Health
Sleeping pills: Pharmacists warn against frequent use
Iyanuoluwa Abiola
Pharmacists have warned that night-shift workers who regularly use sleeping pills to force themselves to sleep during the day are at risk of drug dependence and addiction, impaired concentration, and reduced alertness when they return to work.
The experts cautioned that repeated use of the medicines could lead to tolerance and dependence, while some preparations could leave users groggy after waking, potentially affecting their ability to function safely at work.
They also warned against taking sleeping pills with alcohol or other medicines that depress the central nervous system, urging people who struggle to sleep after night shifts to seek professional guidance rather than routinely relying on medication.
The World Health Organisation notes that tolerance and dependence on sedatives and sleeping pills can develop after a short period of use, while the medicines can also cause drowsiness, dizziness, confusion and difficulty concentrating. It warns that combining some sedatives and sleeping pills with alcohol, opioids or other depressant drugs can markedly increase the risk of overdose and death.
In Nigeria, the National Drug Use Survey estimated that 481,000 people aged 15 to 64 used tranquilizers or sedatives in 2017, representing 0.5 per cent of the population in that age group.
Also, a Nigerian mental health survey involving 6,752 adults in 21 states found that 11.8 per cent had experienced insomnia in the previous 12 months.
In an exclusive interview with PUNCH Healthwise, the Superintendent Pharmacist at Engraced Pharmacy, Idimu, Lagos State, Jonah Okotie, said regular use of sleeping pills could lead to dependence, addiction and reduced cognition.
“It will lead to dependence, addiction, loss or reduction in cognition, making them prone to accidents at work amongst other things,” he said.
Okotie stated that repeated use of the medicines could also increase the risk of tolerance and dependence.
“Yes, it really does!” he said.
He cautioned night-shift workers against relying on sleeping pills to force themselves to sleep after returning home during the day, noting that such use could have consequences for their health and ability to function.
“They are harming themselves. So, if you have to force it, it means your body cannot handle it,” he said.
The pharmacist added that the effects could extend beyond the individual worker if the person resumed duty while still affected by the medicine.
“Yes, it does. Not only theirs, but also their colleagues and the entire organisation with them. Not considering the long-term effects on their health and capabilities in the long run,” he stated.
Okotie also raised concerns about people obtaining sleeping medicines without appropriate medical supervision, particularly prescription medicines.
“This is nothing other than drug abuse and misuse,” he said.
He explained that some sleeping medicines were controlled medicines that required proper medical assessment and prescription, expressing concern about how some people obtained them outside regulated channels.
“There are too many illegal outlets where these medications are accessed, from hawkers under the table of some persons, to motor parks, Mallams or persons who claim to be working in government health facilities and by doing so, become automatic healthcare professionals,” he stated.
According to him, stronger enforcement, monitoring and proper record-keeping were needed to control access to such medicines.
He also cautioned against combining sleeping pills with alcohol or other medicines that depress the central nervous system.
“Taking alcohol, which is a brain activity inhibitor, as well as other medicines in that category, is tantamount to depressing the brain more and for a longer period, besides the attendant risks involved,” Okotie said.
The pharmacist identified behavioural changes as possible signs of dependence and advised people who could no longer sleep without medication to seek professional help.
“Signs of dependence and addiction, including behavioural changes that point to such,” he said.
Okotie urged people struggling with dependence to involve family members, friends and other people who could support them in seeking treatment.
“Seek medical attention. And to do this, it involves everyone: family, friends, the organisation he’s been working for and all. It takes a community to raise a man. Left to himself, he may not do anything,” he said.
For night-shift workers who need to sleep during the day, Okotie advised creating conditions that would allow the body to rest naturally rather than relying routinely on sleeping medicines.
He urged workers to avoid activities that could keep the mind alert when they should be preparing to sleep.
“As much as possible, that is not the time to pick up responsibilities, going through their phones and all. It takes one thing to keep the mind alert. They need to be in a shutdown mode like it’s night,” he said.
He also advised night workers to avoid stimulant-containing beverages such as coffee, kolanut, other caffeine-containing products and energy drinks when preparing for daytime sleep.
Okotie stressed that sleeping medicines were not all the same, noting that their risks depended on the specific medicine and its category.
“They are definitely not the same. The risks truly differ depending on not just the type (category) of medicine, but the medicine itself,” he said.
Also speaking with PUNCH Healthwise, the Co-founder and Chief Executive Officer of Welnex Pharmacy, Lagos State, Chioma Omattah, said using sleeping medicines could disrupt the body’s natural sleep pattern, particularly among night-shift workers who remain awake during the period when the body is biologically prepared for sleep.
She explained that night workers already had to adjust their normal sleep-wake pattern because of their work schedules, and using medicines to induce daytime sleep could further interfere with the body’s natural processes.
“Taking those pills, onnaturally distorts the body’s natural routine,” Omattah said.
She noted that sleeping medicines differed in their effects, with some being habit-forming and others having lower risks of dependence.
“We have the habit-forming, that is the one that one can become addicted to, and the non-habit-forming,” she said.
Omattah said some habit-forming sleeping medicines could leave users groggy after waking, potentially affecting their alertness and concentration when they resumed work.
“For those that are habit-forming, the ones that can predispose them to becoming dependent, most times they tend to have that grogginess. The aftereffect of grogginess. Once the person wakes up, the person is still a bit fuzzy; the brain is not clear; the person is groggy,” she said.
She added, “It can actually affect the person’s alertness; it can affect their concentration, their ability to function.”
The pharmacist stressed that sleeping medicines, whether prescription-only or available over the counter, should be used under professional guidance, particularly when a person is taking other medicines.
“It’s very important that these medications are used under the strict supervision of your pharmacist or your physician,” Omattah said.
She explained that healthcare professionals could guide users on appropriate dosage, possible interactions, and how long the effects of a medicine could last.
Omattah also warned against combining sleeping medicines with alcohol, noting that both could depress functions such as breathing and heart rate.
“It might lead to an over-depression of the respiratory rate and the heart rate, which might not make the person able to wake up,” she said.
She advised people not to assume that all sleeping medicines carried the same risks, urging them to consult qualified healthcare professionals before using them.
The pharmacist identified inability to sleep without the medicine as one of the common signs of dependence.
“One of the most common signs you can point out is that he or she is unable to achieve sleep without taking that medication. So what it means is that the person is now dependent on it,” she said.
Omattah advised people who had become dependent on sleeping medicines to seek help from qualified professionals rather than attempting to stop or manage the medication themselves.
She said treatment could involve psychological support and, depending on the medicine involved, a gradual reduction in dosage under professional supervision.
“It can be handled by a therapist, it can also be handled by a qualified and experienced clinical pharmacist, as well as your physician,” she said.
For night-shift workers struggling to sleep during the day, Omattah recommended creating a dark, quiet and comfortable sleeping environment.
“The room has to be set at the right ambience to achieve sleep. You know, your black curtains, your soft lights, the bed has to be relaxing enough for the body to ease off and then fall asleep,” she said.
She also advised workers to reduce screen exposure before bedtime and make their sleeping environment conducive to rest.
“Then we also encourage reduced use of screen time, either your television or your phone, when the person is about to fall asleep,” she said.
Omattah maintained that the risks associated with sleeping medicines depended on their class and specific formulation.
“Not all sleep pills are the same. We have the habit forming and we have the non-habit forming. Yes, the risk differs depending on the type of medication, depending on the class of the medication that the individual is making use of,” she said.
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