Sleeping tablets in the UK: short-term use, risks and alternatives

Z-drugs such as zopiclone and zolpidem, and benzodiazepines such as temazepam, act on brain receptors to promote sleep. Some antihistamines sold over the counter cause drowsiness but lose effect and can cause next-day grogginess and confusion in older people. Certain antidepressants are sometimes used at low doses for sleep, usually when mood is also affected. Newer medicines that block orexin signalling are available for chronic insomnia in specific circumstances.

• Tolerance: the effect diminishes with regular use.

• Dependence and withdrawal, including rebound insomnia and anxiety.

• Next-day drowsiness, impaired concentration and driving risk.

• Falls and confusion, especially in older adults.

• Interactions with alcohol and other sedatives.

• Possible complex sleep behaviours such as sleepwalking with Z-drugs.

Melatonin is a hormone that regulates the sleep-wake cycle. In the UK it is prescription-only, with a licensed modified-release product for short-term treatment of insomnia in people aged 55 and over, and other formulations used for specific childhood neurodevelopmental sleep problems. Products sold online or as supplements elsewhere vary in strength and are not regulated in the same way here. Do not import or buy unregulated melatonin without advice.

Some sleeping medicines impair driving the next day. It is an offence to drive while impaired by any drug, and some medicines are covered by specific drug-driving limits, with a medical defence if taken as prescribed and not impaired. Avoid driving if you feel drowsy. Do not combine with alcohol. Store tablets safely, away from children.

If you have taken sleeping tablets regularly for weeks or months, do not stop suddenly. A prescriber can supervise gradual dose reduction, often over weeks to months, and may combine it with CBT for insomnia. Expect some temporary sleep disturbance. Withdrawal symptoms such as anxiety, tremor, sweating or seizures need medical attention. Support is available through GPs and addiction services.

CBT for insomnia, sleep scheduling, relaxation techniques, regular wake times, daylight exposure, daytime activity, limiting caffeine and alcohol and treating underlying conditions such as sleep apnoea, restless legs, pain, menopause symptoms or depression help sleep more durably. If you take medicines that disturb sleep, such as some stimulants, steroids or beta-blockers, ask your clinician about timing or alternatives.

Ask why a sleeping tablet is being suggested, how long you should take it and what the plan is for stopping. Ask about side effects, driving and alcohol, and whether there are alternatives that could be started alongside it, such as CBT for insomnia. Ask what to do if it does not help or if you feel unusually drowsy. If you already take other sedating medicines, mention them. If you are older or have breathing problems, ask specifically about falls and about the effect on breathing during sleep.