Insomniacs can't fall asleep, so they keep taking sleeping pills? The love-hate relationship between insomniacs and sleeping pills

Author: Jiang Molin Beijing Hospital of Traditional Chinese Medicine, Capital Medical University

Reviewer: Zhang Jie, Chief Physician, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Member of the Standing Committee of the Psychosomatic Medicine Professional Committee of the Chinese Medical Association

"Doctor, thanks to this sleeping pill, I can sleep after taking it."

"I've been taking sleeping pills all my life, and I can't live without them"

"I took sleeping pills and my brain slowed down and my memory became worse. What should I do?"

"I heard that sleeping pills are like drugs, you get addicted and can't stop taking them. I dare not take them no matter how uncomfortable I feel."

…

Sleeping pills have saved countless insomniacs from sleepless nights, but they have been labeled with negative labels such as "addictive", "side effects", and "memory damage". Many people love and hate sleeping pills. They can't live without them, but they want to get rid of them every moment. What exactly are sleeping pills? Are they angels that save sleep, or devils that steal health? How can we use sleeping pills to find sweet dreams?

Figure 1 Sleeping pills, angel or devil?

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1. Types of sleeping pills

Sleeping pills are a type of drug that has a sedative and hypnotic effect. They promote sleep by blocking the activation of brain functional areas such as the reticular system. Sleeping pills can be divided into short-acting, medium-acting, and long-acting. Short-acting sleeping pills have a fast onset of action and a short metabolism time. They are mainly suitable for patients who have difficulty falling asleep to avoid hangover phenomena such as drowsiness and lethargy the next day. Medium- and long-acting sleeping pills can prolong total sleep time and reduce the number of awakenings at night. They are suitable for patients who have difficulty maintaining sleep. Some drugs also have anti-anxiety effects. Common adverse reactions include daytime drowsiness, dizziness, amnesia, bitter taste in the mouth, falls, dependence and tolerance caused by long-term use, etc.

2. How to use sleeping pills reasonably

In order to achieve good results and avoid adverse reactions, it is necessary to pay attention to the rational use of sleeping pills. The choice of drugs should follow the principle of individualization. First, the selection should be based on the characteristics of each patient's insomnia. For example, patients with difficulty falling asleep should take short-acting drugs, patients who wake up early should take medium- and long-acting drugs, and those who are irritable and thoughtful before going to bed should use anti-anxiety drugs. Secondly, appropriate drugs should be selected in combination with the patient's age, underlying disease, liver and kidney function, and previous medication to reduce adverse reactions. It should be noted that children, pregnant women, lactating women, patients with severe liver and kidney damage, severe sleep apnea, and myasthenia gravis should not take sleeping pills. Drug treatment should start with a small dose, and the drug dose should not be adjusted at will after reaching the effective dose. In addition, it is necessary to pay attention to on-demand and intermittent administration. Take the drug 3 to 5 days a week, not continuously every night. Patients who need long-term drug treatment can take the drug if they still cannot fall asleep 30 minutes after going to bed; take the drug before going to bed if there is important work or things during the day the next day; wake up ≥5 hours earlier than the usual time and cannot fall asleep again. The duration of continuous medication should not exceed 4 weeks. If the sleep condition does not improve, timely follow-up, regular evaluation, and intermittent treatment should be adopted.

Figure 2 Rational use of sleeping pills

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Insomnia not only affects people's normal work and life during the day, but also induces or aggravates heart disease, hypertension, diabetes, mood disorders, and immune dysfunction. Therefore, some long-term insomnia patients refuse to take sleeping pills for fear of adverse reactions, and it is not advisable to take the approach of "hard resistance". It is safe and effective to take sleeping pills within a reasonable dosage range and duration. Reasonable use of sleeping pills can not only help us improve our sleep conditions as soon as possible and reduce the health damage caused by insomnia, but also effectively avoid the adverse reactions of sleeping pills such as fatigue, forgetfulness, and dependence. If you are an insomnia patient, please don't be afraid to resist sleeping pills, it is not a devil that steals health. If you can see a doctor in time, do regular evaluations, and use medications reasonably, sleeping pills can be a good helper for you to regain healthy sleep.