At 68, what is the safest way to continue my sleeping pills?

Question

Hello, Doctor,

I am 68 years old and have been taking sleeping tablets almost every night for nearly eight years because of chronic insomnia. They still help me fall asleep, but I have started worrying about staying on them for so long. A few months ago I forgot to take a dose and hardly slept at all, which made me wonder if my body has become dependent on them. I want to avoid stopping suddenly if that could cause problems, but I'm not sure continuing them is the best option.

Should a 68-year-old on long-term sleep medication ask about tapering off safely?
Could you explain the safest way to approach this?

Kindly advise.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Yes, taking long-term sleeping tablets is not the best strategy, and it causes addiction. Over time, tolerance builds, and you might need to raise the dose too.

You cannot quit tablets all of a sudden, and it is not only difficult but also dangerous as well. Our brain adapts to high levels of the neurotransmitter gamma-aminobutyric acid (GABA), which protects us from developing seizures. If we suddenly stop this medicine, it can bounce back and can develop withdrawal symptoms such as insomnia, restlessness, anxiety, sweating, palpitations, fear, seeing people or hearing voices, and seizures. That is why gradual tapering is preferred.

If you are taking short acting such as Alprazolam or Lorazepam (benzodiazepine), first of all, we need to change it with long acting such as Diazepam. As you have been taking it for a long time, it is best to calculate it to make it 5-10 percent of the total dose. For instance, if you are taking 10 milligrams (mg), then reduce 5-10 percent of that dose weekly or even fortnightly. Do not rush, and eventually you will be able to reduce it completely. Gradual tapering allows the brain to adapt, and it can save you from fearsome side effects and withdrawal symptoms.

It is very much possible to taper off the dose, but with calculation and monitoring of symptoms.

If you could share the dose, name, and duration of your medicine; any physical comorbidities; any underlying psychiatric disorders; the reason for your initiation; and any symptoms that started after taking these medicines, I will be able to help you more.

Therefore, get these blood tests done too.

I hope this information helps you.

Take care.