What are Sleeping Pills and Tranquillizers?

Sleeping pills and tranquillizers are drugs which are used to relieve

• anxiety
• stress
• sleeping problems
• muscle tension

They are often called
• sedatives
• nerve pills
• muscle relaxants

Most medications used to relieve anxiety and stress, or help with sleeping problems belong to a family of drugs called benzodiazepines, which must be prescribed by a doctor. Benzodiazepines depress or slow down the central nervous system. These medications are often used for relief of depression, anxiety or sleeping difficulties which may be caused by life changes such as retirement, reduced financial resources, poor health, the loss of loved ones, or physical and social isolation. Also, normal changes in sleeping patterns as we age may be interpreted as a sleeping disorder. While doctors prescribe sleeping pills and tranquillizers less often than in the past, these medications are still used more than they should be to relieve these symptoms.

Effects of Sleeping Pills and Tranquillizers

Sleeping pills and tranquillizers may relieve anxiety and sleeping difficulties but, because they treat the symptoms of stress and not the cause, the relief is only temporary. They may help during a very stressful time, but they are not meant to be used for more than 7 to 10 days.

Side Effects

Aging and severe illness increase the body's sensitivity to sleeping pills and tranquillizers. Most of the side effects of these medications are more likely to occur in seniors. Drugs stay in seniors' bodies longer, therefore the effects of medication can be different in a senior than in a younger person.

The following side effects may be experienced:

• drowsy during the day
• groggy
• confusion and lack of concentration
• forgetful
• dizzy or uncoordinated which can result in a fall or another kind of accident
• irritable
• anxious
• depression
• headache
• nausea
• constipation
• changes in heart rate

Unlike other medications, the side effects do not disappear with continued use.

Dependency

All prescription sleeping pills can cause physical and/or mental dependence, especially when used regularly for more than a few weeks. Signs of dependency can be the need to take more of these drugs to get the same effect, or finding it hard to do without the drugs.

If a physical dependency develops, severe withdrawal symptoms can occur if the drug is stopped suddenly.

Withdrawal Symptoms

If a dependence on sleeping pills and/or tranquillizers has developed, withdrawal from these drugs must be supervised by a health professional to reduce the risk of severe withdrawal symptoms which may be life threatening.

Watch for the following withdrawal symptoms:

• anxiety
• irritability
• agitation
• abdominal cramps
• vomiting
• diarrhea
• sweating
• increased heart rate
• tremors
• seizures

Drug Interactions

When taking sleeping pills and/or tranquillizers with other prescription or non-prescription medications, harmful reactions can occur. Alcohol will increase the effect of sleeping pills and tranquillizers and can produce unintended side effects.

Do not drink alcohol when taking these medications. Tell your doctors and pharmacists about all the medication you are taking and the amount of alcohol you drink to decrease the risk of these reactions.

Alternatives to Sleeping Pills and Tranquillizers

Instead of taking sleeping pills or tranquillizers, the following healthy ideas can help with sleeping, loneliness and anxiety problems.

If you can't sleep:

• Make your bedroom more comfortable, keep it cool and quiet.
• Get up and do something else. Then, go back to bed.
• Drink warm milk or hot water before you go to bed.
• Take a warm bath, read a little or listen to some quiet music in the evening.

Get fresh air and exercise during the day, but remember: exercise before bed can keep you awake.

• Go to bed and get up at the same time every day.
• Don't take naps during the day.
• Avoid coffee, tea or soft drinks after 5 p.m.
• Don't smoke or drink alcohol in the evening—it can keep you awake.
• Don't eat spicy food in the evening.

If you often wake up during the night to go to the bathroom and can't get back to sleep, try not to drink anything two hours before you go to bed. But remember: if you need to take medication at bedtime, it is best to take pills with a full glass of water.

If you feel lonely:

You can spend time with other people by

• Becoming a volunteer.
• Joining a seniors' club at your local church or community centre.
• Taking a course at your local school or community centre and learning a new activity.

You can also call and talk to a different friend or family member every day.

You may want to write a short letter to a friend or family member who lives far away. Sometimes, just writing to someone can help you feel that this person is with you.

If you are anxious or tense:

• Try to relax by breathing slowly and deeply.
• Take a walk.
• Choose an activity you really enjoy doing, like listening to your favourite music, and do it.
• Tell a friend, a family member or your doctor how you feel.
• Join a support group so that you can talk more about your anxious feelings.
• Do relaxation exercises, like yoga.
• Take a course and learn how to do an activity, like needlework or wood carving, at your local community or seniors' centre.

Tips on the Responsible Use of Sleeping Pills and Tranquillizers

For those already taking sleeping pills or tranquillizers, here are some important guidelines.

Take sleeping pills and tranquillizers only through a very stressful time. Remember that these drugs do not solve your loneliness, anxiety or sleeping problems because they treat symptoms and not causes.

Don't take sleeping pills or tranquillizers for more than 7 to 10 days unless your physician advises otherwise.

This medication is not recommended to be used for more than 7 to 10 days. In fact, one of the effects of long-term use of sleeping pills is not being able to sleep.

Know your medication:

• What is it called?
• How often should you take it?
• How long should you take it for?
• Is it safe to drive or use machinery while you take it?
• Is it safe to use alcohol while taking this medication?

Write down the answers or ask for written information about the medication.

Always ask your doctor for the smallest effective dose.

Aging and severe illness can increase the body's sensitivity to these drugs. This increases the risk of side effects.

Don't drink alcohol when you are taking sleeping pills or tranquillizers.

Even small amounts of alcohol can intensify the effects of the medication and result in injury due to dizziness, confusion, fainting and/or lack of coordination.

Tell all the doctors and pharmacists you visit about all the prescription, non-prescription and herbal remedies you take.

Combining medications can cause adverse reactions.

Do not keep taking your medication if it is not helping you or if you have uncomfortable feelings after taking it.

Talk to your doctor and pharmacist if your symptoms are not relieved or get worse after you take your medication.

Check with your doctor when you stop taking sleeping pills or tranquillizers.

After you stop using this medication, your body may need time to adjust. During this time, you may notice trouble in sleeping, nervousness and irritability.

Remember: If you have been taking sleeping pills and/or tranquillizers for a long time, stopping this medication suddenly can cause serious withdrawal symptoms.

Never borrow or share medication.

For more information, please contact:

Division of Aging and Seniors
Public Health Agency of Canada
Address Locator 1908A1
Tunney's Pasture
Ottawa, Ontario K1A 1B4
Telephone: (613) 952-7606
Fax: (613) 957-7626
E-mail: seniors@phac-aspc.gc.ca
Internet: www.phac-aspc.gc.ca/seniors-aines

Supported by Federal Provincial Territorial Ministers Responsible for Seniors