Sleeping Pills: What They Do, What They Cost, and Why They're Last

Summary

Sleeping pills — prescription Z-drugs (zolpidem) and benzodiazepines, OTC antihistamines (diphenhydramine/doxylamine), and newer orexin-receptor antagonists — all share one problem: **they manage the symptom without fixing the insomnia, and the durable fix (CBT-I) is non-drug**; the prescription sedatives buy a *modest* objective gain (Z-drugs cut sleep-onset latency by roughly 22 minutes) at the price of tolerance, dependence, rebound insomnia, and falls/cognitive impairment that hit the elderly hardest, while the OTC antihistamine route is the worst-evidenced of all — fast tolerance, next-da