Key takeaways:

  • As well as addiction, sleeping pills also pose several health-related risks, some of which can be life-threatening
  • Common signs of sleeping pill abuse include: unsteady footing or walking, unexplained euphoria, appearing delirious, daytime drowsiness
  • Alcohol is a central nervous system depressant that reacts to the sedative-hypnotic properties of z drugs which lead to respiratory depression, starving the brain of oxygen, and decreased heart rate, all of which can cause death

The CDC estimates that about 4-5% of the US population uses sleep aids to help overcome insomnia, which may include either prescription medications or over-the-counter sleep aids. A small number of these individuals will abuse these medications to enhance their effects or achieve a more relaxed state. The signs of sleeping pill abuse can be difficult to detect and may be confused with normal side effects.

Warning signs of sleeping pill misuse

Sleeping pills or z drugs are used widely throughout the US to help those suffering from insomnia and other sleep-related conditions.[1][2][3] While most people are able to take sleeping pills to help regulate sleep without developing a problem, the drugs hold a high potential for dependence, and addiction if abused, and many are controlled substances.[2][3] This is why prescriptions for sleeping pills are typically short-term, as opposed to being prescribed as a long-term solution for insomnia.

As well as addiction, sleeping pills also pose several health-related risks, some of which can be life-threatening. These risks are heightened if someone is abusing sleeping pills with CNS depressants such as alcohol or opioid painkillers. Spotting the signs of sleeping pill abuse and addiction early can be critical to getting treatment and saving the lives of those misusing the medication. 

Misuse of a prescription drug involves any of the following:

  • Using higher doses than prescribed
  • Using prescription drugs without a valid prescription
  • Using for ‘off-label’ reasons (i.e. to relax)
  • Taking other drugs to enhance the effects
  • Using more often than prescribed

Common signs of sleeping pill abuse

  • Short-term memory issues
  • Lack of concentration
  • Slurred speech or appearing intoxicated
  • Lack of focus or poor thinking skills
  • Dark circles, tired eyes
  • Unsteady footing or walking
  • Unexplained euphoria 
  • Appearing delirious 
  • Daytime drowsiness
  • Sleeping through alarms, often being late
  • Running out of prescriptions early
  • Doctor shopping[2][3][4]


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Get help during Covid-19

At Recovered, we recognize the impact COVID-19 has had and the continued challenges it poses to getting advice and treatment for substance use disorders. SAMHSA has a wealth of information and resources to assist providers, individuals, communities, and states during this difficult time and is ready to help in any way possible.

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The risks of sleeping pill abuse

The risks associated with sleeping pills, even when taken at standard doses, are widely known, and most exercise extreme caution when using them. Taking more than the recommended dose of sleeping pills can cause a range of life-threatening side effects including depressed breathing, coma, and seizures. They can also cause allergic reactions such as nausea, swelling, and chest pain so always consult a doctor fully before taking z drugs if you have allergies. 

There is also the risk of overdosing from taking too many sleeping aids. This risk is greatly increased when taking the drugs alongside other drugs such as alcohol. Alcohol is a central nervous system depressant that reacts to the sedative-hypnotic properties of z drugs which lead to respiratory depression, starving the brain of oxygen, and decreased heart rate, all of which can cause death.

Other dangerous side-effects of sleeping pill abuse

  • Dizziness
  • Dry mouth
  • Difficulty with coordination
  • Daytime drowsiness
  • Unusual dreams
  • Itching and swelling
  • Depressed breathing rate
  • Confusion
  • Memory problems
  • Balance issues
  • Parasomnia activities (driving, walking, eating, etc. while sleeping.)
  • Withdrawal symptoms when not taking z drugs

Those who take sleeping pills over a long period of time or abuse them in high doses are at risk of developing exacerbated side effects such as depression, high blood pressure, and irregular heartbeat or palpitations.

How to spot a sleeping pill addiction

Sleeping aids are generally only prescribed for short periods of time owing to their high potential for abuse and addiction. Some patients may start abusing pills innocently enough, taking an extra pill here and there or getting another prescription before their current one runs out. They may not realize that the brain develops a tolerance to sleeping pills rapidly and the extra pill here and there can cause them to become physically dependent on the drug to sleep or feel normal. 

According to reports, around 30% of people who use sleeping pills will develop an addiction. [3] Not everyone who develops an addiction to sleeping pills will become physically addicted to their medication, but may instead develop other signs indicative of psychological dependence. Sedative use disorder (the official diagnosis for a sleeping pill addiction) is diagnosed using a standardized set of symptoms from the DSM 5.[5]

Signs of sleeping pill addiction (sedative use disorder, 2 or more of the following)

  1. Urges or cravings to use the substance
  2. Having a desire to stop or limit use of the substance without being able to quit or reduce use
  3. Extending use or increasing the amount past what it is meant to be
  4. Using the substance even when it compromises safety
  5. Continuing to use the substance even though it’s causing relationship problems
  6. Neglecting other parts of life such as work or school due to substance use
  7. Spending a lengthy amount of time obtaining, using, or recovering from the substance
  8. Neglecting social, recreational, or occupational activities or opportunities due to the substance
  9. Tolerance or needing more of the drug to get the desired effects
  10. Withdrawal (uncomfortable physical or psychological effects when cutting back or stopping)
  11. Using the substance despite having a condition that may have been caused or worsened by it

Getting help for sleeping pill addiction

Sleeping pill addiction can be difficult to overcome alone and can lead to further substance abuse and potentially life-threatening overdose. If you or someone you know has a problem with sleeping pill use, then getting help is vital. While you cannot force a person to get treatment, letting them know you are concerned about them and offering to help them find and attend an appointment is a good first step. With treatment, it is often possible to overcome a sleeping pill addiction.