At what level of insomnia do you need to take sleeping pills? Will you become addicted?

Expert of this article: Li Xue, Peking Union Medical College, Doctor of Medicine

Everyone knows the importance of sleep. However, due to various reasons, many people have insomnia problems, whether mild or severe.

Poor sleep will not only affect your memory, mood, work and study status, but will also cause short-term or even long-term harm to your physical health.

When suffering from insomnia, some people will choose to take sleeping pills to help them sleep. However, sleeping pills are not to be taken casually. You must be clear about these before taking them!

At what level of insomnia do you need to take sleeping pills?

Treatment for insomnia usually includes psychological counseling and drug therapy.

For acute insomnia caused by specific psychological stress events or environmental changes, drug intervention is generally not required. It can be controlled in a timely manner by promptly dealing with stressful events, conducting psychological counseling (such as sleep hygiene education and cognitive behavioral therapy for insomnia, CBT-I), and writing sleep diaries to prevent it from turning into chronic insomnia.

For chronic insomnia, especially chronic insomnia accompanied by depression and anxiety symptoms, it is usually recommended to give appropriate drug treatment according to the situation, and it is best to conduct psychological counseling at the same time.

What types of sleeping pills are there?

The drugs currently used to treat insomnia mainly include the following categories:

Benzodiazepines: They were first used in the 1960s, such as long-acting diazepam (Valium), medium-acting estazolam, short-acting midazolam, etc. These drugs have sedative, muscle relaxant and anticonvulsant effects, and long-term and large-scale use will cause dependence.

Nondiazepine drugs: appeared in the 1980s, mainly including zolpidem, zopiclone, zaleplon, etc. This type of drug only has a hypnotic effect, and has no sedative, muscle relaxant and anticonvulsant effects.

Antidepressants with hypnotic effects: These drugs can also be used to treat insomnia because of their sedative effects, especially when insomnia is accompanied by depression and anxiety, but they are not the first choice for treating insomnia.

Phenobarbital drugs are no longer recommended for use as sleeping pills both at home and abroad, and non-benzodiazepine drugs are now recommended as the first choice.

Are sleeping pills addictive?

Only when benzodiazepine sleeping pills are taken in large quantities for a long time will there be a certain degree of dependence.

In this regard, the World Health Organization (WHO) has several principles on the use of sleeping pills: it is best not to take all sleeping pills for more than 4 weeks. If the symptoms do not improve, you can switch to another sleeping pill; try to use less or no benzodiazepine sleeping pills to avoid drug dependence or addiction; tranquilizers may cause dizziness, slow reaction, unsteady walking, etc. after taking them, but there is no need to worry too much about this situation. Generally, you will return to normal within two or three days of stopping the drug, and it will not have a lasting effect on the brain.

What should I pay attention to when taking sleeping pills?

1. When taking sleeping pills, you should follow the doctor's instructions and take them regularly and systematically. It is best to take them in small doses, for a short period of time, and intermittently. It is also recommended that you change or stop taking the medicine under the guidance of a doctor. It is not advisable to stop taking the medicine suddenly, and you should not increase the dosage without authorization if you think the dosage is not enough.

2. At present, there are still many patients in China who are taking benzodiazepines, such as estazolam (Sulopenia), midazolam (Duomecon), clonazepam (clonazepam), and even diazepam (Valium) and nitrazepam (nitrazepam). In order to avoid drug dependence or addiction, they should try to switch to non-benzodiazepine drugs.

3. Elderly people should be more cautious when taking benzodiazepine sedatives and hypnotics, because these drugs also have muscle relaxant effects. Elderly people should be careful to prevent unstable walking and falls. New non-benzodiazepine drugs are more suitable for elderly patients.

4. People should be aware of the side effects of drugs, especially those who work at heights or drive, and should avoid safety hazards caused by side effects of drugs.

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