Is It Safe to Take Sleeping Pills for Insomnia? Here's What the Research Says

Insomnia affects between 15% and 30% of the global population, making it one of the most common sleep disorders today. For many individuals struggling with restless nights, sleeping pills appear to offer a straightforward solution, helping them fall asleep faster and wake up feeling more rested.

But is it safe to rely on sleeping pills?

Understanding the safety, benefits, and potential risks associated with these medications is important when considering them as part of a long-term sleep health.

This article takes a closer look at what sleeping pills can and cannot offer, what current research suggests, and what other options may support better, sustainable sleep over time.

What Is Insomnia and Why Is It Hard to Treat?

Insomnia goes beyond the occasional restless night. Clinically, it is defined as difficulty falling asleep, staying asleep, or waking up too early at least three times per week for over three months. Chronic insomnia can significantly impact mood, cognitive function, daily performance, and overall well-being.

Its causes vary widely—from stress, anxiety, and chronic pain to poor sleep habits or environmental disruptions. In some cases, no clear underlying cause can be identified, making treatment more challenging.

For those experiencing disrupted sleep night after night, sleeping pills may seem like an immediate source of relief. However, evaluating their short-term and long-term effects is important before deciding on a treatment path.

What Kinds of Sleeping Pills Are Commonly Used?

Today, several classes of medications are prescribed to manage insomnia. Each class works differently in the brain and carries its own profile of potential benefits and considerations.

1. Benzodiazepines (BZDs)

Examples: temazepam (Restoril), triazolam (Halcion)

These medications enhance the activity of GABA, a neurotransmitter that slows brain activity. They are effective at promoting sleep onset but are associated with risks such as dependency, cognitive decline, and increased risk of falls, particularly with long-term use.

Among commonly prescribed options, benzodiazepines, including temazepam and triazolam, have been identified in research as higher-risk sleeping pills, especially when used beyond short periods.

2. Non-Benzodiazepine Hypnotics ("Z-drugs")

Examples: zolpidem (Ambien), eszopiclone (Lunesta)

Z-drugs act on similar receptors as benzodiazepines but are chemically distinct. They are commonly prescribed due to a somewhat lower risk of dependence, although side effects such as sleepwalking, memory loss, and next-day drowsiness have been reported.

• Standard forms like zolpidem help with falling asleep.

• Extended-release forms (e.g., Ambien CR) assist with both sleep onset and maintenance.

• Sublingual forms (e.g., Edluar, Intermezzo) are designed for middle-of-the-night awakenings.

Women may be at greater risk of certain side effects from some sleeping pills. Studies show that women metabolize medications like zolpidem more slowly than men, leading to higher blood concentrations the following morning and an increased likelihood of next-day drowsiness or impaired alertness.

3. Melatonin Receptor Agonists

Example: ramelteon (Rozerem). 

This medication mimics the body's natural melatonin to regulate sleep-wake cycles. It is generally not associated with dependence and primarily aids in falling asleep.

4. Orexin Receptor Antagonists

Examples: suvorexant (Belsomra), lemborexant (Dayvigo), daridorexant (Quviviq)

These medications target orexin, a neurotransmitter that promotes wakefulness. They are newer options and have shown effectiveness for both sleep onset and maintenance, with a lower risk of dependency. 

5. Certain Antidepressants

Examples: low-dose doxepin (Silenor), trazodone (off-label)

Some antidepressants are used at low doses to aid sleep, particularly for maintaining sleep throughout the night. Side effects may include dry mouth, dizziness, or next-day grogginess.

Also Read: Study Shows Sex is More Effective than OTC Sleeping Pills

Do Sleeping Pills Actually Improve Sleep Quality?

In short-term studies, sleeping pills have been shown to:

• It helps people fall asleep about 15–30 minutes faster.
  

• Increase total sleep time by 25–60 minutes per night.
  

• Reduce nighttime awakenings.

However, effectiveness can vary depending on the medication and individual response. Some medications are more helpful for sleep initiation (falling asleep), while others better support sleep maintenance (staying asleep).

Longer-term findings are more mixed:

• Most clinical studies follow participants for only 4 to 12 weeks.
  

• Tolerance may develop with some medications, reducing their effectiveness.
  

• Dependency may also influence perceived benefits.

There is limited evidence that long-term use improves daytime functioning or long-term health outcomes. 

Sleeping pills, while effective for short-term relief, can carry side effects that range from mild next-day drowsiness to more serious risks such as cognitive impairment, complex sleep behaviors, and increased risk of falls.

How Long Is It Safe to Use Sleeping Pills?

Traditional recommendations have emphasized short-term use, particularly for benzodiazepines and Z-drugs, typically less than 2 to 4 weeks.

However, newer research suggests that:

• Some medications, including eszopiclone, doxepin, ramelteon, and orexin receptor antagonists, have been studied for 6 to 12 months without significant tolerance development.
  

• A 2023 review in the Journal of Clinical Medicine involving experts from institutions such as Harvard, Stanford, and Northwestern noted that some modern insomnia medications may be safe for longer-term use under medical supervision [1].

Even so, most experts advise reassessment over time and using the lowest effective dose for the shortest necessary period.

Also Read: Not All Sleep Supplements are Created Equally

What Are the Risks of Using Sleeping Pills Regularly?

Several studies have documented potential risks associated with long-term sleeping pill use.

1. Cognitive Impairment and Memory Issues

Long-term use of benzodiazepines has been associated with cognitive decline and an increased risk of dementia, particularly in older adults.

A large case-control study published in the BMJ found that past use of benzodiazepines for three months or longer was associated with up to a 51% increased risk of Alzheimer's disease.

According to the researchers, "the stronger association seen with long-term exposures reinforces the suspicion of a possible direct association," although causality has not been definitively established.

They emphasized that treatments "should be of short duration and not exceed three months," especially for elderly patients.

2. Dependence and Withdrawal Symptoms

Sleeping pills can cause physical and psychological dependence. Withdrawal symptoms may include:

• Rebound insomnia
  

• Anxiety
  

• Sweating
  

• Tremors
  

• Nausea
  

3. Increased Risk of Falls and Accidents

Older adults using sleep medications have been found to experience higher rates of falls and fractures. Daytime drowsiness may also increase the risk of motor vehicle accidents.

4. Complex Sleep Behaviors

Medications, particularly Z-drugs, may sometimes lead to activities performed while not fully awake, including:

• Sleepwalking
  

• Sleep-eating
  

• Sleep-driving

These behaviors can occur without memory of the event and may pose safety concerns.

5. Potential Mortality Risk

An observational study cited in the Journal of Clinical Medicine reported a 55% increased risk of mortality among regular sleeping pill users compared to non-users. While causality has not been firmly established, the findings highlight the importance of careful use.

A large-scale study conducted by the University of Warwick, published in BMJ, tracked over 34,000 individuals for an average of 7.5 years. The study found that several types of anti-anxiety and hypnotic medications were associated with up to twice the risk of death, even after controlling for other contributing factors.

Professor Scott Weich, lead author of the study, emphasized that "we really do have to use these drugs more carefully," noting the importance of minimizing reliance on anxiolytics and sleeping pills whenever possible and exploring non-drug approaches such as cognitive behavioral therapy.

6. Interactions with Other Substances

Sleep medications can interact with:

• Alcohol
  

• Opioids
  

• Certain antidepressants
  

• Muscle relaxants
  

• Over-the-counter antihistamines
  

These interactions can amplify sedation and respiratory depression risks.

7. Delayed Arousal to Threats During Sleep

Another concern involves the brain’s reduced ability to respond to danger signals during sleep. A 2019 study published in Frontiers in Behavioral Neuroscience found that benzodiazepines, such as triazolam, significantly delayed arousal in response to threatening stimuli—such as loud alarms, predator scents, or tremors.

“Benzodiazepines stimulate the widespread brain receptor GABA-A, which makes us sleepy but also suppresses off-target brain areas — including the ‘gatekeeper’ that decides which sensory inputs to process,” explained Professor Tomoyuki Kuwaki, senior author of the study.

In contrast, newer dual orexin receptor antagonists (DORAs) allowed test subjects (mice) to wake when sensing danger while still offering sleep benefits and quicker return to sleep.

Who Should Be Particularly Cautious About Sleeping Pills?

Higher caution is generally advised for:

• Older adults (65+), due to slower metabolism and greater risk of cognitive side effects and falls.
  

• Individuals with respiratory conditions like sleep apnea or COPD.
  

• Those taking multiple medications that depress the central nervous system.
  

• People with a history of substance use disorders.
  

• Pregnant individuals, due to limited safety data.
  

The American Geriatrics Society specifically advises avoiding benzodiazepines and Z-drugs for older adults whenever possible.

Are Over-the-Counter Sleep Aids Any Safer?

Many over-the-counter (OTC) options are available, but they are not without risks.

Antihistamine-Based Sleep Aids

Products containing diphenhydramine (e.g., Benadryl, ZzzQuil) or doxylamine (Unisom) can cause:

• Daytime grogginess
  

• Memory problems
  

• Urinary retention
  

• Constipation
  

Melatonin Supplements

Melatonin is often perceived as safer, but research shows that:

• The actual melatonin content in supplements may vary by up to 478% compared to the label.
  

• About 26% of tested melatonin products contained serotonin.
  

• Optimal doses appear to be lower (around 0.5–1mg).

Evidence for melatonin’s effectiveness in chronic insomnia remains mixed.

Also Read: HealthNews Warns of Dangers of Using Too Much Melatonin

What Do Sleep Experts Recommend Instead?

Leading sleep authorities recommend prioritizing behavioral and lifestyle-based approaches:

• Cognitive Behavioral Therapy for Insomnia (CBT-I): Considered the gold standard for chronic insomnia, CBT-I addresses both thought patterns and behaviors that interfere with sleep.
  

• Sleep hygiene practices: Consistent sleep and wake times, reducing screen use before bed, creating a sleep-conducive environment, and avoiding late-day caffeine.
  

• Natural methods: Relaxation techniques, mindfulness, progressive muscle relaxation, pink noise sound therapy, and light therapy.

These methods often show longer-lasting improvements compared to sleeping pills.

Could Natural Sleep Aids Like Sip2Sleep® Be a Safer Alternative?

As more individuals seek non-habit-forming approaches to support better sleep, natural sleep aids are gaining attention.

Sip2Sleep® is made with all-natural ingredients that work with the body’s natural sleep-wake cycle (circadian rhythm):

• Montmorency Tart Cherry Extract: A natural source of melatonin and tryptophan, supporting sleep cycle regulation.
  

• Rafuma Leaf: Helps promote relaxation by supporting GABA and serotonin activity naturally.
  

• Sublingual delivery: Enables faster absorption without needing water, making it convenient for nighttime routines.

While natural sleep aids are not substitutes for medical treatment when needed, they may offer an option for those seeking holistic and gentle support for better sleep quality.

Also Read: Can't Sleep? Discover Why Sip2Sleep® Works Better Than Melatonin

 Are Sleeping Pills a Good Way to Go?

While sleeping pills may seem like a convenient solution for insomnia, experts advise weighing both the short-term benefits and the potential long-term risks carefully before deciding if they are the right path to better sleep.

Behavioral therapies such as CBT-I, sleep hygiene improvements, and natural sleep aids like Sip2Sleep® may offer additional pathways toward achieving holistic, restorative sleep.

As always, discussing any sleep concerns and treatment options with a qualified healthcare provider is the best way to find a sleep solution that supports both safety and wellness.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a healthcare professional before starting or discontinuing any medication or supplement.

References:

1. Zee PC, Bertisch SM, Morin CM, Pelayo R, Watson NF, Winkelman JW, Krystal AD. Long-Term Use of Insomnia Medications: An Appraisal of the Current Clinical and Scientific Evidence. J Clin Med. 2023 Feb 17;12(4):1629. doi: 10.3390/jcm12041629. PMID: 36836164; PMCID: PMC9959182.