Sleeping Pills: An Introduction 1 1 Sleeping Pills: An Introduction What Are Sleeping Pills? Most sleeping pills are “sedative hypnotics.” That’s a specific class of drugs used to induce and/or maintain sleep. Sedative hypnotics include benzodiazepines, barbiturates, and various hypnotics. SLEEPING PILL ABUSE: ITS SIGNS AND SYMPTOMS A number of people underestimate the powerful grip sleeping pills like Ambien or Sonata can have over someone’s life and the dangers of abusing these drugs. 2 The Effortless Sleep Method: Cure for Insomnia... Many people abusing sleeping pills experience memory and concentration problems. Some of the signs of sleeping pill abuse include: • Slurred speech • Uncoordinated movements • Unsteady gait • Inability to focus • Impaired memory • Unusual euphoria. SLEEPING PILLS: ITS MAIN DANGERS Both the immediate and long-term dangers of sleeping pill abuse are enough for most people to exercise caution when using them. However, many people aren’t aware of the dangers of these medications. The dangerous effects of sleep medications range from seizures to depressed breathing. Some people also experience allergic reactions from sleeping pills that can cause difficulty breathing, chest pain, nausea and swelling. Though rare, people who use sleeping pills may even develop parasomnias. Parasomnias are defined as sleep disorders that include behaviors like sleep-walking, sleep-eating, sleep-sex, sleep- driving and other potentially dangerous sleep-related activities. The immediate dangers of sleeping pills range from minor fatigue to coma. Some of these side effects can even lead to deadly overdoses, casting light on the true dangers of sleeping pills. Common symptoms of sleeping pill abuse are: • Dizziness • Dry mouth • Difficulty with coordination • Daytime drowsiness • Memory loss • Unusual dreams • Itching and swelling Sleeping Pills: An Introduction 3 • Lightheadedness • Depressed breathing rate. The people who use sleeping pills over a long period of time are likely to experience intensified side effects. As they continue taking these pills over time, the substance builds up in their body and produces unwanted side effects. These effects may include high blood pressure, irregular heartbeat and depression. One side effect that most chronic sleeping pill users experience is “rebound insomnia,” or the resurgence of sleeping troubles once the user stops taking the drug. Often, this kind of insomnia is worse than the original insomnia. 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. Recognizing a Sleeping Pill Addiction Sleeping pills pose a serious threat of dependence, as they are oft-prescribed and commonly abused. Several people who develop an addiction to sleeping pills have reported increasing their dose after the effects had diminished. Over time, they developed a tolerance that turned into an addiction. The first step in overcoming this powerful addiction is recognizing that there’s a problem. The Diagnostic and Statistical Manual of Mental Disorders outlines the full criteria for clinically diagnosing an addiction. These criteria include behavioral and physical symptoms that result from prolonged drug use. Those who become addicted to their sleep medication may exhibit symptoms such as: • Needing larger doses to fall asleep • Trying and failing to quit more than once • Ignoring social, professional and familial obligations • Seeming confused or frequently detached. 4 The Effortless Sleep Method: Cure for Insomnia... Intervention and Next Steps If someone you care about exhibits the signs and symptoms of having an addiction to sleeping pills, whether it’s Lunesta, Sonata or Ambien, it’s time to talk to them about getting help. Staging an intervention is one of the best ways to show an addicted person that you are on their side and that it’s okay to get help. The objective of intervention is to get the addicted person in treatment immediately. Some families hire an intervention specialist for help managing the situation. Specialists can also help you figure out what to say to your loved one and outline consequences if they refuse to get help. Withdrawal and Treatment Those who have taken sleeping pills frequently over a long period of time will experiencewithdrawal symptoms when quitting. These symptoms may last for over a month depending on the user. These symptoms can be damaging and are best managed through a professional medical detox. These withdrawal symptoms are caused by the body’s dependence on sleeping pills to create a physical and mental equilibrium. Symptoms include anxiety, sweating, and, sometimes, seizures. Rebound insomnia is also particularly hard to overcome for many people, but it can be managed through proper treatment. A trained medical professional can help you overcome your sleeping pill addiction without the symptoms of quitting “cold turkey.” SLEEPING PILLS AND THE ALTERNATIVES More than 10 million prescriptions for sleeping pills are given each year in England, but medication only offers short-term relief. Non-drug treatments have been under-used, but sleep experts say they offer the best long-term solutions to chronic insomnia. Professor Kevin Morgan of Loughborough University’s Sleep Research Centre says that sleeping tablets treat the symptoms of Sleeping Pills: An Introduction 5 insomnia, not its causes. He has been researching psychological treatments for insomnia, focusing on behavioural change and self- help to promote better sleeping patterns. It was always assumed that if people had insomnia alongside a more serious condition, then curing that illness would cure the insomnia. Nowadays, however, insomnia is generally treated as a separate illness. Before your GP can make a diagnosis, you may be asked to keep asleep diary, in order to record bedtimes, wake times, hours slept and quality of sleep each morning. “Sleep diaries are an invaluable insight into the patient’s sleeping habits. If continued during therapy, they’re a useful way of monitoring the outcome of treatment,” says Professor Morgan. If insomnia is diagnosed, the main treatments are: Sorting out ‘sleep hygiene’ Lifestyle, especially your sleeping habits, have a big impact on your quality of sleep. Addressing so-called “sleep hygiene” should be the first step in any insomnia treatment. Sleep hygiene is a list of lifestyle dos and don’ts. It has proved to be effective in stopping insomnia from getting worse, and making it easier to benefit from further treatment. “It’s a useful first step in treatment, and sends the important message that behaviour and lifestyle choices can influence sleep quality,” says Professor Morgan. 6 The Effortless Sleep Method: Cure for Insomnia... Habits such as drinking too many caffeine-based drinks (including coffee, tea and some energy drinks) or exercising too close to bedtime will affect your sleep. “If you have a sleep problem, it’s worth looking at your personal habits. It could be that your sleep is being ruined by your regular espresso before bed,” says Professor Morgan. “Sleep is fragile,” he says. “You’ve got to look after it.” Cognitive behavioural therapy (CBT) Once sleep hygiene has been addressed, and there’s no improvement in your insomnia, CBT is the next step. It’s a package of treatments that usually includes sleep restriction, stimulus control, cognitive therapy and relaxation techniques. • Sleep restriction: Some people with insomnia may benefit from a sleep restriction programme that allows only a few hours of sleep during the night, at first. Gradually, the time is increased until you achieve a more regular night’s sleep. • Stimulus control: This therapy rebuilds the association between the bedroom and sleep by limiting the amount of time you spend awake in bed. “The environment can stimulate behaviour,” says Professor Morgan. • Cognitive therapy: Thought-blocking therapies are used to reduce anxiety about not falling asleep. Professor Morgan says: “Cognitive therapy can help break this vicious circle by teaching you a different way of worrying. Do your worrying at a different time, write down your fears and discipline yourself not to worry about things around bedtime.” • Relaxation therapy: There are specific effective techniques that can reduce or eliminate anxiety and body tension. As a result, the person’s mind stops racing, the muscles relax and restful sleep can follow. Sleeping tablets GPs are advised to turn to hypnotic drug therapy only after considering non-drug therapies, such as those outlined above. Sleeping Pills: An Introduction 7 Benzodiazepines (such as Temazepam or Loprazolam) and the newer “Z medicines” (such as Zopiclone or Zolpidem) are the preferred drugs for insomnia. Both types of drugs work in a similar way. If one doesn’t work, swapping to the other is unlikely to have a different effect. “These drugs are very effective sleep inducers,” says Professor Morgan. “They work immediately, they’re not toxic and they’ve been shown to be safe in overdose.” However, they’re only recommended for the short-term treatment of insomnia – up to four weeks. “Very few insomnia cases only last four weeks,” says Professor Morgan. “Most clinical insomnias are chronic, so most of these drugs are prescribed for longer than they should.” In any case, the drugs lose their effectiveness over time because the body gets used to them. By that stage, the person has become psychologically dependent on them. SLEEPING PILLS COULD SHORTEN YOUR LIFE For over 35 years a person worked to assess the risks of sleeping pills. He has learned that sleeping pills are associated with significantly increased mortality. He first became interested when he saw the work of Dr. E. Cuyler Hammond at the American Cancer Society. In 1975, he went to visit The American Cancer Society, starting a collaboration which lasted for many years.