Most of the people who come to me for help with sleep are already on sleeping pills – so why do they still have insomnia?
If the so called “sleeping pills” aren’t working, then why do some seniors have so much resistance to stopping them, or even reducing them? Sleeping pills can cause insomnia and using sleeping pills nightly can lead to a vicious cycle of medication tolerance and subsequent sleeplessness, prompting a request for a higher dose and additional sedatives.
Is it insomnia?
Below are a few true or false questions about sleeping pills to test your knowledge:
Seniors who are currently taking sleeping pills should stop them immediately.
FALSE - If you’re reading this and thinking about stopping your sleeping pills, don’t do so abruptly or without guidance from a physician or pharmacist. Stopping suddenly can cause withdrawal symptoms, such as shakiness, irritability, headaches, sweating, and, naturally, insomnia. Seizures can even occur with abrupt discontinuation of some types of sleep medications (the benzodiazepines, especially).
Over the counter (OTC) sleep aids are safer than prescriptions for older adults.
FALSE Most OTC sleep aids contain mediations that are intended to treat other conditions, like allergies or motion sickness, but have sedating properties. These types of medicines can interact with prescriptions and with common health conditions (see Box 1, below)
Some people need to be on sleeping pills for the rest of their lives in order to sleep at all.FALSE Sleeping pills are meant to be used for two weeks or less and using them for longer than that is more likely to result in a lack of effect and a perceived need for a higher dose. In fact, the recommended first line treatment for insomnia is not a pill at all.
Otc sleep aids – beware!
OTC’s like Gravol, Benadryl, Nyquil or Tylenol PM are used by many insomnia sufferers for their sedating side effects, but can interact with common conditions such as dementia, osteoporosis, falls.
Their common side effects include: dry mouth, constipation, falls, low blood pressure.
They can interact with other meds, such as: antidepressants, pain relievers, cough and cold remedies.
OTCs are not necessarily safer than prescription sleeping pills!
Having described the hazards of sleeping medications, you may wonder how sleep challenges can be treated at all. However, there is reason for those with insomnia to be hopeful – the advent of Cognitive Behavioural Therapy for Insomnia (CBTi). You have probably heard of Cognitive Behavioural Therapy (CBT) for the management of anxiety or obsessive-compulsive disorder, and CBT is a treatment plan of learning techniques of self talk and reframing thinking.
Find out more about sleep changes with aging in this video by Dr. Didyk:
The Wrinkle Can Help
Contact Dr.Didyk if you need help with techniques to get to sleep and stay asleep.
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