Over 14 million Italians have insomnia (source: Aims – Italian Association of Sleep Medicine ), a problem that prevents them from resting well during the night and creates disparate consequences, which can have a significant impact on the quality of life of a person. Person, both physically and mentally. First of all, there is the stress that engulfs everyday life, which is halfway between the cause and effect of insomnia.
The rhythms of the days are distorted by the lack of adequate rest, with all that this entails. This is why we end up looking for drugs to sleep, from powerful sleeping pills to natural remedies with a hypnotic effect. Although seeking the remedy to cure insomnia through effective sleeping pills is a common practice, it is essential always to maintain great caution.
In this regard, it is advisable to delve deeper first to find out the possible causes of sleep disorders and find the best treatment (supervised by a specialist). As for sleeping pills, it is best to ask your doctor for advice on the dosage of these drugs, as they can still affect the body and cause side effects. It should also be noted that sleeping pills have a mechanism of action that varies depending on the class they belong to and can influence different aspects of the sleep-wake cycle.
The Different Types Of Sleeping Pills, Benzodiazepines And Nonbenzodiazepines
Sleeping pills, also called sedatives or hypnotics, are divided into two large categories: benzodiazepines and benzodiazepine-like drugs, which do not belong to the benzodiazepine class but simulate their mechanism. They are also called “Z drugs” (Z-drug) due to their names, which all begin with “Z”. More potent sleeping pills, commonly classified as sedatives or hypnotics, work on the central nervous system to speed the onset of sleep and increase its duration.
Benzodiazepines (Or BZDs)
Benzodiazepines are a group of drugs prescribed to treat insomnia and other sleep disorders. Known for their sedative and hypnotic effect, they act on the central nervous system, increasing the activity of a neurotransmitter called gamma-aminobutyric acid (GABA ). Their action slows down the activity of the body and brain, reduces anxiety, relaxes muscles and induces sleep (which remains constant throughout the night).
Among the generally prescribed benzodiazepines are diazepam , lorazepam , and alprazolam . Typically, because they are powerful sleeping pills, these drugs are prescribed only for the treatment of severe insomnia, either as a single dose or as a short-term treatment for up to 4 weeks. Their effectiveness may fade over time due to the brain becoming accustomed to the drug.
Additionally, if you take them for too long, you may become dependent on the pills and struggle to stop taking them. Also not to be overlooked are the possible unwanted side effects of a powerful sleeping pill, such as daytime drowsiness, mental confusion, addiction, memory problems, dizziness and dizziness, muscle weakness, and sleepwalking. Benzodiazepines are generally recommended if you suffer from any of the following conditions :
- sleep apnea (problems breathing during sleep);
- lung diseases;
- liver or kidney disease;
- myasthenia gravis (a neuromuscular disease).
Z Drugs – Benzodiazepine-Like
Benzodiazepines are not the only type of drugs used to treat insomnia. There are also sleeping pills or non-benzodiazepine hypnotics, which, despite having a different chemical structure, act with a similar mechanism of action in the brain on GABA receptors, producing a sedative and hypnotic effect. The three active ingredients of Z drugs are:
- zolpidem;
- zopiclone;
- zaleplon.
These non-benzodiazepine sleeping pills are considered a “less invasive” choice than benzodiazepines. However, they can cause addiction and dependence in case of prolonged use. The most common side effects associated with these drugs include a bitter or metallic taste in the mouth, dry mouth and feeling tired, sleepwalking, and hallucinations. Furthermore, among the contraindications, z-drugs may also not be suitable if you suffer from one of the health conditions not indicated for the use of benzodiazepines.
Melatonin, Sleep Hormone
Melatonin ( N-acetyl-5-methoxytryptamine ), also called “sleep hormone”, is the primary hormone produced by the pituitary gland ( or pineal gland ) located in the brain. It is an endogenous substance, i.e. produced naturally within the body and involved in the sleep-wake cycle, in the regulation of sleep and the circadian rhythm.
Melatonin production is influenced by light-dark alternation: darkness stimulates melatonin synthesis, while light inhibits it. In fact, it is released in the evening when it gets dark to encourage the body to prepare for sleep. Another way to improve sleep and promote the work of melatonin already produced by the body is to take this hormone through supplements in the form of drops and tablets for a period of 1 to 4 weeks.
Herbal Supplements, Natural Sleeping Pills
To solve the problem of insomnia, you can also follow natural alternative paths, from adopting healthier habits and lifestyles to sleeping remedies. This includes avoiding stimulants such as caffeine and alcohol before bed, limiting exposure to blue light from electronic devices, and creating a relaxing environment in the bedroom. The combination of these practices can significantly help those who have difficulty falling asleep.
Several herbs and plants can be used as natural sleeping pills. Among these, for example, valerian, lemon balm, passion flower, chamomile and hops. Their action is carried out thanks to their active ingredients, which can have a soothing and anxiolytic effect. Let’s see them in detail:
- Valerian, for example, contains compounds that can help reduce anxiety and promote sleep;
- lemon balm is known for its calming properties and can help you relax before bed;
- passionflower is known for its relaxing effect and can promote more peaceful sleep;
- chamomile is appreciated for its calming properties and can be consumed as a herbal tea before sleeping ;
- Hops are known for their soothing effect and can help improve the quality of sleep.
Although these natural remedies can be helpful in promoting sleep, it is always advisable to consult a specialist to confirm whether these remedies are actually effective for your condition. Before taking any pharmacological or natural remedy, it is good to consider these elements :
- long-term side effects of sleeping solid pills;
- addiction to sleeping pills;
- daytime drowsiness caused by sleeping solid pills;
- drug interactions with sleeping pills.
Long-term side effects of pharmacological sleeping pills:
- daytime drowsiness;
- dizziness;
- amnesia;
- addiction trigger;
- episodes of sleepwalking.
Causes And Consequences Of Insomnia
The causes of insomnia are many and can vary from one person to another. Below, we see the main ones:
- Psychological factors: stress and anxiety are among the most common causes of insomnia. Worries about work, family or health can disturb sleep;
- chaotic and disturbing night environment: a bedroom with an unsuitable temperature, exposed to noise or too bright, can prevent good rest and fall asleep;
- lifestyle: habits such as shift work, jet lag, or the use of electronic devices, TV, alcohol, and caffeine before bed can negatively affect sleep;
- Mental health problems: Conditions such as depression can both cause and be worsened by insomnia.
- physical health problems: several medical conditions can cause insomnia, including breathing disorders, chronic pain, heart disease, and neurological disorders such as restless legs syndrome;
- medications: Some medications, including antidepressants, epilepsy medications, and steroids, may have insomnia as a side effect ;
- Aging: Changes in sleep structure are common with advancing age, including decreased deep sleep and increased nocturnal awakenings;
- hormonal changes: occur during menopause, pregnancy, or due to thyroid problems;
- diet and physical activity: diet and physical activity can influence the quality of sleep. Eating heavily before bed or exercising too close to bedtime can disturb sleep.
Suffering From Insomnia: The Consequences
Insomnia can cause fatigue, daytime sleepiness, difficulty concentrating and memory problems. Additionally, it can negatively affect mood, causing irritability and exacerbating conditions such as anxiety and depression. The consequences of insomnia can also extend to the physical sphere. Lack of adequate sleep can compromise the immune system, making the body more susceptible to certain diseases and disorders such as obesity, diabetes and cardiovascular disease .
On a social level, insomnia can affect interpersonal relationships and work performance. Lack of sleep can make a person irritable, less friendly and less productive, compromising their general well-being and the quality of personal and work relationships. It is essential, therefore, to address this condition in a conscious way to improve the quality of sleep, starting with a possible consultation with a doctor specializing in sleep medicine to evaluate the most suitable treatment.
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