The Dangers of Mixing Sleeping Pills and Alcohol

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Sleeping pills are medications that encompass a wide array of over-the-counter (OTC) or prescription drugs used to help individuals who have difficulty falling or staying asleep throughout the night. These include benzodiazepines, hypnotics, antihistamines, and some antidepressants. Unfortunately, many people with insomnia take sleeping pills and also self-medicate by misusing alcohol for its sedating effects. Unfortunately, alcohol can amplify the side effects of sleep medications, reduce their effectiveness, and even have life-threatening or lethal consequences in severe cases.

If you are struggling with a sleep disorder and alcohol dependence, you are urged to seek professional help. Guardian Recovery features comprehensive treatment programs tailored to address each individual’s unique needs, overall health, and psychological well-being. Our treatment team will design an individualized recovery plan, including integrated therapies that focus on alcohol misuse and sleep disturbances and address them simultaneously. When you’re ready to begin your recovery journey, call us to learn more about your treatment options.

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Sleeping Aid Use

If you have sleep difficulties and take sleep aids regularly, you are not, by any means, alone. According to the Centers for Disease Control and Prevention (CDC), up to 70 million Americans (21% of the population) suffer from chronic sleep disturbances. (1) Many affected individuals turn to OTC or prescription sleep aids to help with their issues. For example, approximately 4% of U.S. adults aged 20 and over report taking prescription sleep aids in the past 30 days. (2) Also, according to a Consumer Reports survey, of the 20% who took an OTC medication in the past year to improve sleep,18% said they did so on a daily basis. Researchers believe that even sleep aids as seemingly benevolent as diphenhydramine can be habit-forming. (3)

Common OTC Sleep Aids Include:

  • Diphenhydramine (DPH), such as Benadryl, Tylenol PM, and generic brands.
  • Doxylamine succinate, such as Unisom and generic brands.
  • Valerian root.
  • Melatonin.

Common Types of Prescription Sleep Aids Include:

  • Benzodiazepines, such as Halcion or Restoril.
  • Hypnotics, such as Ambien, Lunesta, and Sonata.
  • Antipsychotics, such as Seroquel.
  • Antidepressants, such as Remeron and Desyrel.

Commonly Misused Sleep Medications Include:

  • Ambien (zolpidem).
  • Dalmane (flurazepam).
  • Desyrel (trazodone).
  • Halcion (triazolam).
  • Lunesta (eszopiclone).
  • Restoril (temazepam).
  • Rozerem (ramelteon).
  • Silenor (doxepin).
  • Sonata (zaleplon).

Although the above medications work in various ways, their primary effect, sedation, always has the potential to interact with alcohol adversely.

Risks of Combining Alcohol & Sleeping Pills

Chronic alcohol use has been associated with sleep complaints in many individuals. (4) So, those suffering from an alcohol use disorder may be more likely than others to entertain the use of sleep aids to offset this problem.

When used independently, excessive amounts of OTC or prescription sleep aids may lead to profound sedation and other severe health risks, but overdoses are rarely fatal. This is not true when these drugs are used with alcohol, however, which can lead to central nervous system (CNS) depression, respiratory arrest, cardiovascular complications, alcohol poisoning, coma, or death.

Sleep aids and alcohol both cause CNS depression due to their interactions with brain chemicals, such as GABA, responsible for feelings of relaxation, well-being, and reward. For this reason, concurrent use could exponentially intensify effects and lead to respiratory depression and arrest. This may be especially true for anti-anxiety medication, as there is a high rate of alcohol involvement in ER visits and deaths related to benzodiazepine misuse. (5)

The risk of death due to being cognitively and physically impaired when drinking and taking sleep aids is also significant. Driving or engaging in activities that require attention and motor skill coordination must be avoided, or catastrophic consequences, including severe injury or death, can occur to oneself or others. Even everyday activities, such as navigating stairs, can be dangerous for those experiencing extreme intoxication.

Being under the influence of alcohol and sleep aids can also increase the risk of participating in compulsive or risky activities, such as unsafe sex or daredevil-type stunts. Likewise, it can contribute to sexual assaults, fights, and other instances of criminal behavior.

Finally, combining sleep aids with alcohol also increases the risk of developing a drug or alcohol use disorder over the long term.

Zolpidem & Alcohol Have Unique Risks

Occasionally, alcohol combined with certain sleep aids, namely Ambien (zolpidem), has been related to strange and erratic behavior unique to this type of drug. It’s been suggested that these sedatives can cause a state of partial arousal. To explain, those under its influence may be partially awakened by outside stimulus but cannot fully awaken due to the sedation. A common consequence of this phenomenon is somnambulism, aka sleepwalking. Other possibilities include sleep-driving, sleep-eating, and sleeping while using social media. (6)

Somnambulists, or sleepwalkers, engage in sometimes complex physical tasks while remaining in a sleep- or trance-like state. Ambien side effects like sleepwalking can be hazardous to the sleepwalker and others. Cases have been reported of individuals cooking, driving, causing accidents, stealing, and even committing homicides while sleepwalking. (7)

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Adverse Effects of OTC Sleep Aids & Alcohol Misuse

OTC medications are often the first-line remedy for those seeking reprieve from sleeping problems. These medications are relatively expensive and easily obtainable without waiting for an office visit or a prescription to be filled. They can also be purchased at many of the same retail stores as alcohol, such as pharmacies and grocery outlets.

A high percentage of persons diagnosed with alcohol use disorder report having sleeping difficulties. (8) Moreover, for a regular drinker, the convenience and ease of accessing an instant “cocktail” for sleep might be incredibly tempting, with little regard given to possible unwanted effects or safety. However, the irony is that drinking is not known to improve sleep and can actually cause short- and long-term reductions in sleep quality. It can also interrupt REM, a deep and critical stage of sleep that promotes healing in the brain and body. (9)

The following includes the most common OTC sleep aids and how they may interact with alcohol:

Diphenhydramine

Diphenhydramine (Benadryl, Tylenol PM), or DPH, is an antihistamine used for various medical purposes, including allergy relief, motion sickness, and to produce drowsiness. An investigation of twelve male subjects examined the effects on their performance after using DPH, alcohol, and the two together. Individuals who took either DPH or alcohol were slower at processing information and tracking objects. However, researchers noted that when the men used both substances, their performance impairments had “an additive effect under the combined drug-alcohol treatment.” This experiment suggests both DPH and alcohol effects were amplified and more significant than either substance used alone. (11)

Doxylamine Succinate

Doxylamine Succinate, or DOX, like DPH, is an antihistamine sometimes used for its sedating effects. According to Drugs.com, alcohol may “potentiate some of the pharmacologic effects” of DOX and other depressive agents, and combining them “may result in additive CNS depression and impairment of judgment, thinking, and psychomotor skills.” (12)

Valerian Root & Alcohol

Valerian root is an herbal supplement commonly used as a sleep aid or to reduce anxiety. Combining alcohol with valerian can increase side effects such as drowsiness, dizziness, confusion, and poor concentration. (13) Moreover, drinking while using valerian root has been associated with an increased risk of mild-moderate liver damage in rare cases. (14)

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Professional Help Is Available for Alcohol Dependence & Insomnia

If you’ve tried to quit drinking to improve your sleep or other health issues, or overcome an alcohol use disorder, contact Guardian Recovery Center today. Through our evidence-based programs, we can also address other substance use disorders, such as dependence on sleeping pills or other prescription drugs.

When you reach out, you will be connected with a skilled Treatment Advisor and be provided a free, no-obligation assessment and health benefits check. We’ll explain your various treatment options and help you determine which level of care might be right for your circumstances. We are dedicated to providing our clients with the tools and support they need to sustain long-lasting sobriety and wellness. We can help you restore sanity to your life and experience the happiness you deserve.

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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

(1)https://www.cdc.gov/nchs/data/databriefs/db127.pdf (2)https://www.cdc.gov/nchs/products/databriefs/db127.htm (3)https://www.consumerreports.org/drugs/over-the-counter-sleep-aids-can-you-get-hooked/ (4)https://neuro.psychiatryonline.org/doi/10.1176/appi.neuropsych.16110307 (5) https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6340a1.htm (6)https://www.drugdangers.com/ambien/ (7)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505131/ (8)https://store.samhsa.gov/sites/default/files/d7/priv/sma14-4859.pdf (9)https://www.sleepfoundation.org/nutrition/alcohol-and-sleep (10)https://pubmed.ncbi.nlm.nih.gov/32457492/ (11) https://pubmed.ncbi.nlm.nih.gov/6995128/ (12)https://www.drugs.com/search.php?searchterm=DOXYLAMINE&sources%5B%5D= (13)https://www.drugs.com/interactions-check.php?drug_list=1034-0,2284-0 (14)https://www.ncbi.nlm.nih.gov/books/NBK548255/

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Reviewed professionally for accuracy by:

Ryan Soave

L.M.H.C.

Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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