'Sleeping pills' are classified as controlled substances to prevent misuse. Because of this, a fear of sleeping pills has been created, and it is also true that there are side effects and dependency issues. However, in reality, sleeping pills can sometimes be necessary for the treatment of insomnia, and if taken under a doctor's guidance, insomnia treatment can be as safe as possible. We will explore which medications are used depending on the type of insomnia, what precautions should be taken, and what misconceptions and truths exist about sleeping pills.

 

◇Insomnia, medication varies depending on the type... If accompanied by depression, antidepressants.

 

In fact, the primary treatment option for insomnia is not sleeping pills but cognitive-behavioral therapy (non-pharmacological treatment) that corrects sleep habits. Unlike sleeping pills, cognitive-behavioral therapy has the advantage of no dependency or side effects, and recently, digital medical devices that help improve insomnia have emerged, making it likely that prescribing cognitive-behavioral therapy will become more common in the future.

However, in actual medical practice, sleeping pills are also frequently used as a treatment option alongside cognitive-behavioral therapy. Due to the nature of healthcare institutions where it is difficult to provide long-term care for each patient, cognitive-behavioral therapy is not easily implemented in practice, and patients tend to prefer not to spend a lot of time and money. Professor Cho Chul-hyun of the Department of Mental Health at Korea University Anam Hospital said, "When seeing outpatients, we always educate patients about cognitive-behavioral therapy, which is the first-line treatment, but there is a challenge in having to convey only the core information within a very short time."

 

 

Specialized medications used for the treatment of insomnia can be broadly divided into ▲non-benzodiazepine sleep aids ▲benzodiazepine sleep aids (anxiolytics) ▲melatonin receptor agonists ▲antidepressants. The drug most commonly associated with sleep aids, zolpidem (HanDok Stilnox tablets), is a non-benzodiazepine drug developed specifically for the treatment of insomnia. It primarily acts on the central nervous system to induce sleep. Benzodiazepine drugs such as lorazepam (Ildong Pharmaceutical Ativan tablets), used as anxiolytics, and triazolam (MyungIn Pharmaceutical Zolmin tablets) also work by suppressing the central nervous system. Benzodiazepine drugs are effective in inducing sleep or reducing anxiety and are used for short-term insomnia and acute anxiety patients. In terms of side effects, non-benzodiazepine drugs tend to have fewer adverse effects compared to benzodiazepine drugs.

 

 

Melatonin receptor agonists and antidepressants are also used as sleep aids. For patients with sleep rhythm disorders, melatonin preparations such as Sercadin sustained-release tablets by Geonil Pharmaceutical are used. Melatonin preparations mimic the action of melatonin to help regulate sleep rhythms. Unlike abroad, where they are treated as over-the-counter drugs or health functional foods, in Korea, a prescription is required. If a patient experiences both sleep disorders and depression, antidepressants such as Trazodone (Trityco tablets by Kookje Pharmaceutical) may be prescribed as sleep aids.

◇Side effects and dependence are not major concerns if guided by a doctor

 

Sleep medications work by suppressing the central nervous system, which is responsible for consciousness, judgment, thinking, memory, and restraint, and their side effects are also closely related to the central nervous system. The main side effects include drowsiness, dizziness, impaired memory, and decreased concentration, and occasionally, individuals may experience 'anterograde amnesia,' where they cannot remember events that occurred after taking the medication, similar to sleepwalking.

 

This is because the sedative effect of the drug on the central nervous system may not disappear even after waking up, depending on the dosage or individual differences. Professor Cho Cheol-hyun said, "It would be ideal if the sedative effect on the central nervous system only lasted until the desired time and disappeared afterward, but such technology does not exist for sleeping pills," adding, "Depending on the dosage, individual metabolic capacity, body weight, gender, and age, people may feel groggy or experience falls even after waking up."

 

Sleep medications, compared to over-the-counter sleep aids, have more definite effects, but the risk of dependence cannot be ignored. Professor Eo Geun-seok of the Department of Psychiatry at Hanyang University Hospital said, "If sleep medications are taken for a long period without following the prescribed dosage, tolerance can develop, requiring higher doses," and "Abruptly stopping the medication can cause withdrawal symptoms." In particular, benzodiazepine drugs have a high likelihood of developing tolerance and dependence if taken for more than a month, so it is advisable to understand and adhere to the correct usage instructions in advance.

 

However, if the doctor’s instructions for medication intake are followed accurately, there is little need to worry about side effects and dependency. Sleep medications are limited to a maximum prescription duration of 3 to 4 weeks, allowing for periodic adjustments to the dosage or frequency based on the patient’s condition. In other words, taking the medication within the prescribed guidelines by the doctor is sufficiently safe. Professor Deuk-seok Lee said, "Doctors also consider dependency and side effects carefully when prescribing necessary medication after consulting with patients suffering from insomnia," and added, "If patients develop side effects or tolerance to sleep medications, the medication can be changed, the dosage or frequency can be adjusted, or non-pharmacological treatments can be combined."

Additionally, a common mistake when taking sleeping pills is to think that combining them with alcohol will enhance their effects. However, alcohol prevents deep sleep and actually reduces sleep quality, thereby impairing the effectiveness of the sleeping pills. Moreover, alcohol dependence can increase dependence on sleeping pills. Above all, excessive suppression of the central nervous system can increase side effects of sleeping pills, and in severe cases, lead to respiratory difficulties or coma.

 

 

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There are side effects from sleeping pills. You must never drink alcohol while taking them.

Our cousin's client also took sleeping pills and alcohol.

Could not wake up in the morning.

 

I asked my sister because I was having trouble sleeping.

They also recommend trying psychiatric counseling.