Insomnia and the Risks of Lendormin Use - Psychiatry

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Insomnia and Sleeping Pills


I'm sorry, doctor, I would like to ask you some questions.
I previously visited a doctor and was diagnosed with autonomic nervous system dysfunction.
During this time, I feel that I don't have any particular stress, and I exercise regularly, but for some reason, I've been unable to sleep at night recently.
Due to my insomnia symptoms, I consulted a doctor who prescribed Lendormin 0.25 mg, which helps me sleep normally.
I would like to ask the doctor: 1.
Can insomnia occur even without specific stress? 2.
Is there a risk of developing a dependency on Lendormin 0.25 mg with long-term use? I'm worried about becoming reliant on it.
3.
If taken long-term, will there be a risk of tolerance, making it less effective for sleep? 4.
Since the doctor mentioned that the dosage of Lendormin 0.25 mg is very low, will it cause harm to my body? 5.
How should I gradually stop taking sleeping pills? I apologize for the many questions, and thank you for your consultation, doctor.

Xiao K, 30~39 year old female. Ask Date: 2020/07/07

Dr. Qiu Junda reply Psychiatry


Hello.
There are many causes of insomnia, and stress is one of the common reasons.
However, sleep issues can also occur without any specific stress.
Most sedative-hypnotic medications have the potential for addiction, and Lendormin 0.25 mg is no exception.
Nevertheless, if treatment is necessary, it should be taken.
Regarding concerns about addiction, side effects, and tapering or discontinuing the medication, these issues can be discussed during follow-up appointments with your physician, which should be helpful.
Thank you.

Reply Date: 2020/07/07

More Info


Insomnia is a complex condition that can arise from various factors, not solely from stress or anxiety. It's important to understand that even in the absence of obvious stressors, other underlying issues such as hormonal changes, lifestyle factors, or even certain medical conditions can contribute to sleep disturbances. In your case, having autonomic nervous system dysregulation may also play a role in your sleep difficulties.

1. Causes of Insomnia Without Apparent Stress: Insomnia can be triggered by a variety of factors, including hormonal fluctuations, changes in routine, dietary habits, and even environmental factors like noise or light. Additionally, psychological factors such as anxiety or depression may not always be overtly recognized but can still impact sleep quality. It's essential to consider a holistic view of your health and lifestyle when addressing insomnia.

2. Risk of Dependence on Lendormin: Lendormin (bromazepam) is a benzodiazepine that can be effective for short-term management of insomnia. However, long-term use can lead to physical dependence, where the body becomes accustomed to the drug, and withdrawal symptoms may occur if you stop taking it suddenly. While the dosage of 0.25 mg is relatively low, the risk of developing a dependence still exists, especially if used regularly over an extended period. It's crucial to discuss your concerns with your healthcare provider, who can help you weigh the benefits and risks of continued use.

3. Tolerance Development: With prolonged use of benzodiazepines like Lendormin, there is a possibility of developing tolerance, meaning that over time, the same dose may become less effective, leading you to require higher doses to achieve the same sedative effects. This can create a cycle of increasing dosage and dependence, which is why it’s generally recommended to use such medications for short periods.

4. Safety of Low Doses: While a low dose of Lendormin (0.25 mg) is less likely to cause significant harm compared to higher doses, it is not without risks. Side effects can include drowsiness, dizziness, and impaired coordination, which can affect daily activities. Long-term use, even at low doses, can still lead to cognitive impairment and other health issues. Regular monitoring by your healthcare provider is essential to ensure that the benefits outweigh any potential risks.

5. Tapering Off Sleep Medications: If you are considering reducing or stopping your use of Lendormin, it is crucial to do so gradually and under the guidance of your healthcare provider. A common approach is to slowly decrease the dosage over time, which can help minimize withdrawal symptoms and reduce the risk of rebound insomnia. Additionally, incorporating non-pharmacological strategies such as cognitive-behavioral therapy for insomnia (CBT-I), relaxation techniques, and good sleep hygiene practices can be beneficial in managing insomnia without relying on medication.

In summary, while Lendormin can provide temporary relief from insomnia, it is essential to be aware of the potential risks associated with long-term use, including dependence and tolerance. Exploring alternative treatments and working closely with your healthcare provider can help you find a sustainable approach to managing your sleep issues. Remember, addressing the root causes of insomnia, rather than just the symptoms, is key to achieving long-term sleep health.

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