Mixing Sleeping Pills and Alcohol

Introduction

You’re experiencing problems sleeping and have been prescribed sleeping pills. Your doctor warns you about the risks associated with drinking alcohol while taking sleeping pills, but you’re wondering if this means you have to give up alcohol completely. Can it be that risky to mix the two? What if you only have one drink?

Find out the facts and risks of mixing sleeping pills with alcohol as we explore this topic together.

What Are Sleeping Pills? 

Sleeping pills are medications used to treat insomnia, restless sleep, or difficulty falling asleep. There are many different sleeping pills, each with a unique chemical structure and pharmacological effect.

Those frequently prescribed are:

• Benzodiazepines (Ativan, Klonopin, Prosom, Restoril, Xanax)
• Nonbenzodiazepines (Ambien, Lunesta, Sonata)
• Antidepressants (trazodone, doxepin, mirtazapine)
• Antihistamines (hydroxyzine)
• Melatonin receptor agonists (Rozerem, agomelatine)

There are also over-the-counter sleep aids and medications known to induce sleepiness as a side effect:

• Antihistamines (Tylenol PM, Unisom, doxylamine, Benadryl/diphenhydramine, Marezine)
• Cold medicines (NyQuil, Robitussin, dextromethorphan)
• Herbal/natural sedatives (valerian, melatonin)

Both prescription and over-the-counter sleeping pills work by slowing down our central nervous system and brain activity. There are different types of sleeping pills out there, but they all basically have the same effects. Most sleep aids take effect 30 minutes after intake and last up to eight hours, but some are made to have an extended release, meaning the effects take longer to manifest and may last longer.

Sleeping pills are used to initiate, sustain, or lengthen sleep. In a survey published by the Centers for Disease Control and Prevention (CDC), roughly 8.4% of adults reported using sleep medication every day or most days of the week in the last 30 days. When used as directed, these medications bring much-needed relief from sleep problems, sleep disorders, and insomnia.

Why Are Sleeping Pills Used?

The answer to this may seem pretty obvious: sleeping pills are used to help us sleep. Right? Well, there’s a little more to it than that.

There are many possible origins of sleep problems, and each comes with its own unique set of challenges. Let’s take a look:.

• Behaviors. Sleep hygiene refers to healthy habits and behaviors that help us sleep. Certain behaviors can interfere with our sleep and disrupt our sleep cycles or restfulness. These include exposure to blue light (e.g., phones, laptops) too close to bedtime, sleeping in a warm room, bright lights, eating or working out close to bedtime, or inconsistent bedtimes.

• Medications. Sleep can be disrupted by prescription medications such as Adderall, Ritalin, bupropion, steroids (such as prednisone), or antidepressants.

• Nonprescription substances. Over-the-counter and recreational stimulants can also prevent sleep. These include pseudoephedrine (Sudafed), phenylephrine (DayQuil), caffeine, cocaine, MDMA (Ecstasy/Molly), nicotine, or alcohol (more on that later!).

• Mental health conditions. Mental health and sleep are closely linked; many mental health conditions disrupt sleep, and poor sleep can fuel existing issues. Conditions that interfere with sleep include depression, anxiety, mania/hypomania, stress, psychosis, attention-deficit/hyperactivity disorder (ADHD), schizophrenia, and post-traumatic stress disorder (PTSD).

• Medical conditions. These include dementia, Alzheimer’s disease, epilepsy/seizures, sleep apnea, chronic pain, asthma, acid reflux, hyperthyroidism, and sleep disorders such as narcolepsy, delayed sleep phase syndrome, and restless leg syndrome.

Any one of these root causes has the potential to interfere with sleep dramatically, producing the umbrella condition known as insomnia.

What Is Insomnia?

From the Latin words “in-” meaning “not” and “somnius” meaning “sleep,” insomnia is pretty straightforward: it means difficulty or inability to sleep. Just about every human being will experience insomnia at some point in their lives, whether it’s a period of insomnia or just an occasional night lying awake. At any given time, 1 in 3 adults are experiencing insomnia symptoms.

Nights of insomnia can produce difficult, low-energy days that seem to drag on forever. Chronic insomnia puts a lot of strain on our health, work life, mental well-being, family life, and relationships. In the 1999 film Fight Club, the protagonist describes it perfectly: “With insomnia, nothing is real. Everything is far away. Everything is a copy of a copy of a copy.”

Those of us with chronic insomnia may start to take drastic measures to get some sleep (although hopefully not as drastic as the ones in Fight Club!). Luckily, sleeping pills are easily available, effective, and safe when taken as directed. However, we may decide to take matters into our own hands if we feel they’re not working well enough (or if we want to solve things without seeing a doctor). In that pursuit, we may end up making some potentially dangerous or harmful decisions.

Dangers of Mixing Alcohol and Sleeping Pills

Mixing alcohol with any medication is risky enough. Combining any two medications poses the risk of interactions, and alcohol interacts with a lot of medications. This is because alcohol is a central nervous system depressant, meaning it slows down our brain signals, making us sleepy, uncoordinated, slow, and foggy. Because it’s a sedative, alcohol can exacerbate the sedative effects of sleeping pills, making us drowsy and slowing down our heart rate and other normal bodily functions to dangerously low levels. 

The bottom line is, it is never safe to mix alcohol with sleeping pills — let’s further explore a few of the most important reasons why.

Risk of Overdose

The overdose potential from mixing sleeping pills and alcohol should not be taken lightly. Studies show that many common sleeping pills can be deadly when mixed with alcohol, especially if too much of either substance is used. Even without alcohol in the equation, it’s important to always take only the prescribed dose of sleeping pills and to carefully read the warning labels on over-the-counter sleeping medications.

Death can occur when the combination of sleeping pills and alcohol suppresses our respiratory rate to a dangerously low level, or if this combination affects the heart. But the dangers go beyond that — in fact, it may be more likely for death to occur as the result of impaired alertness, judgment, or coordination. These impairments make seemingly simple activities like swimming, driving, or crossing the road potentially deadly.

Sleep Interactions

Mixing sleeping pills and alcohol can also lead to sleepwalking and impaired memory. There are several documented cases of people sleepwalking, sleep-eating, and even sleep-driving on the popular sleeping medication Ambien, and they don’t always remember what they did when they wake up. Scary!

When alcohol is mixed with a medication like Ambien, the effects are worse. These episodes could result in injury or, in some situations (such as sleep-driving), may lead to arrest or harm to others.

Decreased Sleep Quality

Believe it or not, excessive or chronic alcohol use can actually cause insomnia! As a depressant, alcohol slows down our central nervous system, making us sleepy/relaxed. As our body metabolizes alcohol, we experience a rebound effect. In an attempt to rebalance itself, our brain releases neurotransmitters to wake us back up. This ends up disrupting our sleep, especially the deep, restorative sleep we need for our brain to function properly.

So in addition to being dangerous, it’s also counterproductive to mix a sleep aid and alcohol.

Healthy Alternatives for Beating Insomnia

The best way to avoid the dangers of mixing sleeping pills and alcohol is to avoid alcohol completely. There are many other ways to improve our sleep or boost the effectiveness of our sleeping pills without negative (or dangerous) side effects.

• Turn off those screens. Our brains are wired to stay awake during the day when it’s light out and go to sleep when it’s dark. For at least an hour before bed, avoid screen time — yes, that includes television! Switch out the sitcom or nightly TikTok scroll for an old-fashioned paper book. You can also consider using an automatic program on your phone to reduce blue light after dark (called Night Shift on Apple products) to help.

• Practice sleep hygiene. Develop a solid bedtime routine that speaks to you. When you start this routine, it’s a cue to your body that it’s time to start winding down. Maybe do 5 to 10 minutes of gentle stretching, a brief meditation, write in your journal, make some calming herbal tea, read a few pages from a book, start an evening skin care routine, or lay out your clothing for the next day.

• Limit in-bed activities. Train your brain to associate bed with sleeping. If you usually watch TV or tap away on your laptop in bed, you may be setting yourself up for sleeplessness. This can be hard if you live in a studio apartment or a dorm room and don’t have many other places to sit or relax — just do your best! Avoid activities that require you to stay alert and limit what you do in bed to only one or two things: sleeping and sex. 

• Mind your diet. Eating a big meal increases heart rate and body temperature, which can make it harder to fall asleep. If you’re hungry before bed, stick to a light snack and try to keep it low-carb.

• Exercise during the day. Sometimes it feels like the answer to every health ailment is “diet and exercise,” right? In this case, both of these heavily influence sleep. Exercising during the day helps regulate our circadian rhythm, ensuring we’re energetic in the day and tuckered out by the evening. Have you ever slept like a log after a long hike or a busy day of spring cleaning? Exercise causes a positive feedback loop with sleep — it tires us out, which causes us to sleep more soundly, thus improving our energy levels during the day.

• Relax at night. On the other hand, exercise at night gets our juices flowing — and it takes a few hours to calm down. If you want to get some movement in at night, consider restorative yoga, sleeping, or walking. It’s not the time to train for your 5K or hit a PR for your squats!

• Avoid stimulants. If you take stimulating medications, use them as prescribed. If you don’t understand how to avoid sleep interactions with your medications, ask your doctor or pharmacist. Avoid drinking caffeine after midday and consider weaning yourself from that morning cup of joe or replacing it with black or green tea, which are lighter on caffeine but still give a boost.
• Sleeping pills are not meant to be taken forever. Often, our doctor will put us on a plan to use sleep aids for a short while, or as needed. It’s best to use our time on sleeping pills as an opportunity to take a break from alcohol. If we find it difficult or impossible to abstain from alcohol while taking sleeping pills, it may be time to reassess the healthiness of our drinking habit. Alcohol, like sleeping pills, should never be a staple of our life.

Wrapping Up

The bottom line is alcohol and sleeping pills should never be mixed. While alcohol and medications are a dangerous combo in general, sleeping pills and alcohol can be very dangerous — and even deadly — if taken together. It’s not worth the risk!