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Sleeping Pill Overdose

Written by Abby Doty

& Medically Reviewed by Leila Khurshid BCPS, PharmD

Medically Reviewed

Up to Date

This article was reviewed by a medical professional to guarantee the delivery of accurate and up-to- date information. View our research policy.

Last Updated - 04/18/22

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Many people may rely on medication to help with sleep, but taking sleeping pills other than directed or prescribed can put you at risk for overdose.

An estimated 50 to 70 million U.S. adults suffer from a sleep disorder. As a result, many people use sleeping pills from time to time. Most sleep aids are classified as sedative hypnotics. These kinds of medications help you to fall asleep or stay asleep. Sometimes, over-the-counter (OTC) medications can help with sleep, but none are recommended for most nights because your body can become dependent on the medication to sleep. In some cases, you may develop a tolerance and need more of a drug to get the same effect.

Popular Sleep Medications

Many different medications are used as sleep aids. These range from OTC medications like allergy pills or Tylenol PM to prescription medications like Ambien or benzos. These medications are perceived as relatively safe but can be dangerous when mixed with other drugs or taken in excess.

OTC Sleep Medications

Common OTC sleep medications include:

  • Diphenhydramine (Benadryl, Aleve PM, etc.)
  • Doxylamine (Unisom)
  • Melatonin
  • Valerian

Prescription Sleep Medications

Popular prescription sleep aids include:

  • Ambien
  • Lunesta
  • Rozerem
  • Restoril
  • Trazodone
  • Doxepin

Can You Overdose on Sleeping Pills?

Newer prescription sleep aids like Ambien and Lunesta were created with the hope of making safer sleep medications. Unfortunately, over the course of the last 20 years, the rate of death related to non-benzodiazepine hypnotics and medications like gabapentin has increased.

Overdosing on sleeping pills is more likely to happen if combined with other drugs or alcohol, called polysubstance abuse. Accidental overdoses can also happen if too much of a medication is taken, leading to excessive sedation or other symptoms. In this case, you may be too tired or sleeping too hard to get help. Possible side effects can include slow breathing, decreased heart rate and impaired cognitive function (confusion or altered mental status). In severe cases, this can lead to overdose, coma and death.

Can You Die From Sleeping Pills?

In short, yes, you can die from taking sleeping pills. This is most likely to happen if too many pills are taken at once or if combined with other medications or alcohol. Sleeping pills were the second most common type of medication to cause adult poisoning in 2019. Some individuals may have taken excessive doses of sleeping pills intentionally in an attempt to take their own lives. If you or a loved one is experiencing suicidal thoughts or tendencies, call the National Suicide Prevention Hotline at 1-833-284-7954.

Sleeping Pill Overdose Symptoms

Taking too many sleeping pills at once or in combination with other drugs or alcohol can have dire effects. Some symptoms of sleeping pill overdose include:

  • Excessive drowsiness
  • Unexpected behaviors or actions
  • Abdominal pain
  • Slowed breathing

Sleeping Pill Overdose Risk Factors

In 2019, 83% of reported exposures to Poison Control were nontoxic or minor. However, intentional exposures were 32 times more likely to be serious or fatal. In the case of intentional overdoses, sleeping pills are often taken with alcohol or other medications, which increases the risk for overdose.

Mixing sleeping pills with other medications or alcohol is likely the biggest contributing factor to sleeping pill overdose. Other risk factors include how much and how consistently a medication is taken, age, liver and kidney function, genetics, etc.

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How Many Mg of Sleeping Pills Is Safe?

Sleeping pills should always be taken at the lowest possible dose and only for short times. If taken consistently, tolerance can develop and lead to higher doses. Always talk with your healthcare provider or pharmacist to determine the best dose for you. The usual dose of Ambien is 5–10 mg and Lunesta is 1–3 mg. While less likely to cause an overdose on their own than older sleeping pills, mixing these medications with other drugs or alcohol can result in intentional or accidental overdoses, even at low doses.

In one study, fatal concentrations of “z-drugs” in the blood were about 33 times higher than therapeutic concentrations. “Z-drug” is the nickname for medications like Ambien, Lunesta or Rozerem because they all have “z” in their generic names. There are reports of fatal overdoses at much lower or much higher concentrations too. It is important to always take these medications as prescribed and avoid taking them with other medications or alcohol.

Which Sleeping Pills Are Most Dangerous?

In 2019, the FDA issued additional Black Box Warnings for Ambien, Lunesta and Sonata after several reports of rare but serious injuries and deaths from sleepwalking, sleep-driving or other behaviors while sleeping like using a stove. This type of warning is the highest, most serious type of warning the FDA can issue. Especially when combined with other medications or drugs or when taken in excess, sleeping pills have resulted in fatalities. And lastly, many of the prescription sleep aid options are classified as controlled medications under the Controlled Substances Act due to their potential for misuse and abuse.

As you can see, there are many ways of considering which sleeping pills are the most dangerous — number of serious warnings, deaths or abuse potential. Each of these medications can be dangerous in different ways and cause severe harm if taken differently than prescribed or with other drugs or alcohol.

Sleeping Pill Overdose Treatment

Some sleeping pills can be reversed with a medication called flumazenil. There are severe risks associated with using this medication, and it can cause a seizure if you use benzos consistently. For this reason, it is not always given. In the ER, gastric lavage (stomach pumping) or activated charcoal are sometimes given if a patient presents soon enough after taking these medications. Usually, Poison Control is called, and supportive care is given. This can mean giving oxygen or ventilation if you are not getting enough oxygen, fluids or other supportive measures.

There is no specific way for reversing most sleeping pills, and the way to remove these medications from the body is with time. Taking too many or taking them with other drugs or alcohol can harm the liver or kidneys and can prolong this time. In severe cases, machines are used to help the body, like hemodialysis. Each of these scenarios would be variable depending on which medications were taken and at what doses.

Sleeping Pill Addiction

If you or someone you love is struggling with a sleeping pill addiction, we can help. Our treatment programs vary from medical detoxification to outpatient services, including teletherapy from the comfort of your own home and aftercare services to support you in your journey. We can provide you with the resources to slowly and safely stop taking these medications and start your path to a drug-free life. Contact us today.

Help is in your hands, and it’s one phone call away. At The Recovery Village Palm Beach at Baptist Health Drug and Alcohol Rehab, your recovery is our mission. Give us a call today


American Sleep Association. “Sleep Statistics: Data About Sleep Disorders.” 2022. Accessed March 14, 2022.

Tardelli, V. T., et al. “Overdose deaths involving non-BZD hypnotic/sedatives in the USA: Trends analyses.” January 24, 2022. Accessed March 15, 2022.

Poison Control. “Poison Statistics National Data 2019.” 2022. Accessed March 15, 2022.

Waller, D. G. and Sampson, A. P. “Z-drug.” Medical Pharmacology & Therapeutics Fifth Edition, 2018. Accessed March 15, 2022.

U.S. Food and Drug Administration. “FDA requires stronger warnings about rare but serious incidents related to certain prescription insomnia medicines.” April 30, 2019. Accessed March 15, 2022.