Prescription Sleep Aids and Stimulants

Most over-the-counter sleep aids are relatively mild and can be used effectively to treat temporary sleeping problems such as insomnia. However, when insomnia is persistent and results in sleepiness during the day that disrupts your ability to perform at work or stay awake in class, it may be necessary to obtain a doctor s prescription for a more potent sleep aid. Prescription sleep aids are often referred to as hypnotics and they decrease the time it takes to fall asleep and keep you asleep longer. 

There are also some cases when a doctor s prescription is needed to obtain a stimulant in order to keep the person awake. Such cases include people with narcolepsy, who are extremely sleepy much of the day, and people who have jobs that require prolonged periods of wakefulness, such as soldiers in the military, long-haul truck drivers, and people who work night shifts or rotating shift-work schedules. 

Barbiturate drugs like pentobarbital (Nembutal ), secobarbital (Seconal ), amobarbital (Amytal ), and phenobarbital are extremely potent sedatives that induce sleep, mostly non-REM sleep. However, barbiturates actually decrease the amount of REM sleep a person gets. Thus, if a person took a barbiturate as a sleep aid nightly for a week, the total amount of REM sleep would be significantly less than if he or she was not taking the drug. Then, when the person stopped taking the barbiturate, he or she would experience a severe REM 

In the 1960s and 1970s, scientists developed a newer class of drugs called benzodiazepines, which appeared to be safer and more effective sleep aids than barbiturates. One of the first benzodiazepines to be developed was diazepam (Valium), which is still commonly prescribed today for the treatment of anxiety. 

Like barbiturates, benzodiazepines reduce the activity of the nervous system. They do this by acting on the type-A GABA (or GABA ) receptor, which is the protein that the neurotransmitter GABA activates when it is secreted by one nerve cell onto another (refer back to Ghapter 1 for an overview of how nerve cells communicate). When this receptor binds GABA, nerve cells become less active. Thus, like GABA, benzodiazepines deactivate nerve cells. 

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Although most of this chapter has focused on prescription sleep aids, there are a few prescription medications available to help you stay awake. The most commonly used OTC stimulant is caffeine. However, people with the sleep disorder narcolepsy are very sleepy during the day (no matter how much sleep they get) and often require prescription stimulants to alleviate their sleepiness. Stimulants are also prescribed for the treatment of attention deficit/hyperactivity disorder (ADHD, sometimes called ADD), asthma, and obesity. 

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