Most people suffer from sleep deprivation caused by short-term disorders such as travel, extreme stress, and hospitalization, or long-term conditions such as chronic insomnia (or another sleep disorder), depression, and anxiety disorders. Start using over-the-counter or prescription drugs to help you cope. hyperthyroidism.
Most of my patients want to stop taking sleeping pills, but many are reluctant to try. There are many reasons why you might want to quit, including:
- A person’s or a doctor’s concern about overreliance on the drug.
- side effects.
- effect is fading.
- Personal health considerations such as pregnancy, upcoming surgery, and drug interactions.
And there are many reasons to keep taking the pill, including:
- The reassurance of having a good night’s sleep and the question of whether you can sleep without medication.
- Intense anxiety about lack of sleep.
- Attempts at weight loss failed, during which they endured difficult insomnia, anxiety, or other withdrawal symptoms.
If you, like my patients, want to taper off or quit your meds, but are feeling discouraged, giving up, feeling anxious, and lacking confidence, I can assure you that there is hope. think.
No single approach to reducing sleep aids
Sleeping pills are not a single category. Hypnotics and sedatives consist of different classes of agents with different modes, durations of action, and withdrawal challenges. There is no one-size-fits-all approach to reducing or stopping these various agents.
Actual considerations also vary by drug. Some tablets are not meant to be cut. Others can be cut, but some are too small to cut accurately. Some people may need to switch to another drug to stop the first drug, or they may need to decide which of two or more drugs to taper off first.
There are many other considerations. For example, if you have only taken the drug for one month, a tapering approach (to avoid long-term use) is probably faster than the gradual approach described below for long-term users.
How to Prepare to Reduce or Stop Sleeping Pills
There are some general principles for successful tapering.
- Work closely with your doctor to determine safe speeds and methods.
- Pharmacists can help by splitting tablets or assisting with compounding to create liquid formulations or split doses.
- go slow The biggest mistake my patients make is doing it too early. They are chastised and discouraged by the experience and eventually return to their normal intake.
But before you start losing weight, know what you’re on medication for. Removing hairballs is not a good idea if you don’t have the proper treatment. underlying sleepy situation. There are numerous examples of undiagnosed restless legs syndrome, sleep apnea, depression, or other conditions that cause sleep deprivation. Sleep specialists are good at classifying diagnoses.
I have a patient who has tried many times over the years to reduce her benzodiazepine intake. But each time she was plagued by her uncontrollable insomnia. I used this metaphor to explain why going slow is important.
Imagine a swimming pool with a shallow end and a deep end. Imagine a ramp connecting the two. It’s not a steep descent, it’s a gradual descent. If you sleep well with the help of medication, it is safe not from deep, but from shallow. But your goal is to become a competent, confident swimmer in the deep end, which means sleeping better without (or with less) medication.
There are three reasons for the slow taper.
- Taking it slow will minimize withdrawal symptoms, as well as insomnia, anxiety, and other symptoms associated with tapering off. If you are reducing the reduction very gradually, the system will hardly notice the change. You are going down the slope one small step at a time.
- The slow approach is of the form: Graded exposure therapy. Every time you go down the ramp, every time you take a new dose, you can minimize and perhaps even overcome your anxiety before moving on to the more difficult steps. Now that you have mastered the previous steps, it may no longer feel difficult. Also, taking small steps feels relatively unsafe.
- A slow taper will give you time to develop sleep skills that will replace your medication. I wrote about some of these skills. Maybe I didn’t need it because I was on medication. By going slow, you will learn the skill of swimming at new depths. By the time you go deep, you will be a good swimmer.
With the doctor’s support, over the course of about a year, my patient reduced her dose by a factor of four.
Steps to stop or reduce the use of sleeping pills
With your doctor’s approval, there is one way to gradually lose weight. My patients tend to find it easy and non-threatening. For the sake of simplicity, let’s assume that she’s taking the whole pill and wants to quit.
- Establish step sizes and milestones. Decide if you want to reduce by 1/8th of a tablet at a time, by 1/4th or some other percentage. Let’s say 1/8. The first milestone is 7/8 of a tablet. Only work towards that milestone at first.
- Gradual increase How many nights during the week you take a milestone dose (e.g. 7/8ths) and how many nights you take a full dose (1 tablet). Start with a low dose once a week and gradually increase to 7 times a week, taking the high dose every night when you don’t take the low dose. You don’t need to hit all the numbers for a 0-7 night trip per week with a lower dose.
- disperse lower doses — For example, every 4 nights if you are taking small doses twice a week.
- It can be repeated for several weeks. For example, if you take a low dose every other night and a high dose on other nights, you can repeat that pattern for another 1-2 weeks.
- Once you reach your first milestone (e.g. 7/8 pills every night), that dose becomes the new high dose, and if you go down another step (eg, 3/4 pills), it becomes the new low dose. I have finished taking the pills. Flexibly repeat the pattern of reaching the first milestone to reach the second and subsequent milestones.
- Slow taper towards the end. An 8x reduction in 1 tablet is only a 12.5 percent reduction initially, while a 4x reduction in 1 tablet is a 50 percent reduction.
- Please do not back up the rampHowever, if necessary, return to the last well-slept step, stabilize there, and then resume the taper more slowly.
- plan what you are going to do Track where you are and stay determined by logging each night in an editable calendar.
You should feel in control. The goal is not perfect sleep or zero anxiety. Confidence in your ability to get through difficult times. You set the pace.
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