Sleeping medication
Prescription sleeping medication is not suitable for everyone and is usually only prescribed for short periods. We look at sleeping medication uses and side effects, as well as at melatonin and over the counter sleep aids.
GPs don’t frequently prescribe sleeping medication for insomnia.
Z-drugs
Clinical guidelines say that you may be offered "Z-drugs" (including Zopiclone and Zolpidem) for short-term insomnia. These will only be prescribed up to a maximum of 4 weeks, and, for example, if:
- you have temporary insomnia due to severe stress, such as a bereavement, or after surgery
- you have temporary insomnia caused by a change in environment or circumstances, such as being in hospital.
Side effects of sleeping medication
Z-drugs aren’t suitable for everyone. Your doctor will give you advice on whether they are right for you.
Side effects of Z-drugs for insomnia can include:
- feeling tired or drowsy the next day. You should allow at least 8 hours before you drive or operate any machinery
- a dry mouth
- dizziness
- headaches
- having bad dreams
- feeling agitated.
They may interfere with your ability to perform some everyday tasks like driving.
For a full list of side effects, always check the patient information leaflet that comes with your medicine.
Clinical guidelines recommend that doctors don’t prescribe Z-drugs to older people where possible. If they are prescribed, a lower dose is recommended. This is because older people tend to be more sensitive to the side effects of sleeping tablets.
Read more about driving and Parkinson’s.
Other issues related to sleeping tablets
Sleeping tablets can cause other issues, including:
- dependence. Sleeping tablets, like Z-drugs, are usually only prescribed for a short time because there is a risk that people can become dependent on them. Being dependent on sleeping tablets means that you feel you need to keep taking them to get to sleep.
- withdrawal (rebound insomnia). This is when your insomnia briefly becomes worse when you stop taking sleeping tablets. If your body gets used to using sleeping tablets, you can develop "tolerance". This means you have to increase your dose to get the same effect. Eventually, sleeping tablets may no longer work. But if you try to stop taking the tablets, you can’t sleep because of rebound insomnia. You may then be taking sleeping pills just to avoid the effects of withdrawal. Although rebound insomnia is temporary, the effects may last long enough to convince you that you can’t sleep without medication.
- needing to come off your sleeping tablets gradually ("tapering off"). You may need support from your specialist or GP when coming off your sleeping tablets. They will help you come off your tablets gradually and discuss with you how long the tapering period will last. They should explain the benefits of coming off of sleeping tablets, but they shouldn’t pressurise you to stop. Never stop taking sleeping tablets suddenly without discussing it with your health professionals first.
Melatonin
Melatonin is a hormone that helps control your sleep cycle and promotes sleep when it gets dark outside. Hormones are chemicals in your body that influence your cells or organs to do certain things.
Your body makes its own melatonin, but you can also take an artificial form of it to help with getting to sleep. This artificial melatonin is a prescription-only medicine taken as a pill that you swallow.
Some researchers think that some Parkinson’s drugs may decrease the amount of melatonin that your body naturally produces.
Further research is required to learn more about the full potential benefits of melatonin on sleep problems for people with Parkinson’s. Other research says that melatonin may help with the movement (motor) symptoms of Parkinson’s. More research is needed in this area. It's always best to speak to your specialist or nurse if you have any questions about treatments.
Melatonin doesn’t cause side effects in most people. However, it can cause:
- dizziness
- headaches
- feeling sleepy the next day.
Melatonin can be prescribed for up to 13 weeks.
Clinical guidelines say melatonin may be prescribed for REM sleep behaviour disorder. It’s not yet fully understood how melatonin helps reduce REM sleep behaviour disorder symptoms.
Sleep aids from a pharmacy
Sleep aids from your local pharmacy may help your sleep. They should only be taken for 1 to 2 weeks. Clinical guidelines don’t recommend over-the-counter sleep aids for insomnia.
Some sleep aids contain plants like lavender or valerian. Others contain antihistamines, which are medicines that can help you feel sleepy.
Antihistamines are often not recommended for people with Parkinson’s. This is because some antihistamines can make your Parkinson’s drugs work less well, or have side effects which could make your movement (motor) symptoms worse. This could include stiffness (rigidity) and involuntary movements (dyskinesia).
Speak to your pharmacist or doctor before you start taking sleep aids.
As sleep aids can make you feel sleepy, they can affect whether you can drive or ride a bike.
Over-the-counter sleep aids are not the same as prescription sleeping pills, which have to be prescribed by your doctor.
Driving and medication that makes you drowsy
It is illegal to drive if your ability to drive is impacted by any medication that you’re taking. This includes both prescribed drugs and medication bought over the counter, such as at a pharmacy.
Talk to your doctor if you are:
- not sure whether it’s safe for you to drive
- taking any medication that causes drowsiness or tiredness
- worried about driving and Parkinson’s.
The UK government website has more about the law on medication and driving.
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