Phasing out sleep medications

Withdrawing from sleep medication

Today is International Sleep Day. This day is a good time to reflect on your "sleep. Perhaps you have been using sleeping pills, such as benzodiazepines, to sleep better for some time. How you can safely taper off and what you can expect from us, you can read below.

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What is the International Day of Sleep?

The International Day of Sleep is designed to draw more attention to the importance of a good night's sleep. Healthy sleep is important for your well-being, concentration and energy during the day. On this day, healthcare and health professionals, like us at the pharmacy, share tips and advice to improve your sleep quality.

What can you do if you sleep badly?

Fixed sleep times - Get up at the same time every day, including weekends.
Avoid naps - Especially after 3 p.m., so as not to disrupt sleep rhythms.
Restrict screen time - Stop using phone, tablet or laptop at least an hour before bed.
Create a sleep ritual - Read a book, take a hot shower or listen to soothing music.
Stay up when awake - Awake for more than 20 minutes? Get out of bed and do something relaxing in dimmed light.

Surroundings

Cool, dark and quiet room - Ensure a temperature around 18°C and blackout curtains.
Comfortable bed - Make sure your mattress and pillow are still good.
No clock watching - This increases stress and makes it harder to relax.

Nutrition and Lifestyle

No caffeine after 2 p.m. - Coffee, tea and cola can disrupt sleep.
Light dinner - Avoid heavy meals right before bed.
Avoid alcohol - Seems relaxing, but disrupts deep sleep.
Regular exercise - Exercise during the day, but not right before bed.

Ontension techniques

Breathing exercises - For example, 4-7-8 breathing (inhale for 4 sec, hold for 7 sec, exhale for 8 sec).
Progressive muscle relaxation - Muscle tension and relaxation from head to toe.
- Breathing exercises - For example, 4-7-8 breathing (inhale for 4 sec, hold for 7 sec, exhale for 8 sec).
- Progressive muscle relaxation - Muscle tension and relaxation from head to toe.
Mindfulness or meditation - Calms the mind and helps release brooding thoughts.

What sleep aids are there and when are they prescribed?

Short-acting benzodiazepines
Short-acting benzodiazepines, also called short-acting sleep aids, work to relax muscles, calm and make you drowsy. They work briefly and are therefore mainly used if you have trouble falling asleep. Examples are brotizolam, flunitrazepam, loprazolam, midazolam, temazepam, zolpidem and zopiclon.

Sleep aids are best used only occasionally and not for long periods of time in a row. This is because with prolonged use, habituation and dependence can develop.

Long-acting benzodiazepines
Long-acting benzodiazepines, also called sleep aids, work to relax muscles, soothe and make you drowsy. They work for a fairly long time and are mainly used to help you sleep through the night. These drugs can also make you drowsy during the day. Examples are diazepam, flurazepam, lorazepam, lormetazepam, nitrazepam and oxazepam.

Sleep aids are best used only occasionally and not for long periods at a time. This is because with prolonged use, habituation and dependence can develop.

Valerian
Valerian is an herbal remedy. It has a mild calming effect. This can help you fall asleep better.

Mapardberry leaf with vine leaf
Mapardberry leaf with vine leaf is an herbal remedy. It can be used for insomnia. Exactly how it works is not known. There is no evidence that this herbal remedy works for insomnia.

Melatonin
Melatonin is a hormone made in the brain. It is thought that melatonin has something to do with human biorhythms. Its release occurs in the evening. Under the influence of light, melatonin release decreases again. Melatonin is used in sleep disorders.

Levomepromazine
Ernestically ill people or people who are dying may be very anxious, restless, confused or in a lot of pain. Artificial sleep can ease this period. Levomepromazine provides artificial sleep. It is used to enhance the effect of the sleep aid midazolam if it does not work adequately.

Chloral hydrate
Chloral hydrate is sometimes used in people with mental disorders.

Amitriptyline
Ernstricken people or people who are dying may suffer from insomnia. Amitriptyline can then be used if benzodiazepines do not work sufficiently.

Trazodone
Trazodone can be used for sleep problems in seriously ill people, people who are dying or people who suffer from post-traumatic stress disorder (PTSD).

Mirtazapine
Mirtazapine can be used for sleep problems in seriously ill people, people who are dying or people who suffer from post-traumatic stress disorder (PTSD). It can also be used for severe sleep problems in depressed adolescents when other measures do not help.

Why taper off benzodiazepines?

Many drugs may initially help you fall asleep faster and promote deep sleep. However, with long-term use, dependence can develop and side effects can occur. Therefore, when you are ready to stop, it is important to work with us to create a phase-out schedule. This will give your body time to slowly get used to less medication and prevent withdrawal symptoms.

Tips for a smooth phaseout

Always consult with us: Don't stop your medication abruptly. Discuss your plans with us so that together we can create a safe phase-out schedule.
Keep a sleep schedule: Record when you go to bed, how long you sleep and how you feel. This helps to see if your sleep improves as you wind down.
Adjust your lifestyle: Get regular exercise, a healthy diet and a quiet bedroom.
Be patient: Tapering off takes time. Withdrawal symptoms may occur at first, but this is usually temporary.