Although sleeping pills are generally safe to take on their own, they can create a number of health risks when taken with CNS depressants like alcohol.

Sleeping pills, whether prescription, over-the-counter or herbal, are used to promote drowsiness in people who have trouble falling asleep and staying asleep. A survey from 2017–2018 found that around 8.2% of American adults³ reported taking medication to help them sleep four or more times in the past week. 

Unfortunately, sleeping pills carry some risks, especially when mixed with other drugs or alcohol. Mixing the wrong substance with a sleep aid can be dangerous or even deadly in some cases. It is important to know what effects drugs and alcohol can have when taken with sleeping pills.

Is It Dangerous To Mix Sleeping Pills and Alcohol?

Medications are typically safe when taken as directed by your health care provider. However, mixing certain prescription and over-the-counter medications with other sedating drugs can be dangerous. Since sleeping pills and alcohol both have sedating effects, it is dangerous to take these substances together.

Risks of Combining Sleeping Pills and Alcohol

Alcohol, prescription sleeping pills and over-the-counter sleep aids are CNS depressants⁷ — substances that slow brain activity. When taken together, these medications have an additive⁷ effect that increases sedation and the risk of side effects. Mixing sleeping pills and alcohol can increase the risk⁶ of:

• Slowed breathing (respiratory depression)
• Increased sedation
• Falls and fractures
• Overdose
• Coma¹¹
• Permanent brain damage¹¹
• Death

Side Effects of Mixing Sleeping Pills and Alcohol

The side effects of sleeping pills and alcohol are magnified when taken together. Even small amounts of alcohol can increase your risk of side effects¹¹ like:

• Slurred speech
• Poor concentration
• Abnormal behavior
• Confusion
• Headache
• Lightheadedness
• Dizziness
• Dry mouth
• Problems with movement and memory
• Lowered blood pressure
• Slowed breathing
• Decreased oxygen to the brain (hypoxia)

Common Prescription Sleeping Pills Mixed with Alcohol

Taking prescription sleeping pills with alcohol can cause serious adverse effects. Both prescription sleeping pills and alcohol are sedating. When taken together, their side effects may be enhanced, which can lead to a potentially fatal sleeping pill overdose. Manufacturers of popular sleeping pills like Ambien and Lunesta have issued warnings about the dangers of mixing sleep aids with alcohol.

Ambien and Alcohol

Ambien (zolpidem) is a prescription-only drug used to treat insomnia¹⁵, a sleep disorder. It is a CNS depressant, meaning it slows brain activity. People who have trouble falling asleep or staying asleep may take Ambien (zolpidem) to improve their sleep quality. You should not take Ambien²⁰ with other CNS depressants, such as alcohol.

Lunesta and Alcohol

Lunesta (eszopiclone)¹⁹ is approved to treat insomnia in people who have trouble falling asleep or staying asleep. It is available by prescription only from an authorized health care provider. Lunesta is a CNS depressant, so using it with other CNS depressants, such as alcohol, is dangerous. Mixing Lunesta and alcohol increases the sedative effects and side effects of Lunesta.

Temazepam and Alcohol

Restoril (temazepam) is a benzodiazepine approved for the treatment¹⁸ of insomnia. Temazepam is prescribed by a health care provider for short-term use (about seven to 10 days)¹⁸. Taking temazepam with other sedating substances¹⁸, such as opioids or alcohol, can cause breathing problems, coma and death.

Doxepin and Alcohol

Silenor (doxepin) is prescribed to treat insomnia¹⁷ in people who have trouble staying asleep. Drinking alcohol with doxepin may increase the sedating effects of alcohol. Increased sedation¹⁰ from mixing alcohol and sleep aids like doxepin can cause breathing problems, coma or death.

Trazodone and Alcohol

Trazodone is a serotonin modulator, meaning it increases serotonin levels in the brain. The medication is commonly used to treat depression¹⁶, but it can also treat insomnia¹⁴ in some people. Drinking alcohol with trazodone¹⁶ may increase its side effects. Some side effects of trazodone¹⁴ that may be increased with alcohol use include:

Other Sleeping Aids Commonly Mixed With Alcohol

Other prescription-only sleep aids include:

Belsomra (suvorexant)

Dayvigo (lemborexant)

Doral (quazepam)

Edluar (zolpidem)

Estazolam

Flurazepam

Halcion (triazolam)

Hetlioz (tasimelteon)

Quviviq (daridorexant)

Rozerem (ramelteon)

Sonata (zaleplon)

Zolpimist (zolpidem)

Over-the-Counter Sleeping Aids and Alcohol

Over-the-counter sleep aids, including herbal products and dietary supplements, carry the same risks as prescription-only sleep aids when combined with alcohol. Combining alcohol with over-the-counter sleep aids increases the sedative effects and side effects⁵ of these medications.

Melatonin and Alcohol

Melatonin is a hormone¹³ that the body naturally produces to regulate sleep. Melatonin derived from beef cattle or synthetically made¹³ is available over the counter as a dietary supplement for various sleep disorders. Melatonin is generally safe¹³ when used alone to improve sleep in people who have trouble falling asleep or staying asleep.

Diphenhydramine and Alcohol

Diphenhydramine is an over-the-counter medication used to treat various conditions², including itching, motion sickness and insomnia. Diphenhydramine is an antihistamine that easily crosses into the brain and results in drowsiness². Sleep aids containing diphenhydramine include:

Advil PM

Tylenol PM

Aleve PM

Nytol

ZzzQuil

Sominex

Unisom SleepGels

Drinking alcohol while taking diphenhydramine may increase the sedative effects of alcohol. Side effects⁹ such as drowsiness, dizziness and slowed breathing may be more intense, and there is an increased risk of overdose. Drinking alcohol should be avoided while taking diphenhydramine.

Doxylamine and Alcohol

Doxylamine (Unisom SleepTabs) is an over-the-counter medication used for the short-term treatment of insomnia¹. Doxylamine is also an ingredient in various over-the-counter cold medications used to control sneezing and runny nose. It is an antihistamine that binds to histamine receptors¹ in both the body and the brain. Its effects in the brain cause drowsiness.

Valerian Root and Alcohol

Valerian root is an herb that promotes sleep and helps relieve anxiety⁸. It is available as an over-the-counter dietary supplement for use as a sleep aid. Dietary supplements are not regulated as drugs, and there are few studies available. Reported side effects⁸ include drowsiness, dizziness and headache. Side effects may be increased by drinking alcohol while taking valerian root.

How Long After Drinking Can You Take a Sleeping Pill?

There is no exact answer to the question of how long you have to wait to take a sleeping pill after drinking. The half-life of alcohol is four to five hours⁴, which is the amount of time it takes for your body to get rid of half the alcohol in your system. It can take up to five half-lives (20 to 25 hours) for your body to clear all the alcohol.

There are many factors⁴ that can affect how quickly your body metabolizes (breaks down) alcohol after drinking. Factors that affect the metabolism of alcohol include:

• The amount of alcohol you use
• How long you have been drinking
• The strength of your drinks
• Your weight and age
• Use of other medications

Which sleep aid you plan on taking can also be a major factor when determining how long after drinking you can take a sleeping pill. Certain sleep aids, such as Lunesta, carry a warning¹⁹ not to take them if you have been drinking that evening or before bedtime. The effects of Lunesta were found to be increased even after the daytime use of other sedatives.

Alcohol increases side effects and sedation associated with all sleep aids, whether over-the-counter or prescription. There may also be lingering side effects while the body continues to metabolize alcohol after drinking. All sleep aids carry a warning to avoid use with alcohol⁹. To avoid the risks and dangers associated with drinking alcohol and taking sleeping pills, you should wait until your body has had time to completely rid itself of alcohol.