Frequently asked Questions

Patients & caregivers FAQ   

What is insomnia? how do I know if I have sleep problems?

If you have been diagnosed with insomnia that means you have a sleep problem regularly. It usually gets better by changing your sleeping habits and solving the causes.

Every person needs different amounts of sleep. On average an adult needs 7 to 9 hours. You are probably not getting enough sleep if you constantly feel tired during the day. There are several signals to help you identify when you have a sleep problem:

  • find it hard to go to sleep (fall asleep)
  • wake up several times during the night and have difficulty falling asleep again
  • lie awake at night
  • wake up early and cannot go back to sleep
  • still feel tired after waking up
  • feel tired and irritable during the day
  • find it difficult to concentrate during the day because you are tired

You can review this document with tips to improve your sleep quality.

Keep in mind that if you have these symptoms, you might have short-term insomnia (lasts less than 3 months) or chronic insomnia (lasts 3 months or longer). The best way to confirm it is to visit your doctor.

  1. When do I need to visit my doctor if I have a sleep problem?

Go to your doctor’s office if:

-  after changing your sleeping habits for several weeks, your sleep quality does not improve
- you have had trouble sleeping for months
- your sleep problems are affecting your daily life in a way that makes it hard for you to cope

  1. What are the causes of sleep problems?

Sleep problems could be caused by different personal situations (external or intrinsic). The most common causes are:

- Intrinsic: stress caused by negative or positive events, anxiety or depression, mental or physical illness, addictions to alcohol, caffeine, nicotine, drugs like cocaine, amphetamine or ecstasy. technologies, or bad sleeping habits.
- External: noise, a room that is too hot or cold, uncomfortable beds, jet lag or shift work.

  1. Why should I try to reduce or completely stop my sleeping pills prescriptions?

All prescription sleeping pills have risks, especially for people with certain health problems, such as liver or kidney disease, and in particular for older people.

Sleeping pills and sedatives can have very strong side effects, including problems with memory or concentration, drowsiness, muscle weakness, abnormal behaviour and sleep disorders. They can also affect people’s ability to drive and, particularly in older and unwell people, increase the likelihood of falling.

If you require help to find a solution to your sleep problems talk with your doctor to find the cause of the problem and check if the recommended first line treatment which is psychological therapy called cognitive-behavioural therapy of insomnia can help before trying the drug treatment.

  1. With whom should I talk if I want to quit my sleep pills prescription? How long does it take to stop taking sleeping pills?

When you are ready to stop taking sleeping pills, follow your doctor’s instructions. If in doubt, you can also discuss your concerns with your pharmacist (site specific?). Keep in mind that sleeping pills should be stopped gradually to avoid withdrawal symptoms. Also, be aware that you may experience a short episode of insomnia due to the rebound effect for a few days after stopping sleeping pills.

  1. I’m a caregiver and I’m worried. What can I do to help my family member who is taking sleeping pills?

Try to listen to your family members without being judgemental or accusatory about the use of sleeping pills. Talk about the support available to his/her doctors that can help to stop it. You could say that there are alternatives. You can suggest discussing this option after he/she talks with her/his doctor.

  1. What are the alternative treatments if I decide to stop taking sleep pills?

Your doctor will try to find out what is causing your sleep problem, so you get the right treatment. But there are various things you can do to help you get to sleep. Sleep problems usually get better by changing your sleeping habits, this is often referred to as good sleep hygiene. Try to:

  • go to bed and wake up at the same time every day
  • relax at least 1 hour before bed, for example, take a bath or read a book
  • make sure your bedroom is dark and quiet – use curtains, blinds, an eye mask or ear plugs if needed
  • exercise regularly during the day
  • make sure your mattress, pillows and covers are comfortable
  • avoid using electronic devices in the bedroom
  • avoid heavy meals late at night
  • avoid alcohol or caffeine 6 hours before going to bed

But, sometimes it is needed other approaches as following cognitive behavioural therapy for insomnia (CBT-I)  based on several techniques that can help you manage your problems by changing the way you behave and think (the behavioural part is essential in CBT-I). In other cases, you may be referred to a sleep clinic if you have symptoms of another sleep disorder such as sleep apnoea.

  1. What can I do if my doctor tells me that there is no problem with my sleeping pills prescription? Why would they say this?

Try to explain how you are worried about the use of sleeping pills because of the adverse effects and you are very interested in trying other strategies to confront sleep problems with alternative treatments. If you are unable to make him/her understand your concerns, seek a second medical opinion.

  1. What are the withdrawal effects associated with stopping sleeping pills?

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  1. What can help when trying to stop taking sleeping pills and sedatives?

The best way to stop taking sleeping pills or sedatives is to gradually reduce the dose with the guidance of a doctor to prevent withdrawal effects. Psychological or therapeutic support can help. Your pharmacist could also contribute to solving your doubts and questions.

Sources:

Using medication: What can help when trying to stop taking sleeping pills and sedatives? Informed Health.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. 2010 Apr 20 [Updated 2017 Aug 10]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK361010

Insomnia. National Health Service (NHS). https://www.nhs.uk/conditions/insomnia/

Guideline on deprescription of benzodiazepine and sedative hypnotics (BSHs) in insomnia disorder: Trustworthy guidelines to reduce BSHs published on MAGICapp website and BE-SAFE portal - Published: August 31st, 2023. Available: https://besafe-horizon.eu/files/be-safe/content/en/Documents/BE-SAFE- Deprescription of benzodiazepine and sedative hypnotics %28BSHs%29_corrected.pdf

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