When counting sheep fails

Insomnia has been around as long as sleep has. Some even believe that William Shakespeare was an insomniac, writing as vividly as he did about sleeplessness, tossing and turning, and sleepwalking in plays like Hamlet and Macbeth. Today, old Will has millions of fellow sufferers.

• The 2007 Sleep in America Survey from the National Sleep Foundation found that 67% of women say they frequently experience a sleep problem.
• The 2005 Sleep in America poll found that 35% of adults experience insomnia every night.

One option today's insomniacs have that Shakespeare didn't, of course, is the sleeping pill. Over the last 10 to 15 years, the market has been inundated with new and improved sleep medications -- ones that don’t come with the same degree of hangovers, side effects, and risk of dependency that previous sleep drugs did. But that doesn’t mean they’re risk-free, or ideal for everyone who has problems getting a solid forty winks.

A Good Night's Sleep, Without the Hangover The older classes of sleep medications, particularly the benzodiazepines -- think Valium and Xanax -- do more than just help you sleep. They affect how you sleep, altering your actual "sleep architecture," says Donna Arand, PhD, clinical director of the Kettering Sleep Disorders Center in Kettering, Ohio. "They tend to decrease the amount of time spent in certain stages of sleep, particularly stages three and four (the deepest, most restful stages of sleep)," says Arand, who serves on the boards of the American Academy of Sleep Medicine and the American Insomnia Association. "People also complained of hangover effects from these medications." That's because they tend to have a longer "half-life," which is the length of time the drug stays in your body. Non-benzodiazepine hypnotics like Ambien, Ambien CR, Rozerem, Sonata, and Lunesta, however, share key advantages over previous generations of sleep drugs:

• They have a relatively short half-life, so you won't wake up groggy the next day. "There are minimal reports of 'hangover' effects with these new drugs," says Arand.
• They are less likely than the older sleeping pills to cause addiction, withdrawal symptoms, or a buildup of tolerance (when you require more and more drug to have the same effect).

Why? The newer medications act only on specific receptors in your brain that are focused on sleep, while older groups of drugs have a more generalized effect on multiple brain receptors. "These new drugs are among the safest medications in medicine," says Thomas Roth, MD, Director of the Sleep Disorders and Research Center at Henry Ford Health System in Detroit.

New Sleeping Pills Aren’t Right for Everyone "If you have insomnia due to sleep-related breathing disorders [sleep apnea] or restless legs syndrome, for example, these drugs won't address your underlying problem," says Roth. Pregnant women, of course, shouldn't take these medications. And if you're "on call," frequently getting up in the middle of the night for work or for a child, they might not work for you.