(Insomnia) Suffering and worrying about addiction… How to take sleeping pills safely?

Sleeping pills are classified as psychotropic drugs to prevent their misuse. This has fostered a fear of sleeping pills, and it's true that they have side effects and can lead to dependence. However, sleeping pills are sometimes necessary for insomnia treatment, and when taken under a doctor's guidance, they can be treated as safely as possible. Let's explore which medications are used for different types of insomnia, what precautions to take, and the misconceptions and truths about sleeping pills.

 

◇ Insomnia, medications vary 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 (a non-pharmacological treatment) that aims to correct sleep habits. Unlike sleeping pills, cognitive behavioral therapy has the advantage of not being associated with dependence or side effects. Furthermore, with the recent emergence of digital medical devices that can help alleviate insomnia, the trend toward prescribing cognitive behavioral therapy is expected to intensify in the future.

However, in actual medical settings, sleeping pills are often used as a treatment option, just as much as cognitive behavioral therapy. Given the difficulty of providing long-term care to a single patient, cognitive behavioral therapy is often difficult to implement in medical institutions. Patients also tend to dislike it due to the significant time and expense involved. Professor Cho Cheol-hyun of the Department of Psychiatry at Korea University Anam Hospital stated, "I always educate patients about cognitive behavioral therapy, the primary treatment, during outpatient visits, but it's challenging to focus on the key points within a very short time frame."

 

 

Prescription medications used to treat insomnia can be broadly divided into ▲non-benzodiazepine hypnotics ▲benzodiazepine hypnotics (anxiety medications) ▲melatonin receptor agonists ▲antidepressants. Zolpidem (Handok Stilnox tablets), the drug that most often comes to mind when thinking of hypnotics, 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) and triazolam (Myungin Pharmaceutical Zolmin tablets), which are used as anti-anxiety medications, also have a central nervous system suppression mechanism. Benzodiazepines are also effective in inducing sleep and reducing anxiety, and are used for patients with short-term insomnia and acute anxiety. Non-benzodiazepine drugs have fewer side effects than benzodiazepines.

 

 

Melatonin receptor agonists and antidepressants are also used as sleeping pills. For patients with sleep disorders, melatonin preparations such as Circadin Extended-Release Tablets from Kunil Pharmaceutical are used. Melatonin preparations mimic the action of melatonin and help regulate sleep rhythms. Unlike overseas, where they are treated as over-the-counter drugs or health functional foods, in Korea, they require a prescription. If a patient experiences both sleep disorders and depression, an antidepressant such as trazodone (Tritico Tablets from Kukje Pharmaceutical) may be prescribed as a sleeping pill.

◇There are no major concerns about side effects or dependence if you follow your doctor's instructions.

 

Sleeping pills work by suppressing the central nervous system, which controls consciousness, judgment, thinking, memory, and self-control. Therefore, their side effects are closely linked to this system. Common side effects include drowsiness, dizziness, memory impairment, and difficulty concentrating. Occasionally, a person may experience "anterograde amnesia," a condition similar to sleepwalking, where they cannot recall events that occurred after taking the drug.

 

This is because, depending on the drug dosage and individual differences, the central nervous system depressant effect may not disappear even after waking up. Professor Cho Cheol-hyun said, "It would be ideal if the central nervous system depressant effect of sleeping pills only worked until a desired point and then disappeared afterward, but that technology doesn't exist for sleeping pills." He added, "Depending on the drug dosage, individual metabolic rate, weight, gender, and age, patients may still feel drowsy or experience falls after waking up."

 

Furthermore, while sleeping pills are more effective than over-the-counter sleeping pills, their dependence risk cannot be ignored. Professor Lee Geon-seok of the Department of Psychiatry at Hanyang University Hospital stated, "If you take sleeping pills for a long period of time without following the prescribed dosage, you will develop tolerance and need a higher dose. Abruptly stopping the medication can lead to withdrawal symptoms." Benzodiazepines, in particular, are highly likely to develop tolerance and dependence if taken for more than a month, so it's crucial to familiarize yourself with the correct dosage beforehand and adhere to it.

 

However, if you follow your doctor's instructions carefully, you don't have to worry too much about side effects or dependence. Sleeping pills are prescribed for a maximum of three to four weeks, so the dosage and frequency can be adjusted periodically based on the patient's condition. In other words, if you take them within the prescribed range and follow the directions, they are completely safe. Professor Lee Geon-seok said, "Doctors also give a lot of thought to dependence and side effects when prescribing medication after consulting with insomnia patients." He added, "If a patient develops side effects or tolerance to sleeping pills, we can change the medication, adjust the dosage or frequency, or use non-pharmacological treatments in conjunction."

A common mistake when taking sleeping pills is taking them with alcohol, believing it will enhance their effects. However, alcohol actually reduces the effectiveness of sleeping pills by preventing deep sleep and reducing sleep quality. Furthermore, alcohol dependence can increase dependence on sleeping pills. Furthermore, excessive central nervous system suppression can increase the side effects of sleeping pills, and in severe cases, it can lead to respiratory distress and even coma.

 

 

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There are side effects to sleeping pills. You should never take them with alcohol.

Our cousin also took sleeping pills and alcohol.

I couldn't wake up in the morning

 

I had trouble sleeping, so I asked my sister,

I also recommend that you seek psychiatric counseling.