As with most prescription drugs, there are side effects associated with hypnotics. The term “hypnotics” refers to a wide range of psychoactive drugs that can induce sleep, alter brain function and affect mood and behavior. There are benzodiazepine hypnotics and non-benzodiazepine hypnotics. Benzodiazepines act as sedatives, muscle relaxants and anti-anxiety medication. Diazepam--also known by its brand name, Valium--is a type of benzodiazepine. Non-benzodiazepine hypnotics act in a similar manner, but are chemically different from benzodiazepine hypnotics. Zolpidem, sold under the brand name Ambien, is a type of non-benzodiazepine. Both benzodiazepine hypnotics and non-benzodiazepine hypnotics have the same potential side effects.
Drowsiness and Fatigue
Since hypnotics are often utilized to help induce sleep, it is not surprising that two of the most common side effects are drowsiness and fatigue. Alcohol consumption compounds this effect and should be avoided. Other depressant drugs should not be taken in conjunction with hypnotics since hypnotics already depress the central nervous system. The elderly should be especially cognizant of the increased risk of falling that accompanies hypnotics due to drowsiness and fatigue.
Allergies
Anaphylaxis is a possible side effect of hypnotics. Anaphylaxis is an allergic reaction so severe that it affects the body on a systemic level and can be life-threatening. The condition does not always occur after the first ingestion of hypnotic medication, sometimes not appearing until several exposures later. Symptoms include difficulty breathing, low blood pressure, hives, swelling and shock.
Sleep Apnea
Sleep apnea is a serious condition that causes an individual to stop breathing intermittently while sleeping. Untreated, sleep apnea can cause death. Benzodiazepine hypnotics can worsen the symptoms of sleep apnea, and many physicians will not prescribe hypnotics to their patients with sleep apnea. Non-benzodiazepine hypnotics can, however, be safe under certain conditions. In the June 2008 issue of Clinical Psychiatry News, Dr. Jan Leard-Hansson writes that non-benzodiazepine hypnotics do not exacerbate mild-to-moderate sleep apnea when prescribed according to accepted guidelines and properly monitored by a physician.
Physical Dependence and Tolerance
Hypnotics can be addictive, and long-term use followed by abrupt discontinuance can result in severe withdrawal symptoms. Another side effect of long-term use, generally four to six months, can result in hypnotic tolerance, or decreased effectiveness of the drugs. In his book “Clinical Manual for Treatment of Alcoholism and Addictions,” Dr. Avram H. Mack writes that patients prescribed hypnotics to treat anxiety may experience an increase in their anxiety symptoms after discontinuing the medication. They may also experience withdrawal symptoms similar to those of narcotics, highly addictive drugs.
Respiratory Distress
On rare occasions, hypnotics can cause respiratory distress. Normally this side effect is due to an undiagnosed or unreported underlying condition, such as bronchitis or chronic obstructive pulmonary disease. For this reason, physicians will not normally prescribe hypnotics to their patients with these disorders. Even in patients who do not present with a pre-existing respiratory condition, a physician may still order a sleep study and recommend deep breathing exercises and relaxation techniques. Respiratory distress can also occur in those patients who combine hypnotics with alcohol or opioids, drugs used to treat pain.
References
- MedlinePlus: Hypnotics
- “Clinical Psychiatry News”; Hypnotics and Sleep Apnea; Jan Leard-Hansson, M.D.; June 2008
- “Clinical Manual for Treatment of Alcoholism and Addictions”; Avram H. Mack, M.D.; February 2010
- “Meyler's Side Effects of Drugs: The International Encyclopedia of Adverse Drug Reactions and Interactions”; Jeffrey K. Aronson, D.Phil., MB.ChB., F.R.C.P; September 2006
