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By Kajal Jain

M. Pharm

14 October 2022
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Kajal Jain
M. Pharm
does-valium-make-you-sleepy
Table of Contents

Sleep disturbances are shown in the case of insomnia; nowadays, each individual suffers from some sleeping difficulties due to a poor environment. Valium is used to treat anxiety disorders. The person who is having anxiety is always connected to sleeping issues due to the excess level of fear; it will make the body and brain awake the whole night and will lead to worsening conditions. 

According to the survey, the national institute of health reports about 7% to 19%  Adults are not getting enough sleep. About 70 million people have chronic sleep disorders. 

Valium is a multipurpose drug used to treat anxiety disorder, muscle spasms, and panic disorder. It is shown that people with sleeping issues related to anxiety can use valium to treat insomnia as an off-label drug use.
Let us understand in detail, 

What Is Valium (Diazepam)?

Valium (diazepam) is a member of the benzodiazepine class of medications. Diazepam was developed to find a drug that might effectively treat anxiety and seizures.

The United States Drug Enforcement Administration classified diazepam as a Schedule IV controlled substance (DEA). This suggests that the drug has the potential for abuse and that those who use it regularly for any period may become physically dependent on it.

Indications

  • Used in treating anxiety disorders.
  • As adjunct therapy for muscle spasms, spasticity associated with upper motor neuron disorders, preoperative anxiety relief, insomnia, management of certain refractory epilepsy patients
  • Alcohol detoxification:  In acute alcohol withdrawal, diazepam helps in symptomatic relief of agitation, tremor, alcoholic hallucinosis, and acute delirium tremens.
  • As an adjunct in recurrent seizures and status epilepticus.
  • Off-label use includes sedation in the ICU and short-term treatment of spasticity in children with cerebral palsy. 
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Mechanism

Diazepam binds to a specific location on the alpha-gamma subunit interface and acts as a positive allosteric modulator of the GABA-A. When diazepam interacts with these locations, neuronal chloride-ion influx increases following GABA binding.

This results in hyperpolarized postsynaptic membranes, amplifying the CNS depression response to GABA. There is evidence that diazepam binds to voltage-gated sodium channels in addition to the GABA-A receptor, which could explain some of its anticonvulsant effects.

Dosing of Valium

1. Treatment of acute ethanol withdrawal:

The initial dose should be 10 mg IM or IV. A 5 to 10 mg follow-up dose is allowed 3 to 4 hours later. The recommended dosage for the oral tablet is 10 mg every 6 to 8 hours for the first 24 hours, followed by 5 mg every 6 to 8 hours as required.

Valium is used to treat sleeping disorders like insomnia; it will help you regulate the brain's chemical called gamma-aminobutyric acid and allow you to get a complete sleep cycle.
When it comes to dosage, it will differ from one to another. For sleep issues related to anxiety, 5mg to 15mg can be taken at bedtime.
The use of the drug valium for more extended periods will lead to Valium abuse and shows side effects like drowsiness, sleeplessness, etc. Overuse of the drug continues, and it worsens your condition.

2. Treatment of anxiety:

2 to 10 mg orally, 2 to 4 times per day. A dose of 2 to 10 mg can be given parenterally and repeated in 3 to 4 hours.

3. Treatment of muscle spasms:  

Administer 2 to 10 mg orally, 3 to 4 times daily. For parenteral administration- an initial dose of 5 to 10 mg may be supplemented with an additional dose of 5 to 10 mg in 3 to 4 hours, if necessary.

4. Treatment of preoperative anxiety:

Administer 10 mg IM before surgery

5. For ICU sedation:

Start with a loading dosage of 5–10 mg, then administer a maintenance dose of 0.03–0.10 mg/kg every 0.5–6 hours.

6. Treatment of seizures:

As adjuvant maintenance therapy, administer 2 to 10 mg orally 2 to 4 times daily to treat seizures. Rectal gel 0.2mg/kg is an alternative for intermittent seizure control.

7. Skeletal muscle relaxant:

Take 2 to 10 mg three to four times a day.

8. Treatment of status epilepticus:

0.15 to 0.20 mg/kg IV per dose, repeatable as necessary. Do not take more than 10 mg in one dose.

Side effects

Side effects of diazepam can depend on the level of use.

  • Euphoria
  • A reduction in motor coordination
  • Decreased rate of thought
  • Drowsiness.
  • Dizziness.
  • Slurred speech.
  • Muscle weakness.
  • Extreme confusion.
  • Disorientation.
  • Extreme weakness.
  • Significantly reduced energy levels.
  • Restlessness.
  • Diarrhea.
  • Dry mouth. 

Does Valium make you sleepy?

Diazepam (Valium) can make you sleepy and impair focus and concentration. Until you know how the medication affects you, avoid activities that require alertness, such as driving or operating machines.

The drug Valium makes you drowsy and can make you sleep even during the day.

How does Valium make you sleepy?

The potential for diazepam to cause daytime sleepiness exists. Drowsiness is one of the medication's frequent side effects. GABA receptors play a significant role in drowsiness caused by Valium.

GABA reduces the nervous system's activity by blocking or inhibiting specific brain messages and produces a calming effect when it binds to the GABA receptor. This explains why GABA is effective in treating seizures and issues like anxiety.

There is evidence that patients with severe daytime sleepiness exhibit higher GABA activity. High GABA concentrations are present in the medial prefrontal cortex. It is simple to draw a connection here, even though more investigation is required.

Valium works by increasing the brain's GABA concentration. An increase in GABA results in daytime sleepiness. The fact that Valium may cause a variety of side effects, such as fatigue, is important because these side effects can all intensify the effects of drowsiness.

When you combine Valium with other drugs or alcohol, these issues only get worse.

Studies related to Valium induced sleepiness

A study published in the Drug Investigation journal examined the ability of several medications to cause daytime sleepiness. In a double-blind, randomized, comparative trial, 44 healthy volunteers were given alprazolam 0.5 mg, buspirone 5 mg, or diazepam 5 mg orally three times daily for seven consecutive days.

Daytime drowsiness on the first and seventh days was assessed using the multiple sleep latency test and direct EEG measurements. Sleep was tracked the night before each test day. Subjects who received alprazolam and diazepam on the first day of the treatment were noticeably sleepier than their buspirone-treated colleagues. 

In one trial, participants with insomnia received 10 mg of diazepam daily for 18 months; while this helped them sleep better, it also made them sleepy during the day.

Others Drugs that cause sleep problems

Drowsiness or experiencing unusual levels of sleepiness is a frequent adverse reaction to numerous drugs. Avoid operating machinery, driving, or performing other tasks that call for alertness, as all can be affected by drowsiness.

The following drugs may make you feel sleepy:

  • Narcotic painkillers (e.g., codeine, morphine)
  • Anti-emetics
  • Alpha-blockers and beta blockers
  • Certain benzodiazepines and sedatives
  • Certain anti-anxiety medications (e.g., diazepam, lorazepam, alprazolam)
  • Certain antidepressants; amitriptyline; and fluvoxamine
  • Certain antihistamines are present in cold and allergy products (e.g., diphenhydramine, chlorpheniramine).

Conclusion

When starting a new medication, it's important not to do any activities that require alertness, such as driving, until you know how it affects you. Alcohol can intensify the effects of the drug, causing you to become even more sleepy.

Valium has the potential for abuse since it is a controlled substance. Due to its ability to activate GABA receptors in your brain, the drug also causes drowsiness. Call your doctor if your medication is making you extremely sleepy or affecting your ability to drive or work.

  • Calcaterra NE, Barrow JC. Classics in chemical neuroscience: diazepam (valium). ACS Chem Neurosci. 2014 Apr 16;5(4):253-60. From https://doi.org/10.1021/cn5000056 Epub 2014 Feb 27. PMID: 24552479; PMCID: PMC3990949. Obatin on 13/10/2022
  • Dhaliwal JS, Rosani A, Saadabadi A. Diazepam. [Updated 2022 Sep 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:  https://www.ncbi.nlm.nih.gov/books/NBK537022/  Obtain on 13/10/2022
  • Dement, W.C., Seidel, W.F., Cohen, S.A. et al. Effects of Alprazolam, Buspirone and Diazepam on Daytime Sedation and Performance. Drug Invest. 3, 148–156 (1991). From  https://doi.org/10.1007/BF03259556 Obtain on 13/10/2022
  • Young, Anne B., Stephen R. Zukin, and Solomon H. Snyder. "Interaction of benzodiazepines with central nervous glycine receptors: possible mechanism of action." Proceedings of the National Academy of Sciences 71.6 (1974): 2246-2250. From https://doi.org/10.1073/pnas.71.6.2246 Obtain on 13/10/2022
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