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Treatments

WHAT IS IT?

Sedative-hypnotic drugs are prescribed to help you sleep. There are at least 40 different drugs classified as sedatives or hypnotics. These drugs vary by how they work (drug class), how quickly they work (onset of action), and how long they work (duration of action). They may help you fall asleep quickly, stay asleep, or both. They come as pills that are swallowed, oral sprays, and pills that dissolve under the tongue. They are thought of as one of the first lines of defense for treatment of insomnia.

OUR BOTTOM LINE, DOES IT HELP?

YES. For women bothered with insomnia these medications can help. Which drug is suggested depends upon the specific type of insomnia or sleep problem. For example: delayed sleep onset (can’t fall asleep); poor sleep maintenance (can’t stay asleep); and early morning awakening (wake up early and can’t go back to sleep). Choice may also be influenced by other drugs being taken to avoid drug interactions. Sleep experts often recommend that cognitive behavioral therapy for sleep is tried before turning to prescription medications. 

HELPS FOR THESE SYMPTOMS

common-insomnia

SLEEP PROBLEMS & INSOMNIA

Sedative/hypnotics do help improve sleep.

POTENTIAL RISKS & SIDE EFFECTS

Risks and side effect vary by the type of drug taken but some of the more comment side effects include:

  • Headache
  • Nausea
  • Short-term forgetfulness
  • Rebound insomnia (sleep problems return after the drug is stopped)
  • Dry mouth
  • Hallucinations
  • Dizziness
  • Drowsiness
  • Confusion
  • Dependence

It is usually recommended that you do not drink in combination with sedative/hypnotics.  These drugs are not considered a long-term solution for sleep problems. Some are recommended only for short-term use. Some need to be withdrawn gradually.

QUALITY OF LIFE EXPECTATIONS

We found no studies of sedative-hypnotics and quality of life related to menopause.

IF I WANT TO TRY THIS TREATMENT WHAT ARE MY NEXT STEPS?

Sleep experts recommend that cognitive behavioral therapy for sleep is tried before using sedative/hypnotics. CBTI works as well or better than these drugs, and continues to work. But CBTI takes time to learn and does not work for everyone. Sometimes sedative-hypnotics are combined with CBTI. If you want to use medication to help you sleep you should discuss it with your health care provider.

NOT USED FOR THESE SYMPTOMS

  • Hot flashes & night sweats
  • Mood, anxiety & depression
  • Heavy, irregular periods
  • Low sex drive
  • Painful sex
  • Vaginal pain not during sex
  • Dry eyes
  • Dry hair & skin
  • Brain fog, cognitive issues
  • Bladder control problems
  • Palpitations
  • Physical aches and pains
  • Weight gain
REFERENCES

Brewster GS, Riegel B, Gehrman PR. Insomnia in the Older Adult. Sleep Med Clin. 2018 Mar;13(1):13-19. doi: 10.1016/j.jsmc.2017.09.002. Epub 2017 Nov 22. PMID: 29412980; PMCID: PMC5847293.

Delamater L, Santoro N. Management of the Perimenopause. Clin Obstet Gynecol. 2018 Sep;61(3):419-432. doi: 10.1097/GRF.0000000000000389. PMID: 29952797; PMCID: PMC6082400.

Hassinger AB, Bletnisky N, Dudekula R, El-Solh AA. Selecting a pharmacotherapy regimen for patients with chronic insomnia. Expert Opin Pharmacother. 2020 Jun;21(9):1035-1043. doi: 10.1080/14656566.2020.1743265. Epub 2020 Mar 23. PMID: 32202451; PMCID: PMC7432988.

Rios P, Cardoso R, Morra D, Nincic V, Goodarzi Z, Farah B, Harricharan S, Morin CM, Leech J, Straus SE, Tricco AC. Comparative effectiveness and safety of pharmacological and non-pharmacological interventions for insomnia: an overview of reviews. Syst Rev. 2019 Nov 15;8(1):281. doi: 10.1186/s13643-019-1163-9. PMID: 31730011; PMCID: PMC6857325.

Last reviewed August, 2021

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