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Sleeping Pill Withdrawal

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Medications that are used to treat sleep disorders, like insomnia, are common in the United States. Sleep disorders are among the most widespread health problems in the country. The U.S. Centers for Disease Control and Prevention (CDC) states that as much as a third of the U.S. population do not get the recommended amount of sleep every night.

Drugs like Ambien and Zoloft are in a relatively new category of psychoactive substances called non-benzodiazepine z-drugs. These medications are similar to benzodiazepines in the way they affect the brain, but they have a unique chemical structure that sets them apart. 

They are also central nervous system depressants like benzodiazepines. They work in the brain to suppress excitability by increasing the effectiveness of a natural chemical called gamma-aminobutyric acid (GABA). GABA is designed to help calm you down and relax. People with sleep disorders may have a biological or psychological issue that prevents their normal processes, including the release of GABA, from effectively allowing them to get enough sleep, can use sleeping pills to promote rest.

However, these sleeping pills can also cause issues like chemical dependency, addiction, overdose, and potentially dangerous withdrawal symptoms. If you’ve been taking sleeping pills, it’s important to recognize the signs of withdrawal and how it can be treated safely. 

What Are Sleeping Pill Withdrawal Symptoms?

Even though they are said to be mild alternatives to benzodiazepines, they can cause some of the same adverse effects, including potentially life-threatening withdrawal symptoms. 

As a central nervous system depressant, a sleeping pill can cause your brain to adapt to its presence in your system. As your brain and nervous system adapt, the levels of excitatory chemicals in your system might increase to counteract the depressant. When you stop using abruptly, you’ll experience the result of a chemical imbalance that sends your nervous system into overdrive. 

Nervous system overstimulation can cause uncomfortable and even dangerous symptoms, including:

  • Anxiety
  • Depression
  • Insomnia
  • Nausea
  • Extreme fatigue
  • Hypertension
  • Sleep disturbances
  • Tremors
  • Shaky hands
  • Seizures
  • Confusion
  • Delirium tremens

Because sleeping pill withdrawal is potentially dangerous, it’s essential to speak to a medical professional if you feel that you’ve become dependent on this medication. If you do feel withdrawal symptoms avoid quitting cold turkey until you’ve spoken to a doctor. 

What Are the Stages of the Sleeping Pill Withdrawal Timeline

The sleeping pill withdrawal timeline that you experience will depend on several factors. One of the most significant of these factors is the type of pill you take. The time between your last dose and your first withdrawal as well as the total length of your withdrawal symptoms can vary based on the biological half-life of the specific chemical you took. 

A chemical’s half-life is the amount of time that it takes for your body to reduce the chemical to half of its original concentration in your blood. Half-life is usually a good indication of how long a chemical will affect you. 

The withdrawal timeline will also be affected by the size of your usual dose, the length of time you’ve been dependent on the drug, and the size of your most recent dose. 

It’s likely that your withdrawal timeline will be similar to the following:

  • 24 hours. You will probably experience your first withdrawal symptoms within the first 24 hours after your last dose. If you were taking a large dose for a long time, symptoms might appear earlier. Your first symptoms may manifest as impaired cognition, discomfort, and irritability. 
  • Two days. Your withdrawal symptoms will worsen over the first two days, and you might start to experience more intense symptoms like nausea, anxiety, and insomnia.
  • Seven days. Your symptoms will peak by the end of the first week, causing the most severe symptoms like paranoia, confusion, tremors, irritability, and delirium tremens.
  • Two weeks. Your symptoms will start to dissipate after their peak, and most of them will be gone by the end of the first week. Physical symptoms will be the first to go, but psychological symptoms can linger for a while longer. 
  • A month or longer. In some cases, symptoms like anxiety, insomnia, and depression last for a long time and need to be addressed in treatment. Drug cravings may also come and go for a long time and need to be addressed in an addiction treatment program. 

Why Should I Detox?

Like other depressants, sleeping pills can cause potentially dangerous symptoms, like seizures and delirium tremens, if you were used to a high dose and you quit cold turkey. Deadly symptoms are less likely with sleeping pill withdrawal than with other depressants like alcohol or benzodiazepines, but they are possible. They may be more likely if you mixed sleeping pills with alcohol, or if you’ve gone through depressant withdrawal symptoms before. A phenomenon called kindling caused changes to the brain that make each subsequence depressant withdrawal phase more dangerous.

Medical detox involves 24-hour access to medically managed care. It can help you avoid some of the most dangerous withdrawal symptoms like seizures and delirium tremens. Detox can also treat other medical needs that are related to or occur alongside addiction. 

What Is the Next Treatment Step?

After medical detox, you may continue onto the next level of care that can best address your ongoing needs. 

If you’ve developed an addiction to sleeping pills, you may need the full continuum of care in addiction treatment. If you have high-level medical or psychological needs, you may go through an inpatient treatment program with 24-hour medical or clinical monitoring. 

If you are able to live at home, you may go through an intensive outpatient treatment program. As you progress, you may go through an outpatient program with fewer than nine hours of treatment per week.

Sources

ASAM. (2015, May 13). What are the ASAM Levels of Care? from https://www.asamcontinuum.org/knowledgebase/what-are-the-asam-levels-of-care/

Centers for Disease Control and Prevention. (2018, February 22). CDC – Sleep Home Page – Sleep and Sleep Disorders. from https://www.cdc.gov/sleep/index.html

National Institute on Drug Abuse. (2016, February). 8: Medical detoxification. from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification

Ogbru, A., & Mark, J. W. (2018, February 6). Benzodiazepines Drug Class: Side Effects, Types & Uses. from https://www.rxlist.com/benzodiazepines/drugs-condition.htm

U.S. National Library of Medicine. (2019, September 7). gamma-Aminobutyric acid. from https://pubchem.ncbi.nlm.nih.gov/compound/gamma-Aminobutyric-acid

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