The National Institutes of Health recommends a non-pharmacological, cognitive behavioral treatment approach for insomnia because multiple studies suggest it is as effective as sleep medications in the short term and more effective in the long term in treating insomnia.
Drug Free Solutions To Treat Insomnia
Nonetheless, sleep medications are the treatment option most patients will encounter when they seek treatment for insomnia from their primary care physician, and over the counter remedies are also abundant. Outside of a comprehensive sleep medicine clinic, awareness of research-supported alternatives to sleep medication is often limited.
We see patients at very different points in their struggle with sleep. We see patients with sleep difficulties that are averse to taking sleep medications and are hoping for guidance in a non drug alternative. Some such individuals may feel sleep medications adequately resolve their sleep complaint, but their PCP or they themselves are concerned about longer term use.
Despite advertising, many patient demonstrate less than adequate response to even potent sleep medications – as such, we see patients who are already taking sleep medications but without satisfactory resolution of the sleep complaint. Finally, we also effectively treat many patients who have been taking sleep medications for years, who are psychologically or physiologically addicted to their sleep medications, and who are currently experiencing decreased effectiveness and increased tolerance of medications.
Potential Side Effects of Sleep Medication
Potential side effects of sleep medication are numerous and may vary greatly based on the individual, specific medication, and dosage. Side effects can include but are not limited to physiological and psychological dependence, decreased effectiveness over time, increased parasomnia behaviors (e.g., sleepwalking, night eating), decreased sleep quality, morning grogginess, and adverse reactions with other medications. Consult with your prescribing physician if you are currently taking any sleep medication and have concerns about side effects.
Working Toward Discontinuation of Sleep Medication
If you are interested in working toward discontinuation of your sleep medication, we can work with you and your prescribing physician to help you taper effectively using research-supported non-pharmacological interventions. A majority of our patients with insomnia who seek treatment at our centers are taking some sort of sleep aid (prescription, over-the-counter, herbal, etc.) when they come to us. As Behavioral Sleep Medicine Specialists, we do not prescribe, recommend, or discourage the use of medications for sleep. Our role is to help provide an alternative, non-pharmacological approach which, according to large-scale studies, is more effective for people with persistent insomnia than medication. Most importantly, the benefits of this drug-free approach have been found to be long-lasting over time.
Withdrawing from sleep medication is rarely easy, but we work closely with our patients to make the process as painless as possible and optimize long-term success. We aim to minimize the rebound insomnia and anxiety often associated with discontinuation. Working with a Behavioral Sleep Medicine Specialist on a short-term basis as you taper your sleep medication is likely to increase your long-term success in staying off sleep medication. Ultimately, our goal is to improve your confidence in your own ability to sleep!
Although many patients are interested in working toward discontinuing their sleep medication when they come to us, not everyone feels this way. We understand the multitude of factors that enter into such decisions, and we respect a patient’s individual goals and preferences under the guidance of your prescribing physician. If you do not feel ready to reduce your use of sleep medication at this time, we can still work effectively with you to help improve your sleep, even while you remain at your current dosage. Later on in treatment with us, you may feel differently about your ability to eventually reduce or eliminate your sleep medication.