Muscle cell damage
- Excessive drowsiness
- Loss of coordination
- Severe breathing problems
Sleeping pill overdose can become life-threatening.7 Call emergency services right away if you suspect that an overdose has occurred.
Risks of Sleeping Pill Addiction
People addicted to other substances, like cannabis or opioids, may face a higher risk of developing an addiction to any sleep aid. 2
Some individuals may use benzodiazepine-based sleeping pills socially or recreationally before developing an addiction.2 Sleeping pill use may start as occasional use and may gradually increase before becoming habitual. This increase in sleeping medication use can increase a person’s risk of developing sleeping pill addiction. Taking more sleeping medication than is needed or taking sleeping medication for non-medical use increases a person’s risk of developing a sleeping pill addiction.
Adolescents and young adults are at higher risk of misusing benzodiazepine sleeping pills to become intoxicated.2 A history of certain factors can increase a person’s risk of becoming addicted to sleeping pills. These factors include:2
- Specific family health concerns
- Mental health conditions
- Childhood trauma or maltreatment
Treatment of Sleeping Pill Addiction
Sleeping pill addiction rehab can offer a safe and long-term source of support for those diagnosed with sleeping pill addiction.10, 12 Before a person can take advantage of a treatment program, withdrawal management services may be beneficial.10 The detoxification (detox) process, often offered at an inpatient treatment program, offers services that can provide medical support while the body eliminates medications from a person’s system.
Detox may be medically necessary if you have a physical dependence on benzodiazepines or barbiturates, which are known to cause medically significant withdrawal symptoms.
Withdrawal management can take place in several different settings, including:10
- Outpatient treatment
- Residential treatment (i.e., a sober living house)
- Inpatient treatment
Inpatient hospitalization can help a person with severe sleeping pill addiction symptoms, especially if they experience psychiatric or medical problems while going through withdrawal.10, 12
Residential Treatment Services
Residential treatment services can offer support 24 hours a day along with withdrawal management services.12 These services can also prepare you for ongoing treatment.12
Outpatient treatment can provide withdrawal management services for individuals who qualify for a lower level of care.10, 12
Once a person has completed detox, they can fully engage in a sleeping pill addiction rehab program.10, 12
Services often provided by addiction treatment and recovery programs include:10, 12
- Individual therapy
- Group therapy
- Family therapy
- Case management
- Medication-assisted treatment
- Coordination with medical services
- Peer and mutual support groups
- Aftercare support
- A recovery-focused community
- Access to supportive relationships
Therapeutic services can help a person recover from sleeping pill addiction in several ways.10, 12 Therapy can offer support in strengthening your:10
- Coping skills
- Stress management
- Relationships with loved ones
- Ability to maintain sobriety
- Willingness to continue taking medications appropriately
- Understanding of addiction
- Motivation to stay committed to recovery
After completing treatment, case management services can help you coordinate the next steps of your recovery from addiction.10 You may need to consult with your doctor if you experience ongoing sleep issues. Certain sleep medications are considered non-habit-forming and are recommended to individuals with a history of substance abuse.
Recovery-oriented housing can offer ongoing supervision and a lifeline to a community of support.12 Remaining connected to therapeutic support can strengthen your addiction recovery skills.
For more information on treatment options for SUDs and sleeping pill addiction, call 800-926-9037 (Who Answers?) to speak with a treatment specialist.
Types of Drug Addiction
- Weaver M. F. (2015, September 03). Prescription Sedative Misuse and Abuse. The Yale Journal of Biology and Medicine, 88(3), 247–256.
- American Psychiatric Association. (2013). Substance-related and addictive disorders. In Diagnostic and statistical manual of mental disorders (5th).
- S. Food & Drug Administration. (2019, April 30). Sleep disorder (sedative hypnotic) drug information.
- S. Food & Drug Administration. (2019, April 30). Taking z-drugs for insomnia? Know the risks.
- Saran, J. S., Barbano, R. L., Schult, R., Wiegand, T. J., & Selioutski, O. (2017). Chronic diphenhydramine abuse and withdrawal: A diagnostic challenge. Clinical practice, 7(5), 439–441.
- S. National Library of Medicine. (2018, August 15). Diphenhydramine. U.S. MedlinePlus.
- United States Drug Enforcement Administration. (2020, April 14). DEA releases 2020 Drugs of Abuse Resource Guide.
- Hoey, N.M. (2019). Overdose. Salem Press Encyclopedia of Health. Salem Press.
- S. National Library of Medicine. (2021, August 05). Overdose. MedlinePlus.
- Miller, W. R., Forcehimes, A. A., & Zweben, A. (2019). Treating addiction: A guide for professionals. The Guilford Press.
- Huynh D. A., Abbas M., Dabaja A. (2021, May 8). Diphenhydramine Toxicity. StatPearls. StatPearls Publishing.
- National Institute on Drug Abuse. (2019, January 17). Treatment Approaches for Drug Addiction DrugFacts.