The Dos and Don’ts of Prescription Sleeping Pills
Almost everyone has trouble sleeping at some point in their lives, and it is particularly common in older adults. You may feel at some point that you need help falling or staying asleep. Here are a few things to know before talking to your doctor or pharmacist about prescription sleeping pills.
Keep a sleep diary
A sleep diary (sleep journal or sleep log) is a record of key information about your sleep and lifestyle factors that may affect your sleep. Below is a list of common information included in a sleep diary. This information will help your doctor make the best decision about choosing a prescription sleeping pill for you.
Ideally, start recording this information before seeing your doctor and bring your sleep diary with you to your appointment.
- Time you go to bed
- Wake-up time
- How long it takes to fall asleep
- The number of times you wake up and how long it takes to fall back asleep
- Number and duration of any daytime naps
- How well you slept and how rested you feel each morning
- Daytime symptoms due to sleep problems such as drowsiness or falling asleep while reading or watching TV
- Caffeine, alcohol, and nicotine consumption
- A list of all prescription medications, over-the-counter (OTC) medications, and any herbal or supplement products that you take regularly or as needed
- Exercise, including the time of day that you exercise
- If you have sleep apnea or any other ongoing lung disease that makes nighttime breathing difficult
Prescription sleeping pills
Prescription medications used to treat sleeping issues have different actions. For example, some medications help you fall asleep such as zaleplon (Sonata) or ramelteon (Rozerem). Others may help you stay asleep such as doxepin (Silenor).
Some may help you to fall asleep and stay asleep such as zolpidem (Ambien, Ambien CR), eszopiclone (Lunesta), and suvorexant (Belsomra). Zolpidem may be used during the night if you wake up and have difficulty returning to sleep.
For older adults, your doctor may first try melatonin (OTC) or doxepin before prescribing other medications for sleep. An antidepressant, trazodone, is prescribed by some doctors off-label (a use not approved by the FDA) to treat insomnia because it causes drowsiness. In some small studies it has shown improvement in sleep for a few weeks. Your doctor will work with you to choose a sleeping pill that works best for your symptoms, age, and other medical conditions.
What do I need to know about prescription sleeping pills?
Keep in mind the following if you are taking or considering taking a prescription sleep medication:
- DO allow 6 to 8 hours for sleep
- DO go to bed right after taking your medication
- DO keep a sleep diary
- DO take your medication as directed by your doctor and pharmacist
- DO be careful if you need to get out of bed after taking a sleep medication because of the risk of falling
- DO ask your doctor or pharmacist about potential side effects
- DON’T drink alcohol or take other medications that make you sleepy
- DON’T drive after taking a prescription sleep medication
- DON’T use if pregnant or nursing unless you talk to your doctor first
Summary
Before you ask your doctor or pharmacist about prescription sleeping pills, be prepared to share your sleep diary and answer questions about your insomnia symptoms. It is important to work with your health care provider to find a medication that is right for you and to tell your doctor or pharmacist right away if you experience any side effects.