Are Sleep Aids Even Helpful?

Pietari Nurmi
Dec 11 · 6 min read

If sleepless nights are starting to pile up, many hope to find relief from sleeping pills. Sleep aids come in all sorts. Most of them require a prescription, but several over-the-counter options exist as well. Sleeping pills have earned a slightly questionable reputation – and for a good reason. Still, they are widely used when treating both short and long term sleeping troubles. Here is a short review of how sleeping drugs work, whether they can be useful or not, and what alternatives you have.

Traditional Sleep Medication

Different drugs work differently, but practically all traditional sleeping drugs are sedatives: they artificially boost your tiredness. For severe insomnia, the doctor might prescribe, for instance, benzodiazepines or Z-drugs. These kinds of sleep aids are very efficient, but unfortunately, their psychoactive nature makes them far from harmless.

One of the most notable downsides is that drug-induced sleep is never as restoring as natural sleep. Sedative substances alter the sleep cycle and natural sleep stage balance, significantly decreasing your sleep quality in the process. That is why medically-induced sleep can never truly compensate for natural rest. If you use strong sleeping medication for long, the effects accumulate, ending up messing with your sleep a big time.

If you are truly suffering from sleepless nights, even poor sleep might feel a better option than no sleep at all. However, there are other downsides too. For one, sleeping pills are notorious for their side effects. The adverse effects range from nausea to hallucination, depending on the substance. Fatigue and haziness often follow the next day impairing cognitive performance, compromising your driving ability, and affecting your mood. Many sleeping drugs are also associated with memory issues and disorders, both in the long and short term, so you really shouldn't take those pills in vain.

If you use sleep medication frequently, your tolerance for the drug grows fast. That is, the same amount of the substance no longer produces the desired effect. These drugs can also be highly addictive when used continuously.

Melatonin and Chronobiological Sleep Aids

The use of melatonin as a sleep aid has become more and more popular lately. One big reason is that it's also available without prescription in many countries, at least in small doses. Melatonin is a natural sleep-promoting hormone produced by your body to keep your sleep-wake cycle in rhythm. Your body releases it in the evening and during nighttime, and it mainly responds to the amount of light in the environment. The melatonin cycle forms the basis of your circadian rhythm and keeps your biological clock in sync.

Melatonin supplements try to utilize the same biological mechanism. They are used to adjust or correct your (potentially misaligned) sleep-wake rhythm to make it easier to fall asleep at the desired hour. If your rhythm is, for example, delayed so much that falling asleep at a decent time gets difficult, taking melatonin a couple of hours before bed might help to push the rhythm back on track. Because of these properties, melatonin can be helpful, especially for travelers suffering from jet lag.

Melatonin is rather harmless and doesn't have side effects of the same scale as the heavier sleep medication. On the other hand, its sleep-promoting properties are significantly weaker. Regardless, it would be best not to form a habit around it. Even though it is not likely to get physically addicted to melatonin, it is possible to get dependent on a psychological level. If you use sleep aids every night, 'just to be sure,' the only thing you'll gain is an unnecessary habit that may prove challenging to get rid of.

Many studies prove that melatonin supplements often have a strong placebo effect. Sometimes it even outweighs the actual pharmacological effect of the supplement. However, even then, the combined sleep-promoting effect is relatively small.

Drugs Are Often Not the Best Sleep Aid

Insomnia is a symptom rather than a diagnosis, and it cannot be cured the same way as diseases. Sleep drugs are designed to ease the symptoms of insomnia, not to address the underlying problem keeping you from falling asleep. Most of the time, behavioral treatments are better than drugs because they try to find the actual causes behind your sleeping troubles and fix them for good. The results will last longer, and as a bonus, you'll avoid the unnecessary side effects and health risks associated with sleep medication.

Severe insomnia is often treated with Cognitive Behavioral Therapy (CBTI). For less dramatic cases, the solution may lay in surprisingly simple changes in behavior. Good sleep hygiene and proper bedtime routines help to establish a firm basis for healthy sleep. In the long term, behavioral methods are way more effective than sleep drugs.

Pills or No Pills?

Even though behavioral methods are often the best course of action, sleep drugs have their place too. Taking a pill can serve as a fast and effective solution when something out of the ordinary (such as jet lag or an exciting interview the next morning) temporarily disrupts your attempts to fall asleep.

If you plan to use a sleep-promoting drug or other substance, it is wise to consult your physician first, even if no prescription is needed. You should only use it when you can easily see the cause behind your sleeping troubles and know that it is nothing more than a temporary inconvenience. Define clearly the case you are using the drug for and use it just for that. Decide right from the beginning for how long you are using the drug and fix a date you will stop the use. Never start using the drug 'for the time being' to avoid forming a nasty habit around it. If you have long-term sleeping troubles and are not certain about their origins, behavioral treatments are likely a better fit for you.

Additional Reading

National Seep Foundation – Safe Use of Sleep Aids