Sleeplessness is a problem that affects your whole life. If you suffer from insomnia or a sleep disorder, it can affect your health, cognitive ability, and hurt your performance in work and in school. Sleep disorders are a common problem in the U.S. with 40 million people suffering from long-term sleep issues like insomnia that stop them from getting restful sleep each night. Another common disorder that can affect your ability to sleep soundly is anxiety. When your mind won’t shut off or when anxiety keeps you up at night, you may understandably seek whatever relief you can find.
For centuries, humanity has looked for ways to help people go to sleep and sleep through the night. Every culture is rife with home remedies that are said to promote relaxation and sedation from a glass of warm milk to sleepytime tea. However, in the 19th and 20th centuries, scientists looked to psychoactive substances to affect the chemical activities in the brain that cause anxiety and sleeplessness.
SLEEP AIDS AND THEIR HISTORY
One of the first psychoactive sedatives synthesized was barbituric acid, which was first conceived in 1864. It would be a precursor to the prescription barbiturates that became popular in the 20th century. Barbiturates are central nervous system depressants that quite literally calm your nerves and promote sleep, relaxation, and anti-anxiety. However, they are quite powerful; they can cause intoxication and they are known for their potential for addiction.
In the 1950s, the negative side effects of barbiturates began to be noticed by the public. They caused nausea, depression, and adverse behavioral effects. In some cases, barbiturates can cause paradoxical effects (effects that are the opposite of the intended use) like aggression, violence, and irritability.
By 1955, another CNS depressant was synthesized called benzodiazepines and its popularity began to grow. In the 60s and 70s, controversial ad campaigns targeting mothers and homemakers touted the benefits of prescription pills that promoted relaxation. The ads were criticized for selling medication to otherwise healthy women. By the late 70s, benzodiazepines were the most popular prescription drug in the world.
Unfortunately, they have some of the same adverse effects as barbiturates including their addiction liability and potential for paradoxical reactions. Still, due to their popularity and perceived safety advantage over barbiturates, they all but completely replaced their predecessor. Today benzos are still widely used while barbiturates are fairly rare in the U.S.
As the adverse effects of benzodiazepines are becoming more of a concern, non-benzodiazepine alternatives have been explored. On such sleep-aid is a class of CNS depressants called z-drugs, which includes brands like Sonata and Lunesta. Z-drugs have effects that are milder than benzos and barbiturates but they work in a similar way. However, they may not be as safe an alternative as doctors and patients would hope.
WHAT ARE Z-DRUGS?
Z-drugs are a central nervous system depressant separate from the benzodiazepine class of drugs. They get their name from the fact that most of the substances in the class start with or include the letter “Z”. Though they are chemically different from benzos and barbiturates, the offer some of the same uses. Typically, they are used to treat insomnia, though some can be used for other purposes like Ambien can be used as a muscle relaxant (though it has not been approved for such treatments).
However, they also share some of the same side effects as other CNS depressants like drowsiness, dizziness, dry mouth, diarrhea, and depression. They have also shown to be more dangerous in older people. As a person ages, they lose their ability to efficiently process Z-drugs and other CNS depressants. As a result, adverse effects are more pronounced in older people. Plus, because falls can be more dangerous in geriatric patients, the dizziness and drowsiness that comes with Z-drugs should be avoided.
HOW DO Z-DRUGS WORK?
Z-drugs work by agonizing GABA receptors in the brain, the same receptors that are affected by benzodiazepines. When bound to the GABA receptor, they increase the efficiency of the GABA neurotransmitters, which is responsible for regulating sedation, relaxation, and calming you down. After long-term use, the nervous system suppressing effects can cause you to grow tolerant, as your brain produces excitatory neurons to balance your brain chemistry.
CAN Z-DRUGS CAUSE DEPENDENCE?
Though Z-drugs are thought to be safer alternatives to other sleep-aids, studies show a link among tolerance, dependence, and addiction. Long-term use of Z-drugs like zolpidem (Ambien) can cause you to build up a tolerance to the drug. As your brain gets used the presence of the sleep aid, it can come to rely on it to maintain a balanced brain chemistry and even work to counteract some of their effects. As tolerance grows, you will need higher doses to achieve the same effects.
Z-drugs, like benzos, can actually make insomnia worse after long-term use. As your tolerance grows, your brain can release excitatory neurons in an attempt to balance you out. After a while, you will depend on the drug to achieve restful sleep and quitting might result in worse insomnia than before.
However, this is just drug dependence, a problem in the neurochemical communication network in your body. Typically, detox can help you return to normal after developing drug tolerance and dependence. Addiction is another story.
Addiction occurs when you can’t stop using a chemical substance despite clear consequences. If Z-drug use starts to negatively affect your work, school, family life, or health, it may be the result of addiction. Unfortunately, Z-drugs seem to have a significant risk for dependence. Both benzodiazepines and similar drugs like Z-Drugs have shown to cause both physical and psychological dependence after high doses or long-term use.
An overdose on Z-drugs is typically not fatal on its own but it can cause severe sedation and slowed breathing, which can be medically dangerous. If you become dependent, suddenly quitting can cause dangerous symptoms like seizures and delirium.
SEEKING ADDICTION HELP
If you or a loved one has been using a Z-drug or another sleep aid, it’s important to monitor for dependency and addiction. If you do feel like you’ve become dependent on a CNS depressant, call the addiction specialists at Maryland House Detox at (855) 928-0596 to learn more about your options. Detox is an essential first step in recovering from depressant addiction, because of how dangerous withdrawal can be from these particular drugs. However, the first step in your journey to freedom from active addiction may be a call away.