about
Benzodiazepine
Short Description
Difficulty in getting to sleep or staying asleep (insomnia) has many causes. Most people suffer from sleepless nights from time to time, usually as a result of a temporary worry or discomfort from a minor illness.
Persistent sleeplessness can be caused by psychological problems including anxiety or depression, or by pain and discomfort arising from a physical disorder.
Usage
For occasional bouts of sleeplessness, simple, common remedies to promote relaxation – for example, taking a warm bath or a hot milk drink before bedtime are usually the best form of treatment.
Sleeping drugs (also known as hypnotics) are normally prescribed only when these self-help remedies have failed, and when lack of sleep is beginning to affect your general health.
These drugs are used to reestablish the habit of sleeping. They should be used in the smallest dose and for the shortest possible time (not more than three weeks).
It is best not to use sleeping tablets every night. Do not use alcohol to get to sleep as it can cause disturbed sleep and insomnia.
Long-term treatment of sleeplessness depends on resolving the underlying cause of the problem.
Mechanism
Most sleeping drugs promote sleep by depressing brain function. The drugs interfere with chemical activity in the brain and nervous system by reducing communication between nerve cells.
This leads to reduced brain activity, allowing you to fall asleep more easily, but the nature of the sleep is affected by the drug. The main class of sleeping drugs, the benzodiazepines.
A sleeping drug rapidly produces drowsiness and slowed reactions. Some people find that the drug makes them appear to be drunk, their speech slurred, especially if they delay going to bed after taking their dose.
Most people find they usually fall asleep within one hour of taking the drug.
Because the sleep induced by drugs is not the same as normal sleep, many people find they do not feel as well rested by it as by a night of natural sleep. This is the result of suppressed brain activity.
Sleeping drugs also suppress the sleep during which dreams occur; both dream sleep and non-dream sleep are essential for a good night’s sleep.
Some people experience a variety of hangover effects the following day.
Some benzodiazepines may produce minor side effects, such as daytime drowsiness, dizziness, and unsteadiness, that can impair the ability to drive or operate machinery.
Elderly people are likely to become confused and selection of an appropriate drug is important.
precautions
Sleeping drugs become less effective after the first few nights and there may be a temptation to increase the dose. Apart from the antihistamines, most sleeping drugs can produce psychological and physical dependence when taken regularly for more than a few weeks, especially if they are taken in larger than normal doses.
When sleeping drugs are suddenly withdrawn, anxiety, seizures, and hallucinations sometimes occur.
Nightmares and vivid dreams may be a problem because the time spent in dream sleep increases. Sleeplessness will recur and may lead to a temptation to use sleeping drugs again.
Anyone who wishes to stop taking sleeping drugs, particularly after prolonged use, should seek his or her doctor’s advice to prevent these withdrawal symptoms from occurring.
drugs and sleep patterns
Normal sleep can be divided into three types: light sleep, deep sleep, and dream sleep.
The proportion of time spent in each type of sleep changes with age and is altered by sleeping drugs. Dramatic changes in sleep patterns also occur in the first few days following abrupt withdrawal of sleeping drugs after regular, prolonged use.
Normal sleep Young adults spend most sleep time in light sleep with roughly equal proportions of dream and deep sleep. Drug-induced sleep has less dream sleep and less deep sleep with relatively more light sleep. Sleep following drug withdrawal There is a marked increase in dream sleep, causing nightmares, following withdrawal of drugs used regularly for a long time. types of sleeping drugs
Benzodiazepines These are the most commonly used class of sleeping drugs as they have comparatively few adverse effects and are relatively safe in overdose. They are also used to treat anxiety. Barbiturates These are now almost never used because of the risks of abuse, dependence, and toxicity in overdose. There is also a risk of prolonged sedation (“hangover”). Chloral derivatives These drugs effectively promote sleep but are little used now. If prescribed, triclofos causes fewer gastrointestinal side effects than chloral hydrate. Other non-benzodiazepine sleeping drugs Zopiclone, zaleplon, and zolpidem work in a similar way to benzodiazepines. They are not intended for long-term use and withdrawal symptoms have been reported. Antihistamines Widely used to treat allergic symptoms , antihistamines also cause drowsiness. They are sometimes used to promote sleep. Antidepressant drugs. Some of these drugs may be used to promote sleep in depressed people, as well as being effective in treating underlying depressive illness.