Sleeping Pills and Next-Day Drowsiness: What Patients Should Know

What Is Next-Day Drowsiness?

Next-day drowsiness refers to feeling unusually sleepy, sluggish, tired, dizzy, or
mentally less alert after taking a sleep medicine the previous night.

It can involve:

• Reduced concentration
• Slower reaction time
• Difficulty making decisions
• Problems with coordination or balance
• Dizziness or lightheadedness
• Memory problems
• Difficulty staying alert
• Increased risk of falls
• Impaired driving or machinery operation

Importantly, feeling awake does not necessarily mean that all effects of a
sleeping pill have disappeared. FDA information on zolpidem notes that
next-morning impairment can occur even when a person feels fully awake.

Why Can Sleeping Pills Cause Drowsiness the Next Day?

Sleep medicines are designed to affect brain activity and promote sleep. Depending on
the medicine, formulation, dose, timing, and individual factors, some of its effects
may remain after waking.

For example, zolpidem is a sedative-hypnotic that works by slowing activity in the
brain. It may cause drowsiness, reduced mental alertness, prolonged reaction time,
coordination problems, and other effects the day after use.

The likelihood and severity of next-day effects can vary depending on:

• The specific sleep medicine
• The prescribed dose and formulation
• When the medicine was taken
• How long the medicine remains in the body
• How much sleep the person gets afterward
• Age and individual metabolism
• Other medicines being taken
• Alcohol or other substances
• Individual sensitivity to the medicine

Which Sleeping Pills Can Cause Next-Day Drowsiness?

Next-day impairment is not limited to one particular type of sleep medicine. The FDA
states that insomnia medicines can impair driving and other activities requiring
alertness the morning after use, although the degree of risk varies between medicines
and individuals.

Z-Drugs

Z-drugs include medicines such as:

• Zolpidem
• Zaleplon
• Eszopiclone

These are prescription sedative-hypnotics used for insomnia. The FDA warns that people
taking Z-drugs may still experience drowsiness or impaired alertness the day after use.

Benzodiazepines

Some benzodiazepines have sedative effects that can continue into the following day.
Their effects can vary considerably depending on the specific medicine,
pharmacokinetic properties, dose, and individual patient factors.

Over-the-Counter Sleep Aids

Many OTC sleep medicines contain sedating antihistamines. These medicines may leave
some people feeling tired or groggy the following day and can contribute to memory
and balance problems, particularly in older adults.

Sleeping Pills and Driving the Next Morning

One of the most important concerns about next-day drowsiness is driving.

The FDA states that sleep medicines can affect activities requiring complete mental
alertness, including driving and operating heavy machinery. Some medicines can continue
affecting a person’s ability to drive several hours after use or into the following day.

A person should not assume that driving is safe simply because they no longer
feel sleepy. Some medicines can impair alertness, reaction time, or coordination
without producing an obvious sensation of sleepiness.

If a sleep medicine causes morning impairment, discuss the problem with a healthcare
professional before changing the dose or medication.

How Zolpidem Can Affect the Next Morning

Zolpidem is one of the sleep medicines for which next-morning impairment has been
specifically evaluated by the FDA.

FDA information explains that zolpidem blood concentrations may remain high enough
the following morning to impair activities requiring alertness, including driving.
The FDA has therefore made dosing recommendations for certain zolpidem products to
reduce the risk of next-morning impairment.

Zolpidem may cause:

• Drowsiness
• Decreased mental alertness
• Prolonged reaction time
• Coordination problems
• Unsteady walking
• Difficulty maintaining balance
• Impaired driving ability

MedlinePlus also advises patients taking certain zolpidem formulations to allow
7–8 hours for sleep after taking the medicine. Getting up too soon may increase the
risk of drowsiness and problems with memory, alertness, or coordination.

Why Getting Enough Sleep Matters

The amount of sleep remaining after taking a sleeping medicine is important.
Some bedtime medicines are intended to be taken only when a person can remain in bed
for an adequate period of time.

For several zolpidem formulations, MedlinePlus recommends planning to remain in bed
for 7–8 hours after taking the medicine. Certain middle-of-the-night formulations
have different instructions.

Taking a bedtime sleep medicine when only a short period of sleep remains can increase
the likelihood of waking while the medicine is still affecting alertness and
coordination.

Factors That May Increase Morning Drowsiness

1. Taking More Than the Prescribed Dose

Taking more medicine than prescribed can increase exposure and potentially increase
sedation and impairment. Patients should use sleep medicines exactly as directed.

2. Taking More Than One Sleep Medicine

Combining sleep medicines without medical direction can increase sedative effects.
Patients should not combine insomnia medicines unless specifically instructed by a
healthcare professional.

3. Alcohol

Alcohol can increase sedation and impairment with many sleep medicines. The FDA
specifically advises avoiding alcohol with prescription Z-drugs because combining
them may increase side effects.

4. Other Medicines That Cause Drowsiness

Other sedating medicines can contribute to impairment. These may include certain
antihistamines, anxiety medicines, opioids, muscle relaxants, and other central
nervous system depressants.

5. Insufficient Sleep

Taking a sleep medicine but waking after only a few hours may leave medication
effects present when the person needs to be active and alert.

6. Individual Differences

Age, metabolism, other medications, medical conditions, and individual sensitivity
to sedative medicines can influence how someone responds.

Can You Be Impaired Without Feeling Sleepy?

Yes.

This is an important consideration for patients taking insomnia medicines.
FDA information explains that people taking certain insomnia medicines may experience
impaired mental alertness the next morning even if they feel fully awake.

Therefore, subjective feelings of alertness should not be the only factor used to
determine whether it is safe to drive or perform safety-sensitive activities.

Next-Day Drowsiness vs. Complex Sleep Behaviors

These are related to insomnia medicines but are not the same problem.

Next-Day Impairment

The person is awake the next morning, but medication effects may impair:

• Alertness
• Reaction time
• Coordination
• Driving ability
• Concentration

Complex Sleep Behaviors

Complex sleep behaviors occur while a person is not fully awake. Reported behaviors
with certain Z-drugs include:

• Sleepwalking
• Sleep-driving
• Preparing food
• Eating
• Making phone calls
• Other activities while asleep

The FDA has issued a boxed warning concerning complex sleep behaviors with zolpidem,
zaleplon, and eszopiclone because serious injuries and deaths have occurred.

If a person experiences a complex sleep behavior after taking a Z-drug, the FDA
advises stopping the medicine and contacting a healthcare professional immediately.

How to Reduce the Risk of Next-Day Drowsiness

Follow the Prescribed Directions

Use prescription medicines exactly as directed. Do not increase the dose because
the medicine does not appear to be working quickly.

Allow Enough Time for Sleep

Take bedtime sleep medicines only when there is sufficient time to sleep according
to the specific medicine’s instructions.

Avoid Alcohol

Alcohol can increase sedation and other adverse effects associated with many sleep
medicines.

Be Careful With Other Sedating Medicines

Tell your healthcare professional about prescription medicines, OTC medicines,
vitamins, supplements, and other substances you use.

Do Not Drive If Impaired

If you feel drowsy, dizzy, confused, slowed, or otherwise impaired, avoid driving
or operating machinery.

Discuss Persistent Morning Drowsiness

If morning impairment continues, a healthcare professional can review the medicine,
dose, timing, interactions, and other possible causes.

What Should You Do If You Feel Very Drowsy the Next Day?

If you experience significant drowsiness after taking a sleeping pill:

1. Avoid driving.
2. Avoid operating machinery.
3. Avoid alcohol.
4. Do not take additional sleep medicine to compensate for poor sleep unless specifically
   instructed by your healthcare professional.
5. Review other medicines that may contribute to sedation with a healthcare professional.
6. Contact your healthcare professional if the problem continues or is severe.

For severe symptoms such as difficulty breathing, inability to stay awake, severe
confusion, loss of consciousness, or suspected overdose, seek emergency medical
assistance immediately.

Should You Stop a Sleeping Pill Suddenly?

Not necessarily. Some sleep medicines can cause withdrawal symptoms or rebound
insomnia if stopped abruptly, particularly after regular use.

If you are experiencing excessive next-day drowsiness, speak with your healthcare
professional rather than independently changing the dose or stopping the medicine.

Can Better Sleep Habits Reduce the Need for Sleeping Pills?

For some people, improving sleep habits and addressing the underlying cause of
insomnia can be an important part of treatment.

Depending on the cause of insomnia, treatment may include:

• Consistent sleep and wake times
• Reducing caffeine later in the day
• Limiting alcohol
• Creating a comfortable sleep environment
• Addressing underlying medical conditions
• Cognitive behavioral therapy for insomnia (CBT-I)
• Appropriate use of medication when clinically indicated

When Should You Talk to a Healthcare Professional?

Talk with a healthcare professional if:

• You regularly feel excessively sleepy after taking a sleep medicine.
• You have difficulty staying awake during the day.
• You have experienced a near-miss or accident while driving.
• You have memory or coordination problems.
• You are taking several medicines that cause drowsiness.
• You regularly use alcohol with sleep medication.
• Your insomnia continues despite treatment.
• You experience unusual behaviors while asleep.

Frequently Asked Questions

1. Why am I still sleepy the morning after taking a sleeping pill?

Some sleep medicines can continue affecting alertness into the following morning.
The effect depends on the medicine, dose, formulation, timing, sleep duration,
and individual factors.

2. Can sleeping pills affect driving the next day?

Yes. FDA guidance states that insomnia medicines can impair driving and other
activities requiring complete mental alertness the following morning.

3. Can I take another sleeping pill if I wake up during the night?

Do not take an additional dose unless your specific medicine is prescribed or labeled
for middle-of-the-night use and you have enough time remaining for sleep. Follow the
medicine’s instructions and ask a healthcare professional if you are uncertain.

4. Does alcohol make next-day drowsiness worse?

Alcohol can increase sedation and other side effects with many sleep medicines.
The FDA specifically advises avoiding alcohol with Z-drugs.

5. Should I stop my sleeping pill if it makes me drowsy the next day?

Do not make medication changes without professional guidance. Talk with your
healthcare professional about the symptoms so they can determine whether the
medicine, dose, timing, interactions, or another factor needs to be addressed.

Final Thoughts

Next-day drowsiness is an important safety consideration when using sleeping pills.
Some medicines can affect alertness, reaction time, coordination, memory, and driving
ability even after a person wakes up and feels fully awake.

Using sleep medicines exactly as directed, allowing adequate time for sleep, avoiding
alcohol and unapproved combinations, and discussing persistent morning impairment
with a healthcare professional can help reduce avoidable risks.

Sleeping pills should be considered as part of an overall insomnia-management plan
rather than a substitute for identifying and addressing persistent sleep problems.