If you can’t sleep, you may end up tossing and turning all night long. It can feel very lonely. While the world catches those coveted Z’s, you are stuck staring at the ceiling. But if you have insomnia or another sleep disorder, you’re not alone.
Insomnia is one of the most common disorders in the United States, with an estimated 60 million Americans struggling to get a healthy night’s rest. Sleeplessness can come with a variety of consequences to both your physical and mental health. Because it’s such a ubiquitous problem, doctors and researchers have developed several pharmaceutical solutions to sleep problems.
Sleeping pills like Ambien, Lunesta, and Sonata are prescription central nervous system depressants that are used for their hypnotic effects. However, they can also cause chemical dependence and potentially dangerous withdrawal symptoms.
Learn more about sleeping pills and how withdrawal symptoms can be treated.
Sleeping pills come in a variety of distinct substances that are prescribed to treat insomnia and other sleep disorders. Non-benzodiazepine sleep aids are often referred to as Z-drugs because most of them have Zs in their name. Though Z-drugs aren’t as habit-forming as other alternatives like barbiturates or benzodiazepines, frequent or heavy use can lead to chemical dependence.
Your brain might start to rely on the drug to maintain a chemical balance. In central nervous system depressants like sleep aids, the brain may respond by decreasing its natural inhibitory effects and increasing its excitatory effects to counteract the drug.
When you stop using, your brain will experience a neurochemical imbalance. Your central nervous system will become overexcited, leading to some uncomfortable and even dangerous symptoms. Sleep aids are fairly mild when compared to other central nervous system depressants like alcohol or benzodiazepines. However, if you were used to high doses of the drug, and you quit abruptly, withdrawal symptoms can even be dangerous.
One of the most common withdrawal symptoms you might experience is referred to as rebounding, which is when the problem that the drug was designed to solve returns when you stop using it. In sleep aids, rebounding can cause insomnia and anxiety.
Other common withdrawal symptoms include:
Sleeping pills can cause dependence, even if a physician prescribes them. Let your doctor know if you start developing a tolerance to the drug, or if you have any withdrawal symptoms. Dependence and addiction are more likely when the drugs are abused or mixed with other drugs or alcohol. If you feel like you’ve become chemically dependent on the drug, it’s important to speak to a doctor or a detox specialist before quitting cold turkey.
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Sleeping pills are a category of prescription drugs that includes many distinct chemicals. Your exact withdrawal timeline will depend on several factors, including the exact type of drug you have been using. Other factors may be the size of your last dose, the amount of time you have been dependent on the drug, and the size of the dose you were used to.
Generally, people who have been using a high dose for a long time will experience symptoms quickly, and those symptoms are more severe. Every person is different, so your experience may not be the same as someone else’s. Before attempting to stop using a sleeping pill, speak to a doctor or medical professional. They may be able to help you wean off of the drug without encountering some of the most intense symptoms.
Here’s what could happen if you quit using sleeping pills cold turkey after becoming dependent:
The first symptoms will appear within the first 24 hours of your last dose. If you were used to a large dose, or if your last dose was smaller than usual, symptoms may show up sooner. Your first symptoms may be similar to a hangover, where you feel a mental fog, fatigue, difficulty focusing, memory issues, headaches, and a lack of alertness.
At this point, you may experience rebounding symptoms like insomnia and anxiety. In addition to the uncomfortable feelings you may have already experienced, you may also experience some psychological symptoms like irritability and agitation.
Within three to seven days, your side effects will peak, and you’ll start to experience the most intense symptoms. Cravings to use may also be severe at this point. As a central nervous system depressant, sleep aids might cause paranoia, confusion, seizures, or delirium. These symptoms are more likely if you were also drinking alcohol with sleep aids.
After your symptoms peak, they will start to taper off, and your risk of severe symptoms will lower. Most of your physical symptoms will be gone by the end of the second week, though you may still experience insomnia.
Sometimes insomnia and psychological symptoms last for much longer than your detox and may even linger for months unless they are treated. However, in addiction treatment, many of these persistent symptoms can be addressed and alleviated.
Medical detox is the highest level of care in addiction treatment, which involves 24-hour medically managed treatment for people that are going through withdrawal. Detox facilities have board-approved medical professionals on staff 24 hours a day to treat your symptoms and help you to avoid any medical complications. Detox typically lasts between five and 10 days as your body readjusts to life without the chemical in your system. In some cases, it can take longer. Ultimately, it depends on your individual needs.
If you’ve been diagnosed with a substance use disorder, you may need to go through other levels of care in addiction treatment. According to the National Institute on Drug Abuse (NIDA), detox may not be enough to effectively lead to long-lasting abstinence. If you complete detox and still have medical or psychological needs that require high-level care, you may need to enroll in an inpatient treatment program. In inpatient treatment, you will have access to 24 hours of care every day, and your condition will be monitored by medical professionals or managed by clinicians, depending on your needs.
Once you can live on your own, you can move to an outpatient program. If you still have fairly pressing medical or psychological needs that need daily monitoring, you might go through a partial hospitalization program, which is a highly intensive form of outpatient treatment that involves more than 20 hours of treatment per week. Intensive outpatient includes more than nine hours per week, and standard outpatient includes fewer than nine hours per week.
National Institute on Drug Abuse. (2016, February). 8: Medical detoxification. Retrieved from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification
RxList. (2018, February 6). Benzodiazepines Drug Class: Side Effects, Types & Uses. Retrieved from https://www.rxlist.com/benzodiazepines/drugs-condition.htm
Tuck. (2017, February). Z-Drugs – Non-Benzodiazepines. Retrieved from https://www.tuck.com/z-drugs-nonbenzodiazepines/
Valentine, V. (2008, May 20). Can't Sleep? Neither Can 60 Million Other Americans. Retrieved from https://www.npr.org/templates/story/story.php?storyId=90638364
(October, 2018). Understanding the Side Effects of Sleeping Pills. WebMD. Retrieved August, 2019 from https://www.webmd.com/sleep-disorders/guide/understanding-the-side-effects-of-sleeping-pills#1