Types of Medications & How They Work

Medications are an important part of treating sleep disorders. They help alleviate symptoms and improve sleep quality for individuals with conditions like insomnia, sleep apnoea, restless legs syndrome, narcolepsy, and shift work sleep disorder. These medications work in different ways, targeting specific aspects of sleep disturbances to promote better rest.

Insomnia

• Sedative-Hypnotics: Sedative-hypnotic medications include drugs like benzodiazepines (temazepam) and non-benzodiazepine receptor agonists (zolpidem), which are often the go-to medications for insomnia. These medications work by uplifting the activity of gamma-aminobutyric acid (GABA), which is a normal neurotransmitter that the body uses to help regulate sleep. By increasing GABA’s natural effects in the brain, you’ll experience relaxation, a reduction in anxiety, and improved sleep.

Sleep Apnoea

• Continuous Positive Airway Pressure (CPAP): CPAP therapy is the leading and most popular treatment for obstructive sleep apnoea. The use of CRAP involves wearing a mask connected to a machine. The mechanism delivers a continuous flow of pressurized air which helps to maintain the body’s airways and keep them open during sleep. The positive air pressure stops the collapse or constriction of the upper airway which allows uninterrupted breathing and reduces your episodes of sleep apnoea during the night.

Restless Legs Syndrome (RLS)

• Dopamine Agonists: Dopamine agonist medications include pramipexole and ropinirole, are commonly used to treat restless legs syndrome. The drugs work by stimulating the body’s natural dopamine receptors in the brain, which helps to regulate and control movement, so you experience a reduction in the symptoms of RLS. By increasing dopamine activity, you won’t feel the urge to move your legs. Also, most people remote fewer or no uncomfortable sensations like tingling, pins, and needles, or creepy crawlies.

Narcolepsy

• Stimulants: Stimulant medications, such as modafinil and methylphenidate, are regularly used to manage excessive daytime sleepiness. These medications work by either increasing the release or blocking the reuptake of very precise neurotransmitters, such as dopamine and norepinephrine, that occur in the brain. You’ll experience greater wakefulness and alertness so you can stay awake during the day.

Excessive Daytime Sleepiness

• Sodium Oxybate: Sodium oxybate, also referred to as gamma-hydroxybutyrate (GHB), is a medication used to treat both excessive daytime sleepiness along with cataplexy in narcolepsy. It works by increasing the amount of slow-wave sleep and consolidating sleep cycles. You’ll experience improved night-time sleep quality.

Shift Work Sleep Disorder (SWSD)

• Wake-Promoting Agents: Wake-promoting agents, such as modafinil and armodafinil, are commonly prescribed if you are experiencing a shift work sleep disorder. The drugs impact certain neurotransmitters in the brain like orexin and dopamine. You will experience greater wakefulness and alertness when you need to while being able to sleep during your downtime. The medications are great if you are having problems adjusting to a tight work schedule.

For all sleep disorders, some sufferers turn to melatonin supplements to help regulate their sleep-wake cycles.

Side Effects

Here are some simple explanations of common side effects associated with medications used for sleep disorders:

• Benzodiazepines: These medications, such as diazepam or lorazepam, can help with sleep problems, but they may cause sleepiness/drowsiness, mental fog or confusion, and difficulty concentrating or keeping your thoughts straight. They may also lead to dependency or addiction if used for a long time.
• Non-Benzodiazepine Hypnotics: Medications like zolpidem may cause varying degrees of headache, dizziness, memory glitches, and daytime sleepiness. In some cases, they can lead to sleepwalking or other unusual behaviours during sleep like agitation, kicking, hitting, talking in your sleep, rocking, rolling, and more.
• Melatonin: Side effects are generally mild and might include unwanted drowsiness, headache, and nausea with vomiting. However, remember that melatonin can interact with other medications.
• Modafinil and armodafinil: These have been known to cause headaches, upset stomach, vomiting, nervousness, dry mouth, and mental dizziness.  A racing heart rate can also occur. Skin reactions like a rash are rare but on occasion can occur.
• Sodium oxybate: The drug often causes stomach upset and vomiting. Some people have dizziness and headache. Others may have a decrease in muscle tone. Some report excessive sleepiness. On rare occasions, you might experience bedwetting, mood swings, or breathing problems.
• Dopamine agonist medications: Sometimes the drug can cause a severely upset stomach and vomiting, light-headedness, impulse control issues like gambling or excessive shopping, depression, low blood pressure, and compulsive eating.

Conclusion

Sleep disorders impact every aspect of your life so medications can be an effective treatment option for sleep disorders. The medications can help improve your sleep quality and well-being.