This chapter focuses on sedative-hypnotic drugs that are sued to alleviate the condition of sleep disturbances. One-third of our life is spent in sleep; the lack, of which, can cause serious physical, social, and psychological problems. This chapter describes the features of an ideal hypnotic drug and provides a classification of sedative-hypnotic drugs currently in use. These include the barbiturates, benzodiazepines, halogenated sedative-hypnotics, heterocyclic sedative-hypnotics, antihistamines, and other sedative-hypnotics. Individual members of all of these classes of drugs are discussed in detail. The chapter also describes the physiology of sleep and the sleep cycle, including the nonrapid eye movement and rapid eye movement sleep. A list of neurotransmitters and nonhypnotic drugs that have a direct and indirect action on the sleep cycle are provided. The pharmacology including the evaluation of sedative-hypnotics are also given. The chapter refers to the discovery of one of the most frequently prescribed hypnotic drugs, Zolpidem. The chapter also examines structure-activity relationships, recent developments, things to come, and available websites.
- GABAA receptor complex;
- states of sleep
What are hypnotics? How do they work (mechanism of action)?
Hypnotics are drugs that are used to help people fall asleep. There are many types of hypnotic drugs, and doctors recommend and prescribe them based on the type of sleep problem you have. Lifestyle and sleep habit changes also are effective for treating certain types of sleep problems.
If you have chronic insomnia or problems sleeping contact your doctor or other health care professional. Doctors specializing in sleep problems (sleep medicine) can help you determine the cause of your insomnia and treat it.
Hypnotic drugs also called sleep aids, sleeping pills, or soporifics.
What are hynotics used to treat?
Doctors prescribe hypnotics to treat insomnia. Insomnia is a sleep problem that may involve difficulty falling or staying asleep. Inadequate sleep affects mood, energy levels, health, and work performance.
Common causes of insomnia are stress, traumatic events, depression, anxiety, and medications. If you know the cause of your insomnia and treat it, it may reduce the need for sleep medications to aid or induce sleep.
Hypnotic side effects
Side effects of hypnotics depend upon the type of hypnotic used.
Some common side effects of some hypnotics include:
Other side effects of hypnotics may include:
Possible serious side effects may include:
Are hypnotics addictive?
Benzodiazepines are addictive hypnotics and are federally controlled substances. People can develop a physical dependence after several days of taking them, and the risk is higher during long-term use.
Doctors should take care when prescribing benzodiazepine drugs to people with a history of drug abuse or alcoholism because they are more likely to become addicted to benzodiazepines.
Can I drink alcohol if I'm taking a hypnotic drug?
Do not drink alcohol before are after taking a sleep medication because drinking alcohol while using a sleep medication or sedative may lead to severe drowsiness.
Quick GuideSleep Disorders: Insomnia, Sleep Apnea, and More
OTC (over-the-counter) hypnotics
Diphenhydramine (for example, Benadryl) and doxylamine (for example, Unisom) are over-the-counter (OTC) drugs that can help people fall asleep. These drugs are antihistamines that cause drowsiness and sedation. Only use these medications for a few days. Talk with your doctor or other health care professional if you have insomnia for more than a couple of weeks.
You should read the instructions and warnings before taking OTC sleep medicine because they can have serious adverse effects if not used properly. They also may interfere with the action of other drugs.
Side effects reported by people taking diphenhydramine or doxylamine include:
Natural, herbal hypnotics and hypnotic supplements
Synthetic melatonin capsules, pills, or tablets may help people fall asleep. Melatonin is most often used for treating jet lag. Melatonin takes few days, up to a few weeks to work when it is used for treating sleep problems.
Valerian is another supplement available to treat insomnia.
Talk with your doctor or pharmacist before taking herbal, natural, or other supplemental products for insomnia.
Types of hypnotics (hypnotic drugs)
The FDA has approved five types of hypnotic medications for the treatment of sleep problems, which include:
- Nonbenzodiazepine receptor agonists
- Melatonin receptor agonists
- Orexin receptor agonist
These medications are all effective for treating sleep problems, but they work in different ways. Some sleep medicines only last a few hours (short-acting medications) while others last longer in the body (long-acting medications). Doctors and other health care professionals choose sleep medications based on the type of sleep problem you have. For example, people who have trouble falling asleep will benefit from a short-acting sleep medicine. People who have trouble staying asleep will benefit more from long-acting sleep drugs.
List and examples of brand and generic names of hypnotic drugs
There are over 40 different sedative/hypnotic drugs available. Talk to your doctor, pharmacist, or other health care professional for any addition information about the generic forms available.
Melatonin receptor agonists
Non-benzodiazepine receptor agonists
The dose of these drugs vary. Talk to your doctor about the exact dose you need to fall asleep.
What drugs or supplements interact with hypnotics?
Combining sleep medications or using other medications that also cause drowsiness will lead to severe drowsiness. Stimulants such as amphetamines or coffee may reduce the effect of sleep medicines.
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Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Medically Reviewed on 8/10/2017
FDA Prescribing Information.
FDA. "Sleep Disorder (Sedative-Hypnotic) Drug Information." Updated: Jun 13, 2017.
Are these drugs safe to take if I am pregnant or breastfeeding?
- Researchers have not studied the effects of most hypnotics in pregnant women. Therefore, they should not be used if you are pregnant unless it is absolutely necessary. Pregnant women who have sleep problems should try improving their sleep hygiene, relaxation, and ways to reduce stress.
- Benzodiazepine use is harmful to the fetus when taken by pregnant women during their first trimester so you should avoid them if you are pregnant.
- Diphenhydramine may have a low risk of causing harm during pregnancy.
If you are pregnant discuss the use of these drugs with your doctor.
Treatment & Diagnosis
FAQs & Doctor's Views
Medications & Supplements
- zolpidem (Ambien, Ambien CR, Zolpimist, Edluar, [Tovalt ODT has been discontinued])
- doxepin (Sinequan and Adapin are discontinued brand in the US; Silenor)
- temazepam, Restoril
- trazodone, Desyrel (discontinued brand)
- diphenhydramine, Benadryl
- mirtazapine, Remeron, Soltab
- zaleplon, Sonata
- triazolam, Halcion
- eszopiclone, Lunesta
- valerian (valeriana officinalis) - oral
- Benzodiazepines (Benzodiazepine Drug Class)
- ramelteon, Rozerem
- Belsomra (suvorexant)
Prevention & Wellness
Hypnotics are sleep medications used to treat different types of insomnia. There are a variety of hypnotic drugs, and they are grouped into five types. Benzodiazepines, nonbenzodiazepines, selective melatonin agonists (these three drug types are classified as sedatives), antidepressants, and an orexin receptor agonist. Some hypnotics can be addictive and may cause withdrawal symptoms if discontinued abruptly.
The side effects of hypnotics depend upon the drug used, but they may include:
Other side effects may include:
Hypnotics may have serious side effects and adverse effects, for example:
Hypnotic drugs available over-the-counter (OTC) include diphenhydramine (Benadryl) and doxylamine (Unisom). Natural herbal supplements used for insomnia are melatonin and Valerian.
Do not drink alcohol while taking hypnotic drugs. Stimulants like caffeine or amphetamines reduce the effect of insomnia medications.
Your doctor or other health care professional will recommend the type of hypnotic drug for you depending upon the type of sleep problem you have, your current lifestyle habits, other medications you are taking, and any other medical problems you may have.
FDA. "Sleep Disorder (Sedative-Hypnotic) Drug Information." Updated: Jun 13, 2017.
Chawala, J, MD. "Insomnia Medication." Medscape. Updated: Aug 01, 2016.