Statistics from the National Sleep Foundation show that a quarter of Americans take sleeping pills each year. Why do so many people suffer from “insomnia” problems? Anxiety, depression, chronic illness, restless leg syndrome, sleep apnea, daily exhaustion …… The reasons are as endless as the variety of drugs on the market. Although sleeping pills are effective in dealing with insomnia, the public has misconceptions about them. For example, many people do not know how many hours the effects of the sleeping pills they take last, nor do they know that most sleeping pills should not be mixed with other medications. If you are taking or planning to take sleeping pills, you must have many questions, right? What kind of sleeping pill should I take? We recommend that people with insomnia problems consult a psychiatrist for a face-to-face examination before making a decision on “whether to take the medication” or “what medication to take”. “Over-the-counter” refers to drugs that are easily available at pharmacies with the OTC symbol on the outside of the package; “prescription” refers to drugs that can only be “dispensed” by a doctor with a prescription. Most doctors do not treat over-the-counter sleeping pills well because they usually do not work for severe insomnia. Many over-the-counter sleeping pills contain antihistamines, similar to the anti-allergy drug Benadryl, which can cause side effects such as dry mouth, dry eyes, and drowsiness the next day. OTC sleeping pills are suitable for people who are occasionally troubled by sleep problems. Note: Antihistamines should be used with caution in breastfeeding women and with caution in the elderly who are more sensitive to the side effects of antihistamine ingredients. Do I need to take sleeping pills? If the symptoms of poor sleep and difficulty sleeping persist for a month and do not show signs of improvement, it is time to seek medical attention. (1) Perhaps the doctor will prescribe a small amount of sleeping pills to ease the symptoms of insomnia for a period of time; (2) Perhaps the doctor will try non-pharmacological treatment first, so don’t think that “you are not a good doctor if you don’t prescribe medication”; (3) Perhaps the doctor will suggest some tests to rule out “sleep apnea” – a breathing disorder that can cause a night’s sleep. -This breathing disorder can lead to being awakened several times a night, sometimes without the patient even noticing it. Can insomnia be treated only with sleeping pills? Of course not. In addition to medication and the treatments described below, the easiest way to treat insomnia is to pay attention to “sleep hygiene”. What is sleep hygiene? 1. Cognitive Behavioral Therapy (CBT) People often blame all negative energy such as irritability on “lack of sleep” and put too much emphasis on sleep, and then insomnia breaks out. During the course of cognitive behavioral psychotherapy, the therapist will help us change our perception of sleep and take us through techniques that help us sleep, such as changing the environment in which we sleep and limiting our bedtime activities. Some studies have shown that CBT is at least as effective as medication, and has no side effects. However, depending on the circumstances, sometimes a combination of medications may still be needed. 2. The most common and aggressive form of insomnia is probably “sleep apnea”. This part of the population needs to wear a sleep-assisting device to deliver a constant flow of air into the airway so that they do not “sleep badly” because they are constantly being kept awake. Can I take it again if it doesn’t work well? Actually, yes, but this method is only applicable to “short-acting drugs”. Short-acting drugs are fast-acting and expire quickly, with an effect time of three to four hours, and are usually used by people who have difficulty falling asleep. If you still can’t sleep after taking short-acting sleeping pills, you can take them again when it’s still early to wake up. However, we need to read the instructions or consult a doctor to make sure that the medication is indeed short-acting. The time to take the medication again depends on your schedule. For example, if you plan to wake up at 6 or 7 a.m., take the medication before 3 a.m. The medication will be largely metabolized by the time you wake up in the morning and will not interfere with your daytime activities. Of course, each medication is different, so it is better to ask your doctor about how to take it. The long-acting sleeping pills for people who have trouble falling asleep and wake up easily can only be taken once a night. Short-acting category: zopiclone, zolpidem, triazolam; medium-acting category: alprazolam, eszopiclone, clonazepam, lorazepam; long-acting category: diazepam, flurazepam. Will I have nightmares if I take the medication? Usually not. However, some sleeping pills can suppress a person’s memory of dreams. Once the medication is stopped or the dose is reduced, those realistic dreams (which may be nightmares) can return. It is not clear why this happens. Does the medicine affect my health if I take it for a long time? No long-term health effects have been found for sleeping pills, but they can be very addictive. After taking the drug for a period of time, the dose needs to be increased to achieve the previous effect, which is the tolerance of sleeping pills. Some patients increase the dosage on their own, and later on, they develop drug dependence. Therefore, if you feel that the medication you are taking is not as effective as it used to be, or if you need to increase the dose to be effective, you must inform your doctor so that he or she can help adjust the medication regimen. How should I stop taking the medication? Please gradually reduce the dose of your medication under the guidance of your doctor. Your doctor may reduce the dose by half each week: say you were taking 10 mg of a drug each night, try taking 5 mg each night for a week, then halve the dose to 2.5 mg the next week, and finally stop taking the drug altogether. However, this is not a reduction strategy that works for everyone, and it is important to follow up with your doctor and gradually adjust your medication under his or her supervision. Note: Some medications can be broken in half, while others cannot, such as extended-release medications, so consult your doctor for details on how to administer them. Will my sleep quality get worse after I stop taking the medication? This may be the case. After stopping the medication, we need a few days to adjust, and if we still can’t sleep, we still have to go to the doctor. As mentioned earlier, after taking sleeping pills for a period of time, drug dependence may occur. This is when withdrawal occurs and the person becomes anxious, restless, and unable to sleep properly.