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Getting off sleeping pills

A lot of people say, "I can't sleep without sleeping pills." I hear it as the main complaint from patients, and it is all over our insomnia forums and the "Can't sleep café." Today, I want to tell you how to get off sleeping pills.
Here is the short answer: You need to develop and practice techniques that help you sleep naturally. You need methods to help you cope when you don't get sleep. If you are sick or have depression or anxiety, they need to be treated. You need to get off the pills slowly, and lastly, your goals need to be realistic.

Let's start with realistic goals. There are some people who need sleeping pills, benefit from sleeping pills, and probably suffer no harm from sleeping pills. The modern sleeping pills are fantastic for their effectiveness, safety, and generally their non-addictive properties. People who seem to need are those with medical illness, mental illness, or those who have tried everything and still can't sleep or function. Like any medication, the risks and benefits must be weighed by you and your doctor.

The practices of cognitive behavioral therapy (CBT) include setting a regular wake up time, limiting time in bed, not being awake and frustrated in bed, and practicing some type of mental relaxation technique. Until you have such a routine as part of your life, you won't be able to get off sleeping pills. Getting off the sleeping pills is hard, and you will not sleep well for some time, so these techniques are to both help you sleep and to help you cope.

If you have a psychiatric or medical illness, beyond jus the stresses of life, you probably need to be on an antidepressant or other medication. CBT is not a cure for real depression, bipolar disease, or other serious problems.

SO: When you have been doing CBT techniques like those in our Can't Sleep Café or in other CBT programs for a few weeks, you can begin to get off the pills. This blog is not a detailed method, but in general, there are 3 ways to do this. First, you can stop them suddenly. This is not dangerous for Lunesta, Ambien, or Sonata in the recommended doses.

But if you are on an older pill like Valium or Halcion, or if the doses of the new pills are high, then you need specific advice from your doctor. Second, you can keep taking them nightly but trim the dose down, say cut it in half every week for 3 weeks to zero. Third, you can start skipping nights, and gradually get to where you only take a dose every 3rd night for a while. Some people can only go this far, but it is probably better than nightly use.