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Rebound insomnia: what is it?

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Rebound insomnia is a side effect of withdrawal from certain sleep aids, particularly benzodiazepines. It can last a few days to three weeks, but eventually goes away. Newer medications like zolpidem, zaleplon, eszopiclone, and ramelteon are less likely to cause rebound insomnia. Good sleep hygiene practices are important to treat rebound insomnia.

Are you weaning yourself off sleeping pills, only to find your insomnia is worse than ever? You may be suffering from rebound insomnia. It is the side effect of withdrawal when certain prescribed sleep aids are withdrawn, particularly in the benzodiazepine family.
Some sleep experts say rebound insomnia is the body’s way of readjusting to sleep without medication. It typically lasts anywhere from a few days to three weeks, but eventually goes away. The problem is that people who have it often go back to their sleeping medications, since they are so unhappy with their lack of sleep.

Benzodiazepines can cause rebound insomnia because they can prevent the body from sleeping properly, in a restorative cycle. A healthy, restorative sleep cycle is when the body alternates between REM sleep and deep sleep. Benzodiazepines can suppress the REM cycle, causing less restful sleep. However, benzodiazepines are the most commonly prescribed class of sleep medications. They can also have other side effects, especially in the elderly, including memory loss, dizziness, nausea and incontinence. These drugs can also cause depression or can exacerbate an existing depressive condition.

Some newer medications are less likely to cause rebound insomnia. These include zolpidem, zaleplon, eszopiclone and ramelteon. These drugs work on a different part of the brain and their side effects are usually not as pronounced and are mostly safer for the elderly.

A good way to treat rebound insomnia is to simply allow it to happen, without worrying about it. This is usually easier said than done, but someone who can simply live with insomnia for a few nights may find themselves sleeping much better afterwards. Remember that this is a normal side effect, not an indication of ill health. Good sleep hygiene practices are also important. These include: using the bedroom only for sleeping (not as an office); develop relaxing sleep rituals, such as reading or listening to soft music; do not exercise just before bedtime; getting up and going to bed around the same time every day; and don’t consume caffeine or nicotine within six hours of going to bed.

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