Could You Have a Sleeping Pill Addiction?

While sleep aids such as melatonin and prescription sleeping pills may be helpful if used once in a while, it's best not to rely on them too often, as frequent use can potentially lead to dependence or even sleeping pill addiction. Here are some signs that you may have a problem, or be developing a problem, with sleeping pills.

Approximately 4% of adults over age 20 have used prescription sleep medication at some point, according to survey data compiled by the Centers for Disease Control and Prevention (CDC).

This pill dependence is especially true with the older types of sleeping pills known as benzodiazepines. These drugs include Valium or Xanax and are also commonly prescribed for anxiety disorders. Newer sleeping pills like Ambien and Sonata often called "Z-drugs," seem to be less physically addictive, though they may foster psychological addiction, Steven Feinsilver, MD, director of the Center for Sleep Medicine at Lenox Hill Hospital in New York City, said.

Physical addiction–in which the body adapts to a drug and responds physiologically if you stop taking it–is rare with Z-drugs, said Tae Woo Park, MD, assistant professor of psychiatry at Boston University School of Medicine. But it can happen, as can psychological addiction, or when you think you can't sleep without meds.

Symptoms of Sleeping Pill Addiction or Dependence

Some people can take sleeping pills every night for years, which may or may not indicate an addiction. "The question becomes what's a treatment of a chronic condition versus what is abuse," said Gregory Carter, MD, PhD, associate professor of neurology at UT Southwestern Medical Center in Dallas, "and that is something that is arguable."

Here are five signs you may be addicted to prescription sleep medications:

You are steadily increasing your dosage. This is a classic sign of most addictions, according to the National Institute on Drug Abuse (NIDA). Over time, the amount of drug you've been prescribed stops working and you need more and more to get the same effect, or at least you think you do. A 2019 report in the British Journal of General Practice states that benzodiazepines are proven to be highly addictive. With the newer Z-drugs, dependence may be more psychological than physical: You find yourself thinking you'll need more to fall asleep, so you take more.

You've taken sleep aids for months or years and can't quit. Not being able to quit, despite trying, is another sign you may be addicted. Long-term use of sleeping pills at any dose isn't recommended.

You look for new doctors to write you a prescription. Whether for benzodiazepines or Z-drugs, "people do shop around," Dr. Feinsilver said.

You experience withdrawal symptoms. Taken in high enough amounts for long enough, sleeping pills, especially benzodiazepines, can lead to withdrawal symptoms. These are similar to alcohol withdrawal symptoms: You start to sweat, your blood pressure and heart rate go up, and you start to shake and get anxious, Dr. Park said.

You start blowing off social and professional obligations. "You start to have functional issues," said Dr. Park. "You ignore things that you normally like to do because you want to use drugs. This affects interpersonal relationships. You don't fulfill certain obligations like work or relationships or school. You spend more time using the substance than is typical. Those are all signs of addiction, whether it's to sleeping pills, alcohol, or heroin."

How to Get Help

If these symptoms sound familiar, there are ways to get help–and there are other ways to fall asleep, too. If you have a long-term habit of taking sleeping pills, don't stop on your own. Talk to your healthcare provider about how to taper off safely. This will minimize any withdrawal symptoms. Certain types of therapy can also help you sleep without meds.

Ideally, adults should get a minimum of seven hours a night, according to a 2015 report in the journal Sleep. People who sleep five hours or less are more prone to using sleep aids, per the CDC. Keeping a regular sleep schedule, exercising (though not right before bed), limiting screen time at night, and avoiding caffeine can all help you get more and better sleep, drug-free.

Don't worry if you get a lousy night's sleep every once in a while. "Many Americans feel they have to get a good night's sleep in order to function, so they tend to use sleeping pills on a continuing basis where they may not need to," said Dr. Carter. "If you only get four hours one night, you'll still be able to function the following day. There's a difference between getting less sleep one night and getting less sleep for a week."

This article was medically reviewed by Steffini Stalos, DO, who is board-certified in Pathology and Lab Medicine, on July 14, 2022.