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07442 978709
Spending five days or a couple of weeks deprived of sleep, the allure of something giving quick relief would be a strong one. As you lie awake in bed, your mind abuzz with thoughts, of course, morning comes, and you would hardly feel rested one bit. Some people begin posing suggestions to their GPs about medications at this point. One of the often-suggested names is hydroxyzine.
Hydroxyzine was not designed to be sold as a sleep aid like some other drugs, but it has been used for many years because of its calming and sedative properties. To address whether it is a good fit for the problems of sleep, you should investigate what hydroxyzine is, how it works, and what the trade-offs are.
When someone is having trouble sleeping, there are a number of drug categories doctors might consider. Some are aimed solely at producing sleep, i.e., the z-drugs and benzodiazepines, whereas others can have a sedating property extending to their antidepressant intent. Finally, there are antihistamines, which were never initially targeted for getting people to sleep, but sometimes work that way.
Hydroxyzine represents strength in this last category. That is a first-generation antihistamine, signalling an era in which the name of non-drowsy allergy medication had yet to appear. In the UK, it is supposed to be prescribed for anxiety, itching, or allergic reactions; however, the sedative properties it presents make it useful for the treatment of insomnia.
Most of us hear about histamine in the context of allergies, but in the brain, it serves a different function: It is one of the chemicals keeping us alert and vigilant during the day. A decrease in histamine activity means a shift towards a drowsier state in the brain.
Hydroxyzine is a medication that exerts a profound effect on the brain by blocking histamine. This is why it can reduce itching but simultaneously make one drowsy. Interactions with other receptors responsible for alertness and anxiety further enhance the sedative effect.
These are factors that make some subjects report that hydroxyzine reduces their allergic symptoms and allows them to fall asleep more comfortably at night.
Almost everyone has an incredibly fast sleep time when using hydroxyzine in the short term. Indeed, the study results indicate that it can lead to reductions in sleep latency and, to some extent, increases in the total hours of sleep. This can be of very practical help to a person who would normally feel active and stimulated at bedtime.
Doctors sometimes prescribe hydroxyzine off-label for insomnia, which means they are using the drug other than the primary FDA-approved indication. In most cases, the dose used for bedtime is 25 mg, but in specific instances, patients may obtain more based on individual circumstances.
The thing it does not do effectively is directly change sleep architecture. It certainly will make you sleepy, but your body never learns to be guided into good sleep on its own through the presence of the drug. That difference lacks relevance when insomnia has been ongoing for several months.
When hydroxyzine is used to support sleep, it is usually taken in the evening shortly before going to bed. Lower doses are preferred, especially in older adults, because the drug can linger in the body and cause next-day sluggishness.
There is also limited research on using hydroxyzine long-term for sleep. Most of the evidence we have looks at short periods, which means doctors have to be cautious about keeping people on it for extended stretches.
Hydroxyzine's sedation-causing properties can also lead to problems. Having slight grogginess during nighttime is common; if grogginess persists into the morning, it will fall flat in everyday life. Some individuals reported feeling dazed and slow or less sharp when awake.
Other side effects might potentially present as dry mouth, visual disturbances, headache, dizziness, and, in some select people, confusion or bizarre thoughts. It is not safe for certain individuals, particularly those with heart problems or those taking other medicines, as the drug can adversely affect the heart's electrical rhythm.
These side effects can become more severe when consuming alcohol or other sedative drugs because they can increase the risk of accidents or the stupor that comes along with them.
A lot of insomniacs are prescribed medications for anxiety, depression, or even pain. Some of these drugs interact with hydroxyzine, either increasing sedation or affecting heart rhythm. That is why it is important for a prescriber to know everything you are taking before adding hydroxyzine to the mix.
Using it regularly for sleep also raises the question of dependence on the routine rather than the drug itself. You may come to feel that you cannot sleep without it, even if the underlying problem has not been addressed.
Medication is not the best treatment for ongoing insomnia. When granted an option in the UK, Cognitive Behavioural Therapy for Insomnia or CBT-i is suggested by other available therapies for the first treatment. CBT-i does not basically focus on sleep or sedation, but underlines changes in the habits and wrong mental patterns that keep people awake.
CBT-i helps in getting back your natural sleeping process, and teaches you to re-associate bed with sleep in your brain. There are positive results here, and the outcomes are encouraged; they usually carry on because it is showing the body how to sleep again.
The truth is, hydroxyzine might make some people sleepy, and some might see momentary relief from horrid nights, but it is associated with side effects, potential drug interactions, and uncertainties if you consider its long-term use for insomnia.
If poor quality sleep has already been an extended part of your life, you would better start a conversation about what is promoting it with your GP about this medication and find some support in the long run to rest.
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Any decisions regarding diagnosis, treatment, or patient care must be made exclusively by qualified and licensed healthcare professionals based on individual circumstances.
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