Finding yourself wide awake at odd hours of the night for no particular reason or finding yourself waking up repeatedly in between a night’s sleep can be a distressing experience. It is all the more worse, when this sleep-deprived or sleep-interrupted situation happens to be a nightly affair and is not the story of one odd night.
Understandable as your case may be, the question is, if your fatigued, desperate self is pushed to seek a quick fix with sleeping tablets, should you succumb without exploring proper medical treatment?
Do ponder over that question, for first among the many things you should know before you pop a sleeping pill is this: As the case stands and for reasons that may not be elaborated here, a perceived lack of ready willingness to undertake a comprehensive evaluation of sleep problems is seen in the medical fraternity itself. The motivation of physicians to prescribe sleeping pills has not received due attention. Most patients who are prescribed sleeping tablets have no documents to justify it. In a way, it accounts for the drastic increase in prescription and associated misuse of hypnotic medication, sleeping pills being one of them.
Prevalence and Symptoms
Poor sleep or sleeplessness is a condition called insomnia. It is the commonest form of sleep disorder. It is estimated that nearly one in three people suffer from insomnia during their lifetime. Over 90 percent of people who suffer from depression also experience insomnia.
When you suffer from insomnia, your most common complaints are difficulty in falling asleep, waking up several times during the night and not feeling refreshed in the morning. Additionally, you are tired, irritable and lacking in motivation through much of the normal waking hours or daytime. You could also develop anticipatory anxiety about not being able to sleep – the harder you try, the less you are able to sleep. Insomnia can be episodic, short lasting or chronic. It is chronic insomnia that makes you more susceptible for the misuse of sleeping tablets. The causes of sleeplessness can be physical, psychological, environmental, dietary and even hereditary.
Why The Need For Sleeping Pills?
Insomnia has serious health and occupational implications for you. Sleeping less than six hours is linked with increased blood pressure, stroke, heart ailments, diabetes, poor immunity and susceptibility to infections. At work, it reduces your productivity and increases absenteeism and work- related stress. The condition is commonly treated with hypnotic medication like Zolpidem, Temazepam, Triazolam, Estazolam and Zopiclone. They should be prescribed by medical practitioners and not bought over the counter. You may take note that the West has strict regulations for the sale of hypnotics, unlike us where hypnotics are easily available and can be bought without a prescription.
It’s Addictive. Stay Warned.
Self-medication without considering the underlying cause for poor sleep is a significant contributor to the epidemic increase in the use of sleeping pills. The use of medically prescribed hypnotics increases with age and it is so despite insomnia being mild in half of these cases. The non-medical use of prescription drugs, such as tranquilizers and hypnotics has become a growing public health problem. It is difficult to accurately estimate the extent of misuse of hypnotics worldwide. In the US, the National Institute on Drug Abuse (NIDA) reports that millions of people in the US abuse prescription drugs and it includes sleeping tablets. Clinical cases show that the misuse is widely prevalent, in India.
- Studies indicate that sleeping pills are associated with early death.
- The risk is notable even in those taking as few as 18 pills a year.
- The risk increases in proportion to the level of dosage.
- The risk of cancer increases with the misuse of hypnotics.
- All hypnotics are addictive.
Taking sleeping pills beyond your requirement without considering the risks and/or seeking alternative remedies amounts to abuse/misuse. You are prone to misuse because it offers you quick remedy. Get a clinician to evaluate your status: Are you misusing your hypnotic medication? Have you become dependent on it? Regular and daily intake of medicine belonging to benzodiazepine group like temazepam, estazolam, for four to six weeks makes you dependent on it, both physically and psychologically. It amounts to nothing but addiction and is characterised by tolerance.
Physically, the dose you take becomes increasingly less effective. Regular users or abusers suffer withdrawal symptoms (anxiety, shakes, tremors and restlessness), when discontinued abruptly. Psychologically you become apprehensive when near to your time for sleep and you feel compelled to take the sleeping tablet.
Nonbenzodiazepine group of medicines such a zolpidem and zopicline have a very low risk of addiction. Stay warned about dependency on sleeping pills and be advised on the development of tolerance. Withdrawal symptoms can make you vulnerable to regular and progressive intake of sleeping tablets.
Handling Insomnia without Hypnotics
Good sleeping habits and attitudes are the best approach for short and long-term sleep problems. Seven hours of sleep is adequate for most individuals. During stressful times, 45 minutes of daytime nap can help reduce stress levels and allow the mind and body to recuperate, even reduce blood pressure. However regular naps should be avoided. Establish Sleep Hygiene – Exercise regularly. Reduce the intake of stimulating foods and drinks like coffee, tea, chocolates, nicotine. Ensure adequate exposure to sunlight during the day. Shower and get into fresh clothes before bedtime. Avoid late night meals and eat at least 3 hours before sleep. Listen to relaxing music and read a book. Avoid electronic media usage at night especially Internet and social media as they busy the mind. Ensure that the room environment is pleasant and warm with dim lighting. Do yoga in the evening for relaxation. Yoga is known to be more effective in combating stress and depression – common causes of insomnia – than any other form of exercise including walking. For those with long-term insomnia, Cognitive Behavioural Psychotherapy (talking therapy) is advisable. It is a scientifically proven non-drug treatment. It helps with effective strategies to conquer your problems and brings about lasting change in sleep patterns. Hypnotic medication may be considered if all the above efforts have failed. The medication should be taken for no longer than a week or two. Long-term use of sleeping pills is not advisable.