Key takeaways:

  • Some sleeping medications (including benzodiazepines like Xanax, Valium, or Ativan) can cause dangerous withdrawal symptoms, including the risk of seizures
  • Rebound insomnia is usually characterized by the inability to sleep (often worse than before taking medication), disturbing dreams, restlessness, anxiety, and irritability
  • Being upfront and honest about how much of the medication you are taking is essential so that your prescriber can make informed recommendations for stopping

Commonly prescribed sleeping pill medications include barbiturates, benzodiazepines, and Z-drugs, all of which can be potentially addiction-forming once a physical dependence has formed. These medications can have harmful effects (especially when abused) including daytime sleepiness, confusion, loss of coordination, and increased rates of accidents and injuries. Long-term users of these medications experience withdrawal symptoms when they stop using. Common side effects of withdrawal included unpleasant or bitter taste, headache, diarrhea, dry mouth, and upper respiratory infection, as well as increased insomnia.

Sleeping pill withdrawal

Over time, people can develop a dependence on sleeping pills and may experience uncomfortable withdrawals if they cut back or stop using, especially abruptly. The physical dependence on these medications can form in as little as three weeks and can make it difficult for people to stop the medications. Not all people who form a dependence on a sleeping medication are abusing their prescription, as it is possible for the brain and body to become dependent on a medication when it is being taken as prescribed.

The specific kind of withdrawal symptoms, how intense they are, and how long they last depend on a number of factors, including the specific medication, dosage, length of time taking it, and also individual factors. It is always advised to consult with the prescribing doctor or healthcare professional before cutting back, changing, or stopping any medication. Some sleeping medications are safer to taper off of slowly, while others can be stopped abruptly, and a healthcare professional can provide sound advice on which is the right course of action for you.

People with any co-occurring substance use disorders may require additional treatment for withdrawals from a sleeping medication. The same is also true of those with co-occurring mental health issues. For those with a history of mental illness, it is essential that they seek additional advice from doctors and psychiatrists before attempting to quit sleeping pills.

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Symptoms of sleeping pill withdrawal

The symptoms of sleeping pills can cause both physical and psychological discomfort. Those with a long history of abuse or who abused sleeping pills in large doses will often experience more severe and distressing withdrawal symptoms. The specific symptoms of sleeping pill withdrawal will vary depending on the type of medication, with benzodiazepines, barbiturates, and Z-drugs having the highest incidence of abuse, addiction, and withdrawal.[1] 

Common withdrawal symptoms experienced by people who stop taking sleeping pills include:

  • Insomnia
  • Restlessness
  • Anxiety/Irritability
  • Depression
  • Hallucinations/confusion/delirium
  • Sweating
  • Increased heart rate
  • Hand tremors
  • Vomiting/nausea

*Some sleeping medications (including benzodiazepines like Xanax, Valium, or Ativan) can cause dangerous withdrawal symptoms, including the risk of seizures. People who are trying to stop using these medications after regular/prolonged use often require an inpatient medical detox to ensure they remain safe during the detox process.

Rebound insomnia

When someone quits sleeping pills abruptly, especially after long periods of use, they may experience rebound insomnia. Rebound insomnia is usually characterized by the inability to sleep (often worse than before taking medication), disturbing dreams, restlessness, anxiety, and irritability. Rebound insomnia is problematic because it increases the likelihood of relapse for those who have become dependent on medication for sleep.[2, 3]

Sleeping pill withdrawal timeline

As with the intensity of withdrawal symptoms from sleeping pills, such as Lunesta, the time it takes to get through them depends from person to person. The time it takes for the drug to fully leave the system and withdrawal symptoms to dissipate can depend on the length of time someone has used the drug, in what dose, and what type of sleeping pill was used.

For most, withdrawal symptoms will start within a day of not taking pills and will fade between the end of the first week and the second. Though for some, post-acute withdrawal symptoms (PAWS) can last for several weeks. These can include insomnia, agitation, lack of concentration, and anxiety. [1] 

First three days - Withdrawal symptoms present themselves within the first 72 hours. These usually include feelings of anxiety or nervousness, confusion, memory loss, and mood swings. 

First week - physical symptoms are their worst in the first ten days with tremors, sweating and increased heart rate being common. Users will normally experience problems sleeping as well as craving and heightened anxiety. 

First two weeks - Physical symptoms should ease at the two-week mark. As some psychological issues may persist, such as anxiety and panic attacks, users have reported feeling depressed. 

PAWS - Some former users have reported PAWS lasting for several months and persistent cravings and depression being the most common symptoms.

Sleeping pill detox

Not everyone who wants to stop or cut back on their use of prescribed sleep aids will require medical detox. Talking with the prescribing doctor or professional about the appropriate way to taper off or stop the medication is advised. Being upfront and honest about how much of the medication you are taking is essential so that your prescriber can make informed recommendations for stopping. 

Some people who are chronic, heavy, or long-term users of certain sleep aids (especially controlled medications or heavy sedatives) will need medically supervised detox to safely withdraw from their medication. During a short-term stay in an inpatient medical detox, people will be given medication, treatment, and medical supervision to ensure the detox process is safe.

Sleeping Pill Addiction Treatment

After medical detox, most people who struggle with an addiction to sleeping pills require longer-term treatment to achieve long-term sobriety. Treatment for sleeping pill addiction can take place in either an inpatient facility, which will involve a stay in residential rehab for 30 to 90 days, or in an outpatient facility. People with less severe addictions may benefit from an outpatient treatment program.

Some of the common treatments provided in inpatient and outpatient addiction programs include:[1, 4, 5]

  • Medication-Assisted Treatment (MAT) whereby patients slowly taper off of sedatives under strict supervision
  • Cognitive-behavioral therapy (CBT) or Dialectical Behavioral Therapy (DBT) can teach people coping skills to reduce cravings and promote sobriety in either group or individual therapy sessions
  • Family therapy to provide wrap-around support for the person in recovery while also improving communication and addressing key issues in the home
  • Motivational interviewing approaches that focus on helping people identify and build internal motivation for change, and follow through with specific goal-directed actions
  • Support groups such as Narcotics Anonymous can offer those with a history of substance abuse disorders a safe and judgment-free space to share experiences and form a network of friends

If you or someone you know is suffering from a substance use disorder including sleeping pill abuse, then call a treatment center today and get the help you need to recover from addiction.