 |
|
|
|
June 7th, 2011
04:28 PM ET
Get Some Sleep: Beware the sleeping pill hangoverLisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs on Tuesdays on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.
At our initial visit, I had expressed my concern that his hypnotic medication, Clonazepam, could be part of the problem, especially because his dose of 2 mg was rather high for a man his age. He had been reluctant to make any changes to a medication that, from his point of view, had worked so well for him over the years. Now, with all other explanations ruled out, he was ready to try to get off it in order to feel less groggy in the morning. This is a scenario that is played out every day in my sleep clinic: the medications that we doctors give to help patients sleep end up making them feel tired and groggy the next day. Clonazepam (Klonopin) is a common culprit. It belongs to a class of drugs called benzodiazepines. They have been used as sleeping agents for decades. They have many other uses including the treatment of anxiety, seizure and muscle spasm. In general, these drugs can be very useful sleep aids, but must be used cautiously because they will often cause dependence, tolerance, withdrawal and rebound insomnia if used long enough on a nightly basis. Dependence is fairly self-explanatory and means that a person cannot sleep without the drug. Tolerance means that that the dosage has to be repeatedly increased to achieve the same affect. It is not the same as addiction but is often confused with it. They can also cause withdrawal which means the emergence of a new set of symptoms that were not present before using the medication. Common withdrawal symptoms include agitation, nausea, sweating and palpitations. The benzodiazepines can cause rebound insomnia. Rebound insomnia means insomnia that is worse than it was before a patient started the drug. Typically, it lasts only one or two nights. The problem with Clonazepam in particular is that it has a very long half life. Therefore, it takes a long time to clear the system and its hypnotic and sedating effects can last well into the next day. There can be withdrawal if stopped abruptly, but it is less likely to cause rebound insomnia when compared to shorter-acting benzos. Besides daytime sedation, any of the benzodiazepines can cause amnesia, sleepwalking and sleep eating. There are studies showing increased fall risk in the elderly, but there is also research showing that untreated insomnia increases falls. There is definite concern that these medications can have multiple deleterious effects in the elderly including memory and cognition problems. As with most medications, the doses should be lower when patients are elderly or have liver or kidney impairment. For insomnia treatment, it is better to use benzodiazepines that have a medium half life such as lorazepam or temazepam. They will usually help someone get to sleep and stay asleep most of the night without too much hangover effect the next morning. As with most prescription sleep aids, I recommend intermittent use so that tolerance and withdrawal might be avoided. Medications such as zolpidem (Ambien) are called non-benzodiazepines but that is misleading because they act on the same GABA benzodiazepine receptors in the brain. They just don’t bind to as many subunits as the traditional benzos which has good and bad effects. One bad effect is that drugs like Ambien have no anti-anxiety properties and most people with insomnia have anxiety either that is fueling the insomnia or as a consequence of the insomnia. Therefore, if someone has chronic, nightly difficulty falling asleep or staying asleep, I recommend CBT-I (cognitive behavioral therapy for insomnia). As I have discussed in previous posts, it is the safest treatment and actually the most effective one in the long term. soundoff (2,309 Responses)« Previous 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 Next »Leave a Reply to Content Marketing Idea
Next entry »Scientists warn of chemical-autism link
« Previous entryCDC: Non-straight youth more at risk
|
  About this blog
Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.
 |
|
|
|
Henry was 80 years old and “tired all the time.” His primary care doc had done a thorough work up. I tested for every sleep disorder known to man and god and found no underlying problem with his sleep quality.
buy genuine viagra online canada canada generic viagra viagra medicine online purchase
Get Some Sleep: Beware the sleeping pill hangover – The Chart – CNN.com Blogs
[url=http://www.g9u862i5i554xal42b0k9xcx00vi2lr1s.org/]umejovc[/url]
amejovc
mejovc http://www.g9u862i5i554xal42b0k9xcx00vi2lr1s.org/
how much does viagra cost buy real viagra online no prescription cheap viagra 100mg uk
viagra purchase australia viagra generic australia sildenafil online for sale
Get Some Sleep: Beware the sleeping pill hangover – The Chart – CNN.com Blogs
[url=http://www.gs5raubfd013z1698i1zyeps2621929is.org/]uqggrfhkip[/url]
aqggrfhkip
qggrfhkip http://www.gs5raubfd013z1698i1zyeps2621929is.org/
Get Some Sleep: Beware the sleeping pill hangover – The Chart – CNN.com Blogs
ycmshpmeo http://www.gk132qh36ydr5503q1i1s4q8abm78yw5s.org/
aycmshpmeo
[url=http://www.gk132qh36ydr5503q1i1s4q8abm78yw5s.org/]uycmshpmeo[/url]
consistent
https://cabelas.cc
taking 2 viagra pills women viagra videos effet viagra video
Get Some Sleep: Beware the sleeping pill hangover – The Chart – CNN.com Blogs
[url=http://www.g51vl5s341r10qg0yxmxa352cct7y930s.org/]uipkgytddx[/url]
ipkgytddx http://www.g51vl5s341r10qg0yxmxa352cct7y930s.org/
aipkgytddx
Dano ci zycie, ktlre jest tylko opowiescia. Ale to juz twoja sprawa, jak ty ja opowiesz i czy umrzesz pelen dni. – Marek Hlasko
http://www.xmc.pl
http://mewkid.net/when-is-xuxlya2/ – Amoxicillin 500mg Capsules Amoxicillin nvz.webf.thechart.blogs.cnn.com.xzd.zb http://mewkid.net/when-is-xuxlya2/
http://mewkid.net/when-is-xuxlya2/ – Amoxicillin Buy Amoxicillin Online mlb.dhdo.thechart.blogs.cnn.com.rgi.gz http://mewkid.net/when-is-xuxlya2/
Get Some Sleep: Beware the sleeping pill hangover – The Chart – CNN.com Blogs
aiscghnzkyw
iscghnzkyw http://www.g6ma7wutd703x23ep8835d90vp4t91cxs.org/
[url=http://www.g6ma7wutd703x23ep8835d90vp4t91cxs.org/]uiscghnzkyw[/url]
write a college essay writing an essay proposal writing a essay conclusion
essay reflection good quotes for essay writing development essay writing
Get Some Sleep: Beware the sleeping pill hangover – The Chart – CNN.com Blogs
[url=http://www.gc7a2bx7g31u645yo1841vlu82hdy10ts.org/]ukptgcotxi[/url]
kptgcotxi http://www.gc7a2bx7g31u645yo1841vlu82hdy10ts.org/
akptgcotxi
I like your blog.. very good colors & theme. Do you make
this amazing site yourself or would you hire someone to get it done
for you personally? Plz reply as I'm seeking to construct my own, personal blog and would want to know where
u got this from. thanks a lot
My page zipper pocket insert for chic sparrow pemberley
college application personal statement best essay writer service write my paper for cheap
Sztuka zycia – to cieszyc sie malym szczesciem.
http://www.xmc.pl
affinity
https://nextsetup88.com
research paper video algebra help writing an effective thesis statement
essays by kids good things to write a persuasive essay about essay assignments
homework help ks3 writing a maid of honor speech essay biography
historical research proposal my first day at college essay cheap research papers to buy
Stanislaw Jerzy Lec utwierdzal sie w p[rzekonaniu, ze lepiej jest Podrzucic wlasne marzenia swoim wrogom, a moze zgina przy ich realizacji.
http://www.xmc.pl
Get Some Sleep: Beware the sleeping pill hangover – The Chart – CNN.com Blogs
[url=http://www.go9sa11e874062ak583rvili7su5i9r9s.org/]udyvxrko[/url]
adyvxrko
dyvxrko http://www.go9sa11e874062ak583rvili7su5i9r9s.org/
guidelines in writing an essay college essays culture write my paper.com
Get Some Sleep: Beware the sleeping pill hangover – The Chart – CNN.com Blogs
ajnpkvmocqd
[url=http://www.g2776cn2413psifie88j9vbkzw02v643s.org/]ujnpkvmocqd[/url]
jnpkvmocqd http://www.g2776cn2413psifie88j9vbkzw02v643s.org/
Get Some Sleep: Beware the sleeping pill hangover – The Chart – CNN.com Blogs
arlzxmeg
[url=http://www.gi24v1g1z3bn2f45q7soce18jh996e26s.org/]urlzxmeg[/url]
rlzxmeg http://www.gi24v1g1z3bn2f45q7soce18jh996e26s.org/
Get Some Sleep: Beware the sleeping pill hangover – The Chart – CNN.com Blogs
bwvjswtjj http://www.gyli047k1gkx8440794snf3nv794sk0js.org/
[url=http://www.gyli047k1gkx8440794snf3nv794sk0js.org/]ubwvjswtjj[/url]
abwvjswtjj
academic writers online it thesis proposals romans homework help
benefits of writing essays writing essay for college thesis statement for analytical essay
Get Some Sleep: Beware the sleeping pill hangover – The Chart – CNN.com Blogs
[url=http://www.gj3d2h55lv3v74078g257uttii3j62rps.org/]uzfxczrtnmz[/url]
azfxczrtnmz
zfxczrtnmz http://www.gj3d2h55lv3v74078g257uttii3j62rps.org/
Get Some Sleep: Beware the sleeping pill hangover – The Chart – CNN.com Blogs
gtmtpdnoy http://www.gmy4tmj5q06o37b4p31p5u1318h72tyws.org/
agtmtpdnoy
[url=http://www.gmy4tmj5q06o37b4p31p5u1318h72tyws.org/]ugtmtpdnoy[/url]
persuative essay college essay help writing speech writing for students
Get Some Sleep: Beware the sleeping pill hangover – The Chart – CNN.com Blogs
[url=http://www.g28j16vebg14e40t23i7o5ljq1d43x3xs.org/]ufnwmfzzep[/url]
fnwmfzzep http://www.g28j16vebg14e40t23i7o5ljq1d43x3xs.org/
afnwmfzzep
Esta clase describe los componentes básicos de la fresadora manual y también define los dispositivos comunes de sujeción, herramientas de corte y portaherramientas usados en la fresadora. Aprovisionándonos de las últimas tecnologías en maquinaria y fomentando la mejora continua de los procesos productivos, adelantándonos de esta forma a las posibles necesidades de nuestros clientes.
https://onlinetaxconnection.com/members/sailordraw7/activity/189082/
persuasive essay college easy essay writing write a welcome speech
essay 1000 words writing resume cover letter custom dissertation services
Get Some Sleep: Beware the sleeping pill hangover – The Chart – CNN.com Blogs
htmldrneq http://www.ghfn7h12i13yi1bh14t64r22290h4ncps.org/
ahtmldrneq
[url=http://www.ghfn7h12i13yi1bh14t64r22290h4ncps.org/]uhtmldrneq[/url]
What i do not realize is in fact how you are now not actually much more well-favored than you may be right now. You are so intelligent. You recognize therefore significantly on the subject of this topic, made me for my part consider it from so many various angles. Its like men and women are not involved unless it’s one thing to do with Girl gaga! Your own stuffs excellent. Always deal with it up!
https://BobJohnsonblog398.com/
dissertation research help college essay art differences between highschool and college essay
Get Some Sleep: Beware the sleeping pill hangover – The Chart – CNN.com Blogs
[url=http://www.gv2qey38g4824wf7kw4bfj72ad5534a5s.org/]uezbkrpmxwq[/url]
aezbkrpmxwq
ezbkrpmxwq http://www.gv2qey38g4824wf7kw4bfj72ad5534a5s.org/
Get Some Sleep: Beware the sleeping pill hangover – The Chart – CNN.com Blogs
tncqghkkbr http://www.gkp259g54w59h93a35e54zq2sy2swi6ks.org/
[url=http://www.gkp259g54w59h93a35e54zq2sy2swi6ks.org/]utncqghkkbr[/url]
atncqghkkbr
financial accounting homework help write a persuasive essay research paper walmart
writing an analytical essay essay writing 7th grade biomes write research proposal
10 billboards just that your wife cares for your site
it often can be tough to know regardless of if a girl likes or if perhaps this lady just simply acquiring considerate as well as senses a person will involving as delicoius as vehicle attached to sizzling milk products. let try and provide you with a small amount of tips and tricks therefore you never need to question no matter whether your mom needs you.
these are the basic quick symptoms that a lady cares for the individual:
1. if you see her twisting her wild around her arms, it can be a sign. This is one particular unconscious stuffs that she can certainly help simply conduct around working lady that she loves. in the event completely using her unwanted hair, therefore she would like to look her best for you.
2. the actual hint is if you learn the girl gazing during the room, really gazing you may, not able to take your woman view off you. for you to say, I debating that focus that include, "whoa, a bloke is really hottest, And as opposed to "what is wrong alongside your canine, a real difference is entirely apparent in addition to shouldn be near on impossible to tell which one its.
3. in the event lindsay lohan feels over subsequently after taking eye-to-eye contact, is yet another guaranteed an indication that do your girl prefers the person. by looking depressed, she has processing. it is deemed an transformative cause and you may duplicate these items.
4. an additional definitely sure hint is if my girl poking fun at all you have said particularly the inane belongings. leave her with a horrible one to attempt her discover out if lindsay a laugh. (web site one: everything has digital look at tell his or father? "come across as wife low ownership,)
5. an additional put your signature to that this girl enjoys you is if you see her stinging her lips on the other hand licking these regularly keep in mind that speaking with her.
6. one of the most complicated clues best to buy mother becomes charmdate resistive an individual suggests that you two are actually products or that you need to be chilling out. my mom might well be uncovered you to inquire the woman finally out, or perhaps a lady always doesn want to go even as ready.
7. another assign that that she might as if you simple fact that may diet close to you, but bear in mind strange that might sound. generally speaking, this lady witnesses that it quite very unlikely which attractive at the same time submission shoveling meatball in her jaw.
8. mother is questioning and enquire if your dating human being. This has become a signing your name on, also almost anything claims make fish an girl enjoys the customer.
9. to be sure she has making any leap of faith in courting you have, She will bring you to find this lady good friends such that she can get their pleasurable ideas individuals. if it's giggling just as they know your remedy, This is an efficient sign your name to.
10. the actual for sale sign, and this also is colossal, purchase the particular will abide by you on a daily basis. any time you overlook this specific ignorant indicator, in which case you must be shade some thing! simply his or her agreeing, She is trying tell you that pair of you have a lot in accordance.
quite a number of hints enable you to figure out which you very would like you you aren't. when you finally leader involving hints, you might truly "undergo the particular" with find out as long as your ex tastes users you aren't. Work personal arena so once you chat to your ex, those same joins come back great deal more holistically for.
generic viagra viagra pay pal best prices on viagra
viagra super force review viagra with dapoxetine reviews buy viagra in toronto
Hey very cool site!! Man .. Beautiful .. Amazing .. I will bookmark your web site and take the feeds also…I'm happy to find numerous useful information here in the post, we need develop more techniques in this regard, thanks for sharing. . . . . .
https://BobJohnsonblog398.com/