Hypnotic

Hypnotic is a term used in pharmacology and medicine to describe substances that induce sleep or have sleep-promoting effects. In broader usage, hypnotic also pertains to hypnosis, a psychological state or technique.

Drug classes termed hypnotics include historical barbiturates; benzodiazepines such as temazepam; non-benzodiazepine “Z-drugs” such as zolpidem, zaleplon, and eszopiclone. Other modern hypnotics include melatonin receptor agonists (ramelteon) and orexin receptor antagonists (suvorexant). The term is often contrasted with sedatives and anxiolytics, reflecting varying effects on sleep initiation and maintenance.

Most hypnotics act by promoting sleep via the central nervous system. Traditional hypnotics like benzodiazepines and Z-drugs enhance GABA-A receptor activity, increasing inhibitory neurotransmission. Melatonin agonists align with circadian signaling, while orexin antagonists reduce wake-promoting signaling.

Clinical use is primarily short-term treatment of insomnia, including difficulties with sleep onset or maintenance. Use should be at the lowest effective dose and for the shortest duration. Risks include tolerance and dependence, withdrawal symptoms, cognitive impairment, daytime sedation, and complex sleep-related behaviors. Caution is advised with alcohol use, respiratory conditions, or in the elderly; interactions with other CNS depressants can be dangerous.

The term hypnotic comes from hypnos, the Greek god of sleep. In clinical contexts, hypnotic distinguishes sleep-inducing agents from other medicines; hypnosis is a separate area of practice involving suggestibility and trance states.