Sleeping Pills and Alcohol
People with disturbed sleep patterns often find sleeping pills very tempting and for all the right reasons. Who would not like dozing off after a hard day at work instead of staring at the ceiling hoping sleep will come to them naturally? Insomnia is one of the most common sleeping disorders affecting a major chunk of the population in the UK. It is reported that 16 million of adult UK population suffers from sleepless nights and a third of them say that they have insomnia. This figure can be disturbing as it reflects the significant number of individuals who will resort to sleeping pills to cope with their insomnia at some point in their life.
Improving sleep is the biggest health ambition of a quarter of people in the UK making them 26% of the entire population. However, half of them do not practice any measures to mitigate their sleep disturbances and out of the other half who try different hacks to get a night of better sleep, 13% of them use sleeping pills to aid their sleep, while 13% of them consume alcohol to help them sleep better.
Ironic enough but the truth is that alcohol does not help you sleep better rather it is known to impair your sleep quality. Alcohol is known to interfere with your sleeping pills making your medications go to waste and resulting in a worsened insomnia. So next time you take alcohol right after your sleeping pills, bear in mind that you are inviting trouble because the combination of sleeping pills and alcohol can be simply devastating.
Sleeping pills are classified as sedative-hypnotics and are considered as a temporary treatment for insomnia. Sleeping pills act by suppressing the central nervous system and this relaxes the body, creating a calming effect and helps people in sleeping faster and longer.
However, sleeping pills are habit-forming and can lead to the development of tolerance after as little as a week’s use. Hence, it is advised to use sleeping pills for not more than the duration suggested by your physician.
Sleeping pills are available on prescription in the UK. Most general practitioners (GPs) are not frequently prescribing sleeping pills out of concern for the potential for dependence and addiction to these drugs.
As good as they may sound, sleeping pills are not devoid of potential side effects. The side effects of each prescription sleeping pill vary and depend on the dose of the drug taken and the duration for which it stayed in your system.
Following are some common side effects experienced after the use of sleeping pills:
- Drowsiness the next day
- Muscle aches
- Difficulty concentrating
- Dry mouth
- Clumsiness or unsteadiness
- Rebound insomnia
It is advised that you should not drive or operate heavy machinery after taking sleeping pills as the sedative effect can take longer to wear off and doing such tasks can increase the risk of accidents.
The greatest risk is linked with the development of tolerance leading to dependence and then addiction follows. Sleeping pills are often used with alcohol to exacerbate their sedative property not realizing the potential hazards linked with it.
There are various types of sleeping pills available in the UK. Following are the sleeping pills available on prescription and as over-the-counter medications.
Benzodiazepines are sedatives, used to treat severe anxiety and insomnia. It acts by depressing the central nervous system by releasing the neurotransmitter GABA thus resulting in a calming and relaxing effect on the brain that promotes sleep and relieves anxiety. However, it should not be used frequently due to the risk of developing dependence on the drug. Benzodiazepines are available on prescription and include Loprazolam, Nitrazepam, Temazepam and Lormetazepam.
The Z drugs
The Z-drugs are so named because the name of the drugs in this class start from the letter ‘Z’. They are non-benzodiazepine sedatives that are not structurally related to benzodiazepine but work similarly to them. The Z drugs are used to treat severe insomnia and helps in maintaining a good night’s sleep.
Z drugs licensed for sale in the UK include Zopiclone and Zolpidem.
Z drugs have the potential for being habit-forming like benzodiazepines but they are superior to other sleeping pills over the fact that they are short-acting and do not cause prolonged drowsiness the next day.
Zopiclone is available with the brand name Zimovane. It is available as tablets and has a half-life of around 5 hours.
Zolpidem with the brand name Stilnoct is available as a tablet and has a half-life of around 2.4 hours.
Anti-histamines are not from the class of sleeping pills. Primarily they are used to treat allergies such as hay fever. However, it is one of the effects of anti-histamines that they increase sedation and drowsiness hence they are used as a treatment for insomnia.
Anti-histamines differ from other sleeping pills in such a way that they are long-acting and do not cause sleep abruptly. Moreover, they are known to cause a ‘hangover’ since the sedative effect of the drug does not wear off the next day and the person continues feeling sleepy even after a good night’s sleep. Anti-histamines are available as over-the-counter medication. Diphenhydramine and Promethazine are the two anti-histamines commonly used as sleeping pills. Diphenhydramine is sold under the brand name Nytol Original among others and it has a half-life ranging from 2.4 to 9.3 hours. Promethazine is available by the brand name Sominex among others and it has a half-life of 5 to 14 hours.
Melatonin is not some formula medicine to help you doze off. It is simply a preparation of melatonin, a natural hormone released by the pineal gland in the brain and it controls your circadian rhythm. Circadian rhythm is the maintenance of the 24-hour cycle of night and day and melatonin regulates it hence it is given to improve sleep patterns.
It is used to treat chronic insomnia in the elderly population above 55 years of age. It is usually given for 3 weeks but if it shows promising results in treating the condition then the treatment can be extended to another 10 weeks. In some countries, Melatonin is also used to treat jet lag however it is not licensed for this use in the UK.
Melatonin is sold under the brand name Circadin among others and has a half-life of 0.5 to 4 hours.
Chloral hydrate and Clomethiazole
These drugs are not commonly used to treat insomnia due to the increased risk of dependence associated with them. These drugs are not used as frequently since benzodiazepines and Z drugs are more popular in the UK.
Barbiturates were used before benzodiazepines were made to treat insomnia but they are now replaced with this newer drug class. Barbiturates are generally given when other treatment modalities have failed in treating insomnia. It should be avoided in older individuals.
No, you cannot mix sleeping pills and alcohol. No matter how tempting it feels to have a drink to unwind yourself before sleeping, you should avoid doing so if you are on sleeping pills as it can lead to deleterious consequences. If you take alcohol concomitantly with your sleep aid it is known to synergize and potentiate the effect of the sleeping pills.
Most of the sleeping pills are central nervous system depressants and alcohol also acts by suppressing the central nervous system. The combined effect of the two can exacerbate the side effects such that a person might stop breathing resulting in death since both the sleeping pills and alcohol depress the respiratory system. Sleeping pills usually come with a warning to avoid using alcohol while taking the drug.
Some people are not aware that alcohol is still in their system when they take a sleeping pill and they mix alcohol and sleeping pills accidentally. However, most of the time people mix alcohol and sleeping pills for recreational purposes to boost the sedative effect not realizing that they are creating complications for themselves.
Mixing sleeping pills and alcohol is hazardous for health since both are sedatives and combining the two heightens the negative effects caused by suppression of the central nervous system which ultimately depresses the respiratory system and affects the activity of the heart resulting in death.
People presume that they will get a good night’s sleep after combining the two depressants when ironically alcohol impairs the quality of sleep making people have a very light sleep. People are known to be sleep-walking, sleep-talking, and doing other activities under the sedation caused by alcohol ad sleeping pills and they tend to not remember any of it when the effect of both the substances wear off.
This condition is referred to as ‘parasomnia’ or ‘blackouts’ in which individuals do not remember the behaviors they engaged in when they are awake. It is associated with increased danger because a person can commit any crime or wrongdoing, harming himself or the people around him under this sedative episode. So to avoid getting into uninvited trouble do not consume alcohol while you are taking sleeping pills.
Alcohol and sleeping pills hamper the cognitive functioning of the brain, decrease concentration, and increases the likelihood of falls and accidents due to impaired coordination and judgment.
There are certain side effects associated with mixing alcohol and sleeping pills. They are as follows:
- Slowed heart rate
- Decrease in blood pressure
- Shallow breathing
- Increased risk of sleeping pill addiction
- Increased risk of overdose
- Deteriorated quality of sleep
- Impaired memory
- Depression of the central nervous system
- Increased risk of alcohol use disorder
- Increased risk of blackouts-inability to remember what happened under the effect of both the substances
- Increased risk of sleep-walking, sleep-talking, sleep-driving, etc.
- Risk of death
Sleeping Pills and alcohol should not be used together due to the amplification of side effects caused by each substance.
Following are some of the sleeping pills in the UK and their effects, when mixed with alcohol, are discussed below:
Zopiclone and Alcohol
Zopiclone is a hypnotic or sleeping pill that belongs to the class of Z drugs. The brand name of Zopiclone is Zimovane. It is available in 3.75mg and 7.5mg tablets. Zimovane should not be taken for more than 10 days as it has significant potential for the development of tolerance if taken for an extended duration. Hence, Zopiclone is used for the short-term treatment of insomnia.
Since Zopiclone acts by depressing the central nervous system it is recommended that people who are using Zopiclone should not consume alcohol. The reason being that Zimovane and alcohol are both sedatives and act on the GABA receptors in the brain so they potentiate the adverse effects of one another. When used concomitantly Zopiclone and alcohol can result in increased drowsiness and impaired concentration. Consequently, you should not drive or operate heavy machinery after taking the two hypnotics together to reduce the risk of accidents.
Zopiclone and Alcohol side effects
After combining alcohol with Zimovane a series of negative findings are present because alcohol aggravates the potential side effects of Zopiclone.
Following are the side effects of Zopiclone and Alcohol:
- Increased drowsiness
- Impaired concentration
- Increased risk of falls and accidents
- Worsens sleep problems
- Reduces breathing
Deaths and suicide danger associated with mixing Alcohol with Zopiclone
As with other hypnotics and central nervous system depressants, mixing alcohol and Zopiclone is associated with the risk of death as the combined effect of the two can be fatal. This is seen in cases of Zopiclone overdose. Zopiclone overdose is not usually considered to be life-threatening unless combined with other CNS depressants such as alcohol.
Central nervous system depression caused by Zimovane can progress to coma in the presence of alcohol. This happens because Zimovane is known to cause respiratory depression which is exacerbated by alcohol and this results in decreased oxygenation to vital organs like the brain and results in coma and death.
Moreover, taking alcohol and Zopiclone before sleeping make the person go into a deep sleep from which it is difficult to wake up and this increases the risk of suicide by using these two substances.
Nytol and Alcohol
Nytol is the brand name of Diphenhydramine which is an anti-histamine. Nytol is known as the UK’s favorite sleep aid brand. Similar to other sleeping pills this medication should not be used regularly for more than 2 weeks without consulting your general physician since tolerance develops and leads to dependence.
Nytol should not be used with alcohol because it is known to increase the side effects of alcohol, therefore alcohol should be avoided. Moreover, alcohol can increase the drowsiness and dizziness associated with diphenhydramine. Hence, you should avoid doing activities that require concentration like driving and operating heavy machinery since it increases the risk of accidents.
Alcohol and Nytol when used together can make a person go into a very deep sleep and the person may find it very difficult to wake up as this is accompanied by reduced breathing. So you should avoid taking alcohol concomitantly with Nytol to mitigate the risk of these fatal consequences.
Sominex and Alcohol
Sominex is the brand name of Promethazine which is an anti-histamine. It is used for the short-term treatment of insomnia. It should be taken 20 minutes before going to bed since it takes 30 minutes to work and cause sedation. Sominex is one of the most sedative anti-histamine. It should not be mixed with alcohol since promethazine causes drowsiness and alcohol potentiates this side effect causing deep sleep after which it might be hard to wake up.
Concomitant use of Sominex and alcohol should be avoided as they both are sedatives. Sominex is known to cause sedation for 12 hours and alcohol should not be used during this period because alcohol will increase the drowsiness and dizziness associated with promethazine.
Is it bad to take melatonin with alcohol?
Yes, it is bad to take melatonin with alcohol. Although melatonin is available as an over-the-counter preparation to treat insomnia and even though it is a natural hormone it should not be mixed with alcohol. Similar to other sleeping pills the combination of alcohol and melatonin can result in increased drowsiness, anxiety, dizziness and can also result in a rise in blood pressure. Hence, you should avoid using alcohol and melatonin to reduce the risk of any side effects.
What sleeping tablets can I take with Sertraline?
You cannot take sleeping pills with sertraline. Sertraline is known to cause insomnia when taken at night and so it should be taken in the morning to prevent this side effect. However, you cannot use sleeping pills with sertraline since it is an anti-depressant and should not be mixed with sleeping pills.
How long does Nytol last?
Nytol should be taken 20 minutes before going to sleep as it takes 30 minutes for Nytol to work. The sedative effect of Nytol lasts for 4 to 6 hours and helps a person to achieve a good night’s sleep.