Sleeping Pills and Side Effects: What You Need to Know
- James Smurthwaite
- 1 day ago
- 6 min read
Getting a good night's sleep is vital for both mental and physical health, yet millions of adults in the UK find themselves tossing and turning. Whether it's due to stress, health conditions, or irregular sleep routines, chronic insomnia affects about one in three people, according to the NHS. As a result, many turn to sleeping aids, both prescription and over the counter, in the hope of reclaiming restorative sleep.
But how safe are these sleep aids? Are they suitable for long-term use? What are the alternatives?
This in-depth guide examines the types of sleeping pills available in the UK, their benefits, side effects, and safer non-drug options that could help improve sleep quality over the long term.
What Are Sleeping Pills?
Sleeping pills (or hypnotics) are medications used to help people fall asleep faster or stay asleep through the night. These drugs work by influencing neurotransmitters in the brain that control the sleep wake cycle. They may be prescribed by a doctor or purchased over the counter depending on the type, strength, and intended use.
In the UK, sleeping pills fall into two main categories:
Prescription sleep medications
Over the counter sleep aids
Both types can provide temporary relief from insomnia, but they also carry risks, particularly when misused or taken for prolonged periods.
Types of Prescription Sleeping Pills in the UK
Doctors may prescribe sleep medications for short-term insomnia or sleep disorders that don't respond to lifestyle changes. Common types include:
Benzodiazepines
Examples: Temazepam, Diazepam
Originally developed for anxiety, benzodiazepines are sometimes prescribed for insomnia due to their sedative effects. However, they carry a high risk of dependence and are not recommended for long-term use.
Z Drugs
Examples: Zopiclone, Zolpidem
Z drugs are among the most commonly prescribed sleeping pills in the UK. They act on the same receptors as benzodiazepines but are typically marketed as having fewer side effects. Nevertheless, they can still lead to dependency, withdrawal symptoms, and unusual behaviours like sleepwalking.
Melatonin-Based Drugs
Example: Circadin
Circadin is a prolonged-release melatonin prescribed mainly for people over 55 with persistent insomnia. It mimics the natural hormone melatonin to help regulate circadian rhythms.
Sedating Antidepressants
Examples: Trazodone, Amitriptyline (off-label use)
Although primarily used for depression, some antidepressants have sedative effects and are prescribed off-label for insomnia. They are usually considered when insomnia is linked to underlying mental health issues.
Over-the-Counter Sleeping Aids in the UK
For those who prefer not to use prescription medication, several over-the-counter sleeping pills options are available. These typically include:
Antihistamines
Examples: Diphenhydramine, Promethazine
Sold under brands like Nytol, these older antihistamines cause drowsiness as a side effect and are available without a prescription. They can be effective short term but often cause grogginess the next day.
Herbal Sleeping Tablets
Ingredients: Valerian root, passionflower, hops, lavender
Products such as Kalms Night or Nytol Herbal contain plant-based ingredients with mild sedative properties. While they are generally well tolerated, the evidence for their effectiveness is mixed.
Melatonin Supplements
Melatonin is not freely available over the counter in the UK in its pure form, but low-dose versions are sometimes included in multivitamin sleep supplements purchased online. These should be used with caution and ideally under medical supervision.
To explore these in more detail, see our dedicated guides on herbal sleeping pills UK and melatonin vs magnesium.
Side Effects of Sleeping Pills
Although sleeping pills can help reset the sleep cycle, they often come with unwanted side effects. Commonly reported symptoms include:
Daytime drowsiness
Headaches
Nausea or digestive issues
Dizziness and balance problems
Memory lapses or "brain fog"
A metallic taste in the mouth (particularly with zopiclone)
Z drugs have been linked to parasomnias such as sleepwalking, sleep eating, or even sleep driving, activities carried out with no memory the next day. Such side effects can be dangerous and are a red flag for stopping the medication under guidance.
More Serious Risks and Long-Term Concerns
The longer sleeping pills are used, the greater the risk of:
1. Dependence and Withdrawal
The body can develop a tolerance, requiring higher doses for the same effect. Once dependent, stopping abruptly can cause rebound insomnia, anxiety, irritability, and in severe cases, seizures.
2. Cognitive Impairment and Dementia Risk
Some long-term studies suggest a link between prolonged benzodiazepine use and an increased risk of memory decline and dementia, particularly in older adults.
3. Respiratory Depression
Sleeping pills slow down breathing, which can be dangerous for individuals with respiratory issues or when combined with alcohol or opioids.
4. Accidents and Falls
In older adults, sedative medications significantly increase the risk of falls, fractures, and hospitalisation.
Read more on the NHS page about sedatives and hypnotics.
How Long Can Sleeping Pills Be Taken?
The NHS recommends using prescription sleep aids for no longer than four weeks. Continued use beyond this point often results in reduced effectiveness and greater side effect risks. If sleep problems persist, healthcare providers usually advise transitioning to Cognitive Behavioural Therapy for Insomnia (CBT I) or other non-drug strategies.
If OTC options are used, similar rules apply. Antihistamine-based products can cause tolerance within days, and prolonged use is discouraged.
Are Sleeping Pills Safe?
When used exactly as prescribed or directed, sleeping pills can be safe in the short term. But this does not mean they are risk-free. Certain groups, including the elderly, people with respiratory conditions, and those with a history of substance misuse, must exercise extra caution.
Always speak with a GP before starting or stopping any sleep medication. Self medication, especially through online purchases, can carry additional dangers due to dosage inconsistencies and poor regulation.
For a broader view on non-prescription products, see our guide to natural sleep aids UK.
Safer Alternatives to Sleeping Pills
If insomnia has become a chronic issue, the most sustainable solutions typically involve non-drug treatments.
Cognitive Behavioural Therapy for Insomnia (CBT I)
This NHS endorsed therapy focuses on changing unhelpful sleep beliefs and behaviours. It is often more effective than medication in the long term.
Sleep Hygiene Improvements
Simple lifestyle changes can go a long way:
Stick to a regular sleep schedule
Avoid caffeine and heavy meals late in the day
Keep the bedroom dark, quiet, and cool
Reduce screen time before bed
Relaxation and Stress Management
Mindfulness, deep breathing, progressive muscle relaxation, and gentle yoga have all been shown to support sleep.
Natural Supplements
Magnesium, valerian root, and glycine are often used to support relaxation. For more, see our breakdown on magnesium for sleep.
When to Speak to a GP
Contact a healthcare provider if:
Insomnia persists beyond four weeks
You feel dependent on sleep aids
You experience unusual side effects like sleepwalking or confusion
You have a history of respiratory or mental health issues
Your GP can assess underlying causes and recommend a tailored treatment plan, which may include alternative medications or a referral for CBT I.
Key Takeaway
Sleeping pills, both prescription and OTC, can offer short-term relief but are not a cure for chronic insomnia. They should be approached with caution and always under the guidance of a healthcare professional. Safer, more effective long-term strategies exist, particularly CBT I and lifestyle changes.
Sleeping Pill Side Effects Frequently Asked Questions (FAQ)
Are sleeping pills available over the counter in the UK?
Yes. Over the counter options include antihistamines like diphenhydramine (e.g. Nytol) and herbal products such as valerian-based tablets. These are intended for short term use and typically have milder effects than prescription sleep aids.
Do you need a prescription for melatonin in the UK?
Are sleeping pills addictive?
Can I take sleeping pills every night?
What is the safest sleeping pill?
There is no one-size-fits-all answer. Melatonin is generally considered safer for short term use in older adults. Herbal options are mild but may not be effective for severe insomnia. All options should be used with caution and ideally under medical supervision.
What are the side effects of sleeping pills?
How long do sleeping pills take to work?
Can I drink alcohol with sleeping pills?
Are herbal sleeping tablets effective?
When should I see a doctor about sleep problems?
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