Sleep difficulties are among common complaints, but their management should not be based solely on quick relief in the form of a pill. For insomnia, it is important to distinguish between short-term help and long-term solutions, as this fundamentally affects both safety and the overall effect of treatment. Current recommendations emphasize that for chronic insomnia, the foundation should primarily be a non-pharmacological approach, especially cognitive-behavioral therapy, while pharmacotherapy should play more of a supportive and often time-limited role.
Sleeping pills can be useful in some situations, for example during temporary worsening of sleep or during periods of significant acute stress. At the same time, it is important to say that many hypnotics can be associated with the risk of daytime drowsiness, impaired attention, memory problems, rebound insomnia after discontinuation, tolerance, and in some groups also with addiction potential. This is precisely why they need to be used only according to a doctor's recommendation, not to exceed the prescribed dose, and to always carefully read the patient information leaflet.
For classic sleeping pills, only short-term use is recommended, often in the range of 2 to 4 weeks, especially for benzodiazepines and hypnotics. The reason is not only the risk of habituation and dependence, but also the possibility of developing tolerance, worsening sleep after discontinuation, and the fact that the medication itself usually does not address the causes that maintain insomnia long-term.
Sleeping pills are not suitable as an automatic long-term solution, and it is safer to view them as short-term support during a precisely defined period.
Special caution is warranted with benzodiazepines (e.g., cinolazepam (Gerodorm), bromazepam (Lexaurin), clonazepam (Rivotril), alprazolam (Neurol, Xanax)) and so-called Z-hypnotics, i.e., medications that act via the benzodiazepine receptor (such as zolpidem (Hypnogen, Stilnox, Adorma, Zolpinox, Sanval, Onirex, ...), zopiclone (Zopitin), eszopiclone (Esogno)).
It is precisely in these groups that the risk of tolerance, withdrawal problems, memory impairment, residual morning drowsiness (sedation), and in some patients the development of dependence is described, especially with prolonged use, higher doses, or when combined with alcohol and other depressant substances.
When taking sleeping pills, it is advisable to follow several basic rules that reduce the risk of complications and support a safer course of treatment.
For natural remedies, it is important to take a sober and scientifically grounded approach. Not every substance that is popular on social media or commonly available in pharmacies truly has convincing support from study data.
Melatonin is among the most frequently studied substances in relation to sleep, and its role is relatively well-documented in the professional literature. It makes the most sense for circadian rhythm disorders and some sleep-onset difficulties, but it is not appropriate to present it as a universal solution for every type of insomnia. For chronic insomnia, recommendations are not as clear-cut as they might initially appear.
Valerian root, i.e., Valeriana officinalis, is among the most frequently studied herbal substances for sleep support. There are clinical studies and review papers that support its use for improving sleep quality, although results are not uniform in all cases. Nevertheless, it is one of the few natural substances where benefits for sleep can be said to be supported by scientific data. Within studies, it was reported that people fell asleep faster (15-20 minutes earlier) and slept longer (30-40 minutes longer). Without rebound effect, i.e., after discontinuation, sleep did not worsen. In studies, dosing was 1 capsule of 400-900 mg taken 30–60 minutes before bedtime.
Ashwagandha, i.e., Withania somnifera, has been studied more frequently in recent years, particularly in relation to stress and subjective sleep quality. Some clinical studies suggest possible benefits, but current evidence is still not strong enough for it to be considered standard insomnia treatment. Within studies, after 8–12 weeks of use, people experienced deeper sleep, woke up less frequently during the night, and had reduced nighttime levels of stress hormones (cortisol). Ashwagandha may help in cases where stress prevents falling asleep.
For lavender, lemon balm, passionflower, or chamomile, professional publications can also be found, but the strength of evidence is usually limited, and results are not always consistent. Lavender may help with sleep if you are simultaneously experiencing anxiety or nervousness. In studies, for example, lavender tea before bedtime over 4 weeks improved sleep quality and reduced anxiety. Capsules with lavender extract (80 mg) are also available, which should be taken half an hour to an hour before bedtime.
When experiencing sleep difficulties, it is understandable to seek quick help, but long-term, the most effective approach is one that combines lifestyle measures, work on the underlying causes of insomnia, and only as needed, carefully selected short-term support. Sleeping pills can help in some situations but should not become a permanent nightly reliance.
Natural remedies can have their place if we choose wisely and stick to substances supported by professional literature. However, even here, "natural" does not automatically mean safe for everyone, as even over-the-counter preparations can have side effects, interactions, or restrictions for certain patient groups.
If sleep problems recur, worsen, or lead to daytime exhaustion, it makes sense to seek their true cause in a broader context. At EUNOMA Clinic, we view sleep comprehensively - in connection with stress, mental health, lifestyle, and overall health status.
This text serves as a basic overview and does not replace individual medical advice. The appropriateness of medications, dietary supplements, and their combinations should always be decided with consideration of the specific health condition, other medications, and the type of sleep difficulties.
I have been working in the field of addiction counselling for more than 10 years. I hold a bachelor’s degree in Addictology from the First Faculty of Medicine and a degree in General Medicine from the Second Faculty of Medicine, Charles University. In my research, I focus on preventive medicine and epidemiology.
In my work with clients, I combine evidence-based knowledge with a holistic approach to mental health. My medical background enables me to understand the broader clinical context and to better support each client’s individual needs.
