Worldwide, sleeping pills are among the most commonly prescribed medications. While hypnotic agents may be helpful if used once in a while, taken too often, they may also lead to dependence. Ultimately, sleeping pills are meant for short-term use.
The keyword here is intermittent use. If a person were to take a sleeping pill on a nightly basis for two to three weeks, then the person is likely to have problems with dependence. Doctors prescribe them for cases of severe insomnia and not necessarily on a strict dosage schedule. These drugs are fast-acting and can often be used on an as-needed (PRN) basis. Unfortunately, many people begin using sleeping pills anytime they have trouble sleeping or face something in life that makes them feel anxious.
One side effect of acute withdrawal from sleeping pills that most chronic users experience is “rebound insomnia,” or the resurgence of sleeping troubles once the user stops taking the drug. Rebound insomnia is most common when the user abruptly stops taking their medication (also known as quitting “cold-turkey”) or reduces their dosage. Often, this kind of insomnia is worse than it was before the person started taking the medicine. Rebound insomnia might even cause bizarre and disturbing dreams that can lead to panic attacks and increased anxiety upon waking.
Rebound insomnia is a withdrawal symptom from an addiction to a sleeping pill and should not be considered a reason to continue use. Rebound insomnia is often the cause of relapse for those trying to recover. This can create a dangerous cycle of abuse. Fortunately, medically assisted detox can help minimize this and other symptoms of withdrawal.
Dependence is especially a problem of the older types of sleeping pills known as benzodiazepines. These drugs include Valium or Xanax and are also commonly prescribed for anxiety disorders. Newer sleeping pills like Zolpidem, often called “Z-drugs,” seem to be less physically addictive, though they may foster psychological addiction. Without the sleeping pill, a person may feel anxious at night and find it difficult to sleep. If that happens, it could be a sign of physical or emotional dependence or both.
Some studies show that long-term use of sleeping pills actually interferes with sleep. The best way to avoid developing a physical or emotional dependence on sleeping pills is to follow the doctor's instructions and stop taking the drug when recommended.
There are two forms of dependence, physical and psychological. Physical dependence means the body adapts to a drug and responds physiologically if he stops taking it. Psychological dependence means that a person thinks that he cannot sleep without meds.
The following signs may indicate that a person is becoming dependent on a sleeping pill:
First, when the individual develops tolerance to the medicine.
Steadily increasing the dosage is a classic sign of most addictions. Over time, the amount of drug he has been prescribed stops working and he needs more and more to get the same effect.
Second, prolonged use of the sleeping pill.
Long term use of sleeping pills is generally not recommended. Taking these sleep aids for months or years and not being able to quit –despite trying– is another sign of dependence.
Third, doctor-hopping to get more of the sleeping pills.
Fourth, having withdrawal symptoms.
Taken in high enough amounts for long enough, sleeping pills, especially benzodiazepines, can lead to withdrawal symptoms like body trembling, increased sweating, anxiety, fast heartbeat or palpitations and surge in blood pressure.
Fifth, when one’s work or social obligations get affected.
The person’s main preoccupation is to search for the medicines, to obtain them and to take them. He ignores and neglects the other aspects of his life – work, studies, family and social occupations, hobbies and relationships.
If an individual has a long-term habit of taking sleeping pills, it is not advisable to stop them on his own as some may experience withdrawal fits or seizures. It is better to seek medical attention and to taper off over a period of two to four months. This will minimise any withdrawal symptoms. Certain types of therapy can also help him sleep without meds.
Sleep medications can be useful in the short term, but relying on them usually is not the best long-term solution for insomnia. For example, medications can mask an underlying problem that needs treatment. The best approach to insomnia is to address whatever is causing sleep problems in the first place. Other therapies include learning new sleep habits (such as keeping your bedtime and wake time consistent from day to day), acquiring strategies to manage anxiety or other psychological concerns, learning relaxation techniques and how to unwind for 1 to 2 hours before bedtime.
