Sleeping Pills Not Working? Here’s What You Need to Know

The Doctor Weighs In
7 min readAug 8, 2018

By Wallace Mendelson MD

Wallace Mendelson, M.D., author of a new book, Understanding Sleeping Pills, explains what you should do when sleeping pills aren’t working for you.

The benefits of most sleeping pills are usually evident within a few days, and if there isn’t an improvement after 7–10 days, it can feel discouraging. Insomnia causes a lot of discomfort and there’s a natural tendency to discard the medicine and try new ones, in what can seem like an endless search for the perfect pill. We’ll talk later about considerations in changing medicines, but first, let’s look at a different approach: going back to the beginning, re-thinking about the sleep disturbance and looking for other possible contributors.

Reviewing the Situation

Consider whether a medical illness is contributing to poor sleep:

A number of illnesses or changes in life can disturb sleep, among them:

  • Hyperthyroidism
  • Gastric reflux
  • Irritable bowel syndrome
  • Arthritis
  • Asthma or chronic pulmonary disease
  • Congestive heart failure
  • Headaches
  • Parkinson’s disease
  • Benign prostatic hypertrophy
  • Chronic pain conditions
  • Changes in life including menopause

If a medical condition is contributing to poor sleep, both the illness and the sleep disturbance should be addressed.

Consider the effect of other medicines on sleep:

A variety of drugs for various medical or psychiatric illnesses can disturb sleep, among them:

  • Stimulants, for instance, given for ADHD
  • Thyroid hormone
  • Steroids
  • Some antidepressants
  • Beta-blockers for high blood pressure or heart rhythms
  • Alpha blockers for high blood pressure or enlarged prostate
  • ACE inhibitors for high blood pressure
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