Using Benzodiazepines to Treat Sleep Disorder

Using Benzodiazepines To Treat Sleep Disorder

Benzodiazepines are potentially dangerous when used in combination with alcohol, and some medications, like the ulcer medication cimetidine, can slow the metabolism of the benzodiazepine.

This type of medication can be highly addictive.  When you stop taking this medication, you will probably have some withdrawl symptoms.  Withdrawal symptoms usually occur after prolonged use and indicate dependence. They can last one to three weeks after stopping the drug and may include the following:

•    Gastrointestinal distress.

•    Sweating.

•    Disturbed heart rhythm.

In severe cases, patients might hallucinate or experience seizures, even a week or more after the drug has been stopped.

Rebound insomnia, which often occurs after withdrawal, typically includes one to two nights of sleep disturbance, daytime sleepiness, and anxiety. In some cases patients may experience the return of original severe insomnia. The chances for rebound are higher with the short-acting benzodiazepines than with the longer-acting ones.

In addition, the following precautions are important in taking sleeping pills:

•    Start with non-prescription medication.

•    If prescription hypnotics are required, start with as low a dose as possible.

•    In general, do not take either prescription nor non-prescription sleeping pills on consecutive days or for more than two to four days a week.

•    If insomnia is still a problem after stopping the drug and continuing with good sleep hygiene, this pattern can be repeated again, but for no longer than four weeks.

•    Medication should be withdrawn gradually and the patient should be aware of the possibility of rebound insomnia when stopping medication.

•    Alcohol intensifies the side effects of all sleeping medication and should be avoided.

If chronic insomnia is a companion to depression or anxiety, treating these problems first may be the best approach. Some newer antidepressants may be effective at treating both depression and insomnia at once.
Over-the-counter and prescription sleeping medications are very commonly used medications.

Antihistamines cause drowsiness and many over-the-counter preparations are available that might help transient insomnia.  Most over the counter sleep aids use antihistamines ingredients, most commonly diphenhydramine. They may simply contain diphenhydramine alone (Nytol, Sleep-Eez, Sominex) or contain combinations of diphenhydramine with pain relievers (Anacin P.M., Exedrin P.M., Tylenol P.M.).  Doxylamine (Unison) is another antihistamine used in sleep medications.

Unfortunately, most of these drugs can leave patients drowsy the next day and may not be very effective in providing restful sleep. Side effects include daytime sleepiness, dizziness, drunken movement, blurred vision, and dry mouth and throat.

In general, these types of medications should be avoided by people with angina, heart arrhythmias, glaucoma, problems urinating, or while taking medications to prevent nausea or motion sickness. Some, such as those containing doxylamine should also be avoided by patients with chronic lung disease.