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Dr. Vijayakumar D.R MBBS, DPM, DNB (NIMHANS), CCST (UK)
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Hypnotics /Sedatives

PATIENT INFORMATION ON HYPNOTICS /SEDATIVES

The name of your medication is benzodiazepines and zolpidem, zopiclone.

Use

This medication is used to treat sleep problems, such as the inability to fall asleep or to remain asleep for reasonable number of hours. Sleeping problems occur in most individuals from time. If, however, sleeping problems persist, this may be a symptom of some other disorder, either medical and psychiatric.

A person may have difficulty in falling asleep because of stress or anxiety felt during the day, pain , physical discomfort or changes in daily routine (e. g., jet-lag, changes in work shifts, etc.) Any disease that causes pain (e. g., ulcers) or breathing difficulties (e. g., asthma or a cold) can interfere with continuous sleep. Stimulant drugs, including caffeine, may also contribute to problems falling asleep ; other medications may change sleep patterns when they are stopped (e. g., antidepressants, antipsychotics ). Sleep will improve when these have been remedied or treated.

Problems remaining asleep may be due to age, as older people tend to sleep less at night. Certain disorders, including depression, may also affect sleep.

Hypnotic/sedatives are similar to an anxiety drugs, but tend to cause more drowsiness and in coordination; therefore, sometimes anti anxiety medications are given to treat sleep problems.

How quickly will the drug start working?

Hypnotics/ sedatives can induce calm or sedation usually within an hour. As some drugs act quickly, take the medication just prior to going to bed and relax in bed until the drug takes effect.

How long should you take this medication?

Sleep problems are usually self-limiting; often when the cause of sleep difficulties is treated or eliminated, sleep will improve. Therefore, hypnotic/sedatives are usually prescribed for a limited period of time. Many individuals take the medication only when needed (during periods of insomnia) rather than on a daily basis. It is suggested that once you have slept well for 2 or 3 

consecutive nights, try to get to sleep without taking the sedative/hypnotic. Tolerance or loss of effectiveness can occur in some individuals if they are used continuously beyond four months.

If you have been taking the medication for a continuous period of time, the physician may try to reduce the dose of this drug slowly to see if sleeping problems persist; if not, the dosage may be further reduced and you may be advised to stop using this medication. Do not increase the dose or stop the drug without consulting with your doctor.

Some patients need to use a sedative/hypnotic drug for longer time periods, because of the type of problems they may be experiencing. Others require it only from time to time, I. e., PRN. 

Side effects

Side effects occur, to some degree, with all medication. They are usually not serious and do not occur in all individuals. Most will decrease or disappear with time. If a side effect continues, speak to your doctor about appropriate treatment.

Common side effects that can occur with sedative/hypnotics drugs include:

  • Morning hangover, drowsiness and lethargy-This problem may decrease with time; inform your doctor. Use of other drugs that make you drowsy will worsen the problem. Avoid driving a car operating machinery if drowsiness persists. 
  • Muscle in coordination, weakness or dizziness-Inform your doctor; an adjustment in your dosage may be needed.
  • Forgetfulness, memory lapses-Inform your doctor.
  • Slurred speech-An adjustment in your dosage may be needed.
  • Nausea or heartburn-If this happens, take the medication with food.
  • Bitter taste-Can occurs with certain drugs (e. g., zopiclone). Avoid milk in the morning to lessen this effect.

Less common side effects that you should report to your physician IMMEDIATELY include:

  • Disorientation, confusion, worsening of your memory, periods of blackouts, or amnesia
  • Nervousness, excitement or any behavior changes
  • In coordination leading to falls
  • Skin rash

Let your doctor know as soon as possible if you miss your period or suspect you may be pregnant.

Precautions

  1. Do not increase your dose without consulting your doctor
  2. Check with your or pharmacist before taking other drugs, including over-the-counter medication such as cold remedies
  3. This drug may impair the mental and physical abilities required for driving a car or operating machinery. Avoid these activities if you feel drowsy or slowed down.
  4. This drug may increase the effects of alcohol, making you more sleepy, dizzy and lightheaded
  5. Take your medication about half an hour before bedtime; do not smoke in bed afterwards.
  6. Do not stop taking the drug suddenly, especially if you have been on the medication for a number of months or have been taking high doses. Hypnotics/sedatives need to be withdrawn gradually to prevent withdrawal reactions.
  7. Avoid excessive consumption of caffeinated beverages (i.e., more than 4 cups of coffee, 6 cups of tea or cola) as it may counteract the beneficial effects of the anxiolytics.
  8. Store your medication in a clean, dry area at room temperature. Keep all medication out of the reach of children.

Some nondrug methods to help you sleep include:

  1. Avoid caffeine-containing beverages or foods (e. g., chocolate) after 6 pm and avoid heavy meals several hours before bedtime. A warm glass of milk is effective for some people.
  2. Napping and sleeping during the day will make restful sleep at night difficult. Keep active during the day and exercise regularly.
  3. Engage in relaxing activities prior o bedtime such a reading, listening to music or taking a warm bath. Strenuous exercise (e. g., jogging) Immediately before bedtime may make it difficult to get to sleep.
  4. Establish a routine or normal pattern of sleeping and waking.
  5. Use the bed and bedroom only for sleep and sexual activity.
  6. Minimize external stimuli which might disturb sleep. If necessary, use dark shades over windows or wear ear plugs.
  7. Once in bed, make sure you are comfortable (I. e., not too hot or cold); use a firm mattress.
  8. If you have problems getting to sleep, rather than toss and turn in bed, have some warm milk, read a book, listen to music, or try relaxation techniques until you again begin to feel tired.
  9. Don’t worry about the amount of sleep you are getting as the amount will vary from day to day. The more you worry the more anxious you will get and this may make it harder for you to fall asleep.

If you have any questions regarding this medication, do not hesitate to contact your doctor, pharmacist, or nurse