Insomnia: Coming off sleeping pills and sedatives

The key thing is to decrease the dose gradually before you stop taking them altogether. It is important to do this gradually to try to prevent withdrawal symptoms. These can occur if your body has become used to a substance and suddenly doesn't get it anymore. The withdrawal symptoms are very similar to the original sleep problem symptoms, and can actually make you want more medication again. This can trigger a vicious circle if people start using sleeping pills or sedatives again to reduce the symptoms.

It is best to talk to your doctor about the right time to start coming off the medication, and how gradually you should decrease the dose. A medication schedule can be useful here.

People who use benzodiazepines or Z-drugs for a long time are likely to have problems. It can be particularly hard in elderly people because their bodies take longer to break down the substances in the medication. Also, they often take a lot of different medications or have various illnesses. Some of the side effects of benzodiazepines and Z-drugs include reduced ability to think straight and increased risk of falling because the muscles become too relaxed. Often, the person's body has already got used to the medication – or is already dependent on it. Then it's really important that they come off the medication carefully.

If you've been taking benzodiazepines or Z-drugs for a long time and want to stop, you should talk to your family doctor first. If you think your medication-taking is out of control, you can turn to an addiction counseling center for help too. They usually draw up a withdrawal plan for you, based on the type of medication, the dose, how long you've been taking it and your personal situation.

Various studies have shown that even quite simple things can help people come off benzodiazepines. For instance, more people stopped taking them if they had support and advice from their doctor.

But the research hasn't shown that taking other medication during the dosage-reduction process makes it easier for people to stop their benzodiazepine use or lessens their withdrawal symptoms. More research is needed to find out whether taking certain medications (such as antidepressants, antihistamines and melatonin) can help people stop taking sleeping pills and sedatives.

Various studies suggest that more people manage to stop taking benzodiazepines if they have psychological support too. The most successful type seems to be cognitive behavioral therapy (CBT). CBT is a talking therapy that aims to identify and then change thoughts and ideas that have a negative effect. Relaxation exercises are often used in psychological treatment too.

Research suggests that cognitive behavioral therapy can help people come off sleeping pills. To help you stay off this medication, you can assess and improve your sleeping habits and incorporate relaxation techniques like autogenic training into your daily routine.