Sleeping Pills And Alcohol
Written by: THE BALANCE
Medically reviewed by Dr. Sarah Boss, MD
Last updated: January 19, 2026
Fact checked
Quick Summary
  • Sleeping pills and alcohol are both central nervous system depressing substances that may be used to help control stress, insomnia, or anxiety.
  • But mix the two and it can be dangerous—about 25 percent of medication-linked emergency room visits involve alcohol, with sleep aids part of the problem.
  • It is important to know the risks of mixing both of these; so, you can make informed and safe choices.
Reading time: 13 min

Sleeping pills and alcohol are both central nervous system depressing substances that may be used to help control stress, insomnia, or anxiety. But mix the two and it can be dangerous—about 25 percent of medication-linked emergency room visits involve alcohol, with sleep aids part of the problem. It is important to know the risks of mixing both of these; so, you can make informed and safe choices.

Medications used to help people fall asleep, sleep better, or help other sleep problems, like insomnia, are collectively termed sleeping pills. Because these drugs are intended to help people get through temporary sleep disturbances due to stress, jet lag, or health issues, they are usually prescribed for short periods. Sleeping pills are intended to work on your central nervous system, getting you to relax, reducing anxiety, or putting you into a state of sleepiness.

Sleeping pills are classified into several groups; benzodiazepines, sedating antidepressants, and nonbenzodiazepine hypnotics. These medications work by increasing the actions of the neurotransmitters, especially gamma-aminobutyric acid (GABA) that helps calm the brain and body [1]. Also, over-the-counter (OTC) sleep aids like antihistamines or melatonin supplements help with sleep by treating mild sleep problems. They are intended for a milder effect compared to prescription drugs.

Sleeping pills are effective, but they do not cure chronic insomnia, or other underlying medical conditions, for that matter. However, they should never be used without the guidance of a doctor and can easily lead to dependency and tolerance or cause adverse effects.

Sleeping pills come in various forms, each with distinct purposes and side effects:

Prescription Sleeping Pills: Commonly prescribed for treating short periods of insomnia are medications such as zolpidem (Ambien), temazepam (Restoril), or eszopiclone (Lunesta). Dizziness, daytime drowsiness, and memory issues are commonly observed adverse effects of these drugs.

Over-the-counter (OTC) Sleep Aids: Antihistamines such as diphenhydramine and doxylamine are included in this group. They can be used effectively for occasional use but side effects can range from dry mouth to reduced alertness, and grogginess.

Natural Supplements: Two of the most common sleep support ingredients used without strong sedation are melatonin and valerian root. For most people, the side effects of these are mild, such as headaches or mild stomach upset.

Long-term use, or use of sleeping pills for longer than necessary, may lead to dependency, or increased tolerance (the need for higher doses) or when the pills are suddenly stopped, can lead to withdrawal symptoms. These medications can also interfere with cognitive and motor function and thus raise the risk of accidents or falls.

How Does Alcohol Affect Your Sleep And Overall Health

Alcohol is a type of central nervous system depressant that alters behavior and the way your brain and body function. A couple of drinks might help someone go to sleep quicker, but it disturbs a healthy sleep cycle, especially during REM (rapid eye movement) sleep [2]. The duration of REM Sleep can be substantially reduced by drinking alcohol, during the night when it is most restful for memory consolidation, emotional regulation, and physical restoration.

Alcohol not only impairs sleep; it damages all aspects of our health. Long–term use can result in heart problems, damage to the liver, and deterioration of the brain. It also damages the immune system and raises the chances of experiencing other mental health problems like anxiety and depression. Binge drinking even occasionally can impair judgment or your ability to move around, and increase the chance of accidents or injuries.

Why It’s Dangerous To Mix Alcohol With Medications

The combination of alcohol with medications, such as sleeping pills, has unpredictable and frequently damaging consequences on their effects. Alcohol slows or speeds up the drug’s metabolism rate. Over-sedation, impaired cognitive function, and some suppression of breathing are possible.

The depressant effects of alcohol combined with the effects of the sleeping pill, put the risk of more severe side effects, such as confusion, lightheadedness, and fainting, or even overdose at higher levels. Further, both substances severely tax the liver, making them even more likely to cause liver damage or failure over the years.

Why Is It Dangerous To Take Alcohol With A Sleeping Pill?

Alcohol and sleeping pills should never be combined, because both medicines affect the central nervous system (CNS) and alcohol makes narcotics come on stronger and last longer. Alcohol and most sleeping pills are CNS depressants which means they slow the body and brain down. While at first, this would seem to promote relaxation or sleep, the combined effects can be lethal.

One big concern is respiratory depression in which your breathing gets very slow, even to the point of unconsciousness or death. Prescription sleeping pills, such as benzodiazepines or non –benzodiazepine hypnotics, which amplify the sedative effect, carry an increased risk of this. That combined depressant effect can overwhelm the body’s ability to perform necessary functions such as breathing and maintaining heart rate.

Other dangers include:

Severe cognitive impairment: These combinations of these substances confuse, blackout of memory, and bad decision-making.

Increased risk of overdose: Even at therapeutic doses of medication, alcohol can exacerbate the effects of sleeping pills and bring on an unintentional overdose.

Heightened accidents and injuries: The risk of falling, crashing the car, or anything going amiss due to impaired coordination or drowsiness is much higher.

How Alcohol + Sleep Medicine Can Be Bad For You – Drug Synergism

Drug synergism is used to describe the boosted and sometimes unpredictable effects arising from the synergistic interaction of two substances. Alcohol and sleeping pills work together to have much more of an effect than the effects of either one individually. Both substances amplify each other’s ability to slow down the CNS. For example:

  • Even if it seems mild on its own, a single glass of wine alongside a sleeping pill will produce extreme drowsiness, slurred speech, or unconsciousness.
  • Mixing sleeping pills even in small amounts with even a little alcohol can cause breathing to slow almost immediately and heart rate to plummet, which can be fatal [2].
  • The body’s ability to metabolize both drugs is hindered by drug synergism. Alcohol and sleeping pills are processed by the liver and when you have both, the liver is overwhelmed. That can result in a toxic buildup of either substance in the bloodstream, which could promote side effects or lead to long-term organ damage.

The Immediate Physical And Mental Health Risks

Combining alcohol and sleeping pills has short-term effects that are very serious and can be seen even on single use. Immediate physical risks include:

Excessive sedation: It may make individuals incredibly drowsy so that they can’t remain awake or perform daily activities.

Respiratory depression: Slower or shallow breathing can lead to oxygen deprivation, fainting, or even death.

Nausea and vomiting: Sleeping pills slow down the gut motility and irritate the stomach lining and having it mixed with alcohol is a recipe for severe gastrointestinal distress resulting in indigestion, nausea, and vomiting.

Mental health risks include:

Confusion and memory loss: Together it can impair cognitive abilities, resulting in blackouts or an inability to remember events.

Poor coordination: Increased clumsiness and poor motor control increase the risk of falls or other accidents.

Mood disturbances: Irritability, anxiety, or depression may occur and become worse after the drugs wear off.

Long-Term Consequences Of Alcohol And Sleep Aids

Repeated use of alcohol and sleeping pills together brings about significant long-term health risks, including:

Addiction and dependency: Both are highly addictive separately and together can lead to a physical or psychological dependence. In time, you need higher doses to achieve the same effect, and the more the dose, the more the health risks.

Organ damage: Since these substances are processed in the liver and kidneys, using them for a long time might damage your liver or kidney, causing liver cirrhosis or renal failure.

Mental health deterioration: Chronic use may exacerbate anxiety, and depression and cause the rapid decline of cognitive skills and decision-making.

Increased risk of overdose: This habitual use desensitizes the brain, making the person want to take more to have the desired effect, leading to more chance of an overdose.

In comparing the health risks of alcohol to sleeping pills we should keep in mind that both cause significant harm to the body based on how they’re used.

Alcohol is consumed in many social gatherings and has now become a social beverage in many places. However, regular or excessive consumption carries with it serious health risks. Regular alcohol misuse can cause liver disease, heart problems, and nerve damage. What’s more, alcohol takes a toll on mental health, leading to a greater risk of depression, anxiety, and problems with dependency.

On the other hand, sleeping pills are medical treatments designed for one purpose – and are usually safe if used as directed. But if they are used for too long or not in the right dose, you could become tolerant, dependent, and suffer severe withdrawal symptoms when you stop. Misuse over the long term can damage cognitive ability and raise the risk of falls or accidents.

In general:

For long-term health: Alcohol is more harmful because it causes systemic damage to organs like the liver and the brain [1].

For short-term risks: Acute side effects from sleeping pills — like impaired coordination or respiratory depression — are more likely when the pills are combined with other substances.

In all, the misuse (or taking in combination with other drugs) of either substance substantially raises the danger of their use.

When Does Alcohol Or Sleeping Pills Present The Highest Health Risk

The risk of a sleeping pill or alcohol depends in part on the person’s metabolism using it and in part on their general health situation.

Alcohol risks peak in these scenarios:

Binge drinking: Consuming large amounts leads to acute health issues (such as alcohol poisoning).

Pre-existing conditions: Alcohol’s effects are more pronounced in people with liver disease, diabetes, and mental health disorders.

Combination with medications: Many medicines, including sedatives and painkillers, are more powerful than alcohol.

Sleeping pill risks are highest in these cases:

Incorrect dosing: Excessive intake past the specified dose results in side effects that are very hard.

Use with alcohol or other depressants: Combined sedative effects can suppress breathing and can be fatal.

Prolonged use: Regular misuse can cause it to become a dependency, to develop tolerance and withdrawal symptoms.

How to Minimize The Risks Of Sleeping Pills or Alcohol

The best way to protect your health is to use sleeping pills and alcohol in moderation (or where possible, not at all). Here are some practical tips:

Follow medical advice for sleeping pills: No matter what, never self-medicate and always follow the prescribed dosage.

Avoid mixing substances: Always avoid mixing sleeping pills or other drugs with alcohol unless you’ve been permitted a health care professional.

Limit alcohol intake: Drink no more than 14 units in a week (proportionate to individual units in most countries).

Seek alternatives: If you’re having trouble sleeping, try talking to your doctor about finding non-medicinal ways to get a better night’s sleep, such as relaxation techniques, therapy, and lifestyle changes.

Store substances safely: Always keep sleep aids away from children and anyone else who may suffer addiction to them.

Monitor usage: If you frequently use sleeping pills or alcohol as a crutch, see a professional to find out what lies beneath the surface.

Non-Medical Alternatives For Getting A Good Night’s Sleep

For those struggling with sleep issues or stress, there are safer and more sustainable solutions than sleeping pills or alcohol:

1. Lifestyle Adjustments

Establish a sleep routine: Going to bed and waking up at the same time every day.

Avoid stimulants: Avoid caffeine and a heavy meal before bedtime.

Create a sleep-friendly environment: Your bedroom should be kept cool, quiet, and dark.

2. Relaxation Techniques

Meditation and mindfulness: Such as deep breathing, or guided meditation can be used to help us relax and enjoy a good night’s sleep.

Progressive muscle relaxation: Reduction in physical tension can be simply done by gradually tensing and releasing muscles. Progressive muscle relaxation can lead to better sleep patterns.

3. Therapy And Counseling

Cognitive Behavioral Therapy for Insomnia (CBT-I): CBT-I is a proven nonpharmacologic treatment of sleep disorders.

Stress management therapy: Addressing the root causes of stress does not only help with stress but does help with overall well-being and sleep disorders.

4. Natural Remedies

Herbal teas: Drinking chamomile or valerian root tea can help to calm your systems and lead to better sleep.

Supplements: Melatonin, magnesium, and L theanine may help with sleep, but it’s better to check with a doctor about the effectiveness and correct use of these.

FAQs

How Long After Drinking Alcohol Can I Take Sleeping Pills?
How long to wait until taking sleeping pills after drinking depends on how much you have drank, and of course the rate at which your body can process and eliminate alcohol. It’s generally a good idea to wait at least 6 to 8 hours after drinking alcohol before driving. This way the interactions cannot block breathing or bring that extreme drowsiness. If you’ve had more than one or two standard drinks, you should probably skip the sleeping pills altogether that night and talk to your doctor about safer alternatives.
Can You Take Red Wine And Sleeping Pills Together?
While taking red wine in moderation is safe, combining it with sleeping pills is not. Both are depressants of the central nervous system and can reinforce the sedative action. In even small amounts, red wine can enhance the effects of sleeping pills to cause a lack of coordination, low breathing levels, or serious drowsiness. In a nutshell, you should not take sleeping pills if you have had red wine to avoid serious health risks.
If You Mix Sleeping Pills And Whiskey What Is Likely To Happen?
Sleeping pills mixed with whiskey (or any hard liquor) are extra dangerous because whiskey contains high alcohol content. Together this increases the risk of severe respiratory depression, extreme sedation, and loss of consciousness. It can also cause poor judgment, and coordination and make you more likely to suffer accidents or injure yourself. In the worst case, you can pass out — or die — from a whiskey sleeping cocktail, even in healthy people.
Can I Use Herbal Sleeping Aids With Alcohol?
Herbal sleeping aids like valerian root or natural aids like melatonin are usually deemed safer. Yet, they can interact negatively with alcohol. Herbal pills may interact with alcohol increasing drowsiness and the risk of impaired functioning. Although these supplements are less likely to have bad side effects than prescription drugs, it is best not to use them with alcohol.
Why Do Older Adults Get More Severely Affected By Alcohol And Sleeping Pills?
 
The metabolism and drug clearance being age-related, older adults are more vulnerable to the effects of alcohol and sleeping pills. Plus, their bodies don’t process substances as quickly, extending the half-life of alcohol and sleeping pills and making them more vulnerable to harmful interactions. Further complicating the effects, older adults often take other medications for other health conditions. These factors are why alcohol and sleeping pills are particularly dangerous when combined for this age group.

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